The association between obstructive sleep apnea and nocturnal enuresis in children: current advances and research trends.

Abstract

Background: Obstructive sleep apnea (OSA) and nocturnal enuresis (NE) represent two clinically prevalent pediatric disorders that frequently present as comorbidities. OSA, characterized by recurrent upper airway collapse during sleep, and NE, defined as involuntary voiding during sleep, collectively contribute to psychosocial distress in children. Emerging evidence suggests that OSA in children can cause NE through multiple mechanisms, though the pathophysiological interplay involving altered arousal thresholds and hormonal dysregulation remains incompletely elucidated. Herein, we summarized the relationship between OSA and NE and identified mainstream research directions and recent hotspots in the relationship between OSA and NA in children and informed further research.

Materials and methods: This review searched for original publications on the relationship between OSA and NE in children in the Web of Science Core Collection from 1981 to 2025. Research trends, countries, institutions, journals, authors, highly cited publications, and keywords were analyzed using bibliometrics. Co-citation networks were mapped using VOSviewer, and research hotspots and trends were analyzed using CiteSpace.

Results: A total of 147 publications were included. The number of publications and related research interest in the relationship between OSA and NE in children has increased globally year after year. Sleep monitoring and multidisciplinary collaboration may be the next hotspot in this field. The occurrence of NE shows a positive correlation with the prevalence of OSA, and children with NE frequently exhibit comorbid sleep-disordered breathing. Adenotonsillectomy has been demonstrated to have therapeutic efficacy as a primary intervention for children with concurrent OSA and NE.

Conclusions: The co-morbid association between NE and OSA may have significant adverse effects on the psychophysical health of children. Adenotonsillectomy shows potential for treating children with co-morbid OSA and NE. However, systematic multidisciplinary clinical evaluation remains critical in this patient population. Furthermore, this review will help researchers to identify the mainstream research directions and latest hotspots in the field of the relationship between OSA and NE.