It is the involuntary loss of urine during sleep. Voiding episodes in patients with enuresis typically occur between the first 30 minutes and three hours of the night. It is considered abnormal, when these losses occur at an inappropriate age, that means, when bladder control should be controlled. This margin is located in the 4-5 years, until this age it should be considered as normal. It is a disorder, that primarily affects children and disappears in adolescence, but also nocturnal enuresis occurs in adults. It has a very high prevalence in children under 5 and their frequency decreases progressively with age. This condition splits into two branches, primary nocturnal enuresis is diagnosed, when there was never total control of the urination, versus secondary nocturnal enuresis is diagnosed, when the subjects were completely continent for an extended period of time between rate 6 and 12 months. Bedwetting is caused by multiple etiologies. The scientific studies establishing that the cause of secondary nocturnal enuresis is always psychologica,l while the primary urinary incontinence is attributed to anatomical factors such as morphology of the bladder, altered size below average or weak secondary muscle or dysfunction of the urethra, urinary tract infections, hormonal or neurological disorders.
The behavioral consequences, especially in children, may cause social and relations problems motivated by feelings of shame and anger at the jokes, which affects the psychosocial development of children in a long term, if there is no right attitude by parents and educators, reaching more serious consequences than the original ailment itself. In his childhood enuresis disappears spontaneously. The treatment indicates pharmacological medication in cases with underlying symptoms in children from age 7. With regard to nonpharmacologic methods it is recommended to change the lifestyle and to control the fluid intake before bedtime (diet therapy), motivational therapy or behavior modification.
Catatrenia (night groaning)
The catatrenia or "nocturnal Groaning" (NG) in the Anglo-Saxon terminology, is a rare entity characterized by irregular groans, monotonous and involuntary most prevalent during REM sleep. Subjects during sleep emit a prolonged expiratory noise resembling a groan, which occurs predominantly in the second half of the night and that is repeated cyclically. The polysomnographic characteristics of the noisy breathing simulate central apnea, although there is no respiratory effort or desaturation. Pathophysiology is still unknown, although clinical studies indicate, that they can be successfully treated with CPAP and oral appliances therapy could be considered, although there is no specific bibliography.
This sensation is not painful, sudden and instantaneous, occurs during periods of dormancy. It is a benign condition, that probably represents a prelude of sleep.