Sleep duration, sleep problems and developmental trajectories of urinary incontinence: a prospective cohort study

Abstract

Abstract Objective To examine if sleep duration and sleep problems are associated with urinary incontinence (UI) in children. Methods We used multinomial logistic regression to examine the association of child sleep duration/problems at 3½ years with developmental trajectories of bedwetting and daytime wetting from 4–9 years in 8,751 (4,507 boys and 4,244 girls) from the Avon Longitudinal Study of Parents and Children. We adjusted for sex, socioeconomic indicators, mothers’ emotional/practical/financial support, developmental delay, stressful life events, temperament, and emotional/behaviour problems. Results Preschool children who slept more than 8½ hours per night had a decreased probability of UI at school-age. There was a 33% reduction in odds of daytime wetting per additional hour of sleep (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.52–0.86). Sleep problems were associated with increased odds of daytime wetting (e.g., getting up after being put to bed: OR = 2.20, 95% CI = 1.43–3.39), delayed bladder control (e.g., breathing problems whilst sleeping: OR = 1.68, 95% CI = 1.12–2.52), and persistent (day and night) wetting (e.g., night-time waking: OR = 1.53, 95% CI = 1.16-2.00). Waking during the night and waking up early in the morning were associated with reduced odds of bedwetting at school-age (OR = 0.76, 95% CI = 0.61–0.96 and OR = 0.80, 95% CI = 0.64–0.99 respectively). Conclusions Preschool children who sleep for longer have a lower likelihood of UI at school-age, whilst those with sleep problems are more likely to experience daytime wetting and combined (day and night) wetting, but not bedwetting alone. Short sleep duration and sleep problems in early childhood could be indicators of future problems attaining and maintaining bladder control.