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Melatonin treatment in children with therapy-resistant monosymptomatic nocturnal enuresis

Journal of Pediatric Urology, Volume 8, Issue 4, 2012, pages 416 - 420

Abstract

Objective

To evaluate the effects of exogenous melatonin on the frequency of wet nights, on the sleep-wake cycle, and on the melatonin profile in children with therapy-resistant MNE.

Patients and methods

24 patients were included. Patients had to maintain a diary including time of sleep and arousal, and whether they had a dry or a wet bed in the morning. We measured baseline melatonin profiles in saliva. Hereafter, patients were randomized to synthetic melatonin or placebo. After 3 and 6 months we evaluated the frequency of enuresis and the melatonin profiles.

Results

11 patients were randomized to melatonin, 13 to placebo. We evaluated melatonin profiles of 7 patients in the melatonin group and of 8 in the placebo group. We observed a change in profile in the melatonin group, but we did not observe a difference in the sleep-wake cycle or the frequency of wet nights in either group.

Conclusion

This is the first time exogenous melatonin has been evaluated in the treatment of MNE. Although we observed a change in melatonin profile after the use of exogenous melatonin, we did not observe a change in enuresis frequency or in the sleep-wake cycle of this select group of patients.

Keywords: Enuresis, Melatonin, Circadian rhythm, Children, Therapy-resistant.

Abbreviations: MNE - Monosymptomatic nocturnal enuresis, dDAVP - desamino-D-arginine Vasopressin, AVP - Arginin vasopressin.

Footnotes

a University Medical Center Utrecht, Heidelberglaan 100, room C04-236, NL 3584 CX Utrecht, The Netherlands

b University Medical Center Groningen, The Netherlands

c Vlietland Hospital Schiedam, The Netherlands

d Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital Essen, Germany

e University Children’s Hospital, University Medical Center Utrecht, The Netherlands

f University Children’s Hospital, Academic Medical Center Amsterdam, The Netherlands

Corresponding author. Tel.: +31887558079; fax: +31302540532.