Allergic rhinitis and the associated risk of nocturnal enuresis in children: a population‐based cohort study

Background Despite controversy, an association between allergy and nocturnal enuresis (NE) has been reported for almost a century. Allergic rhinitis (AR)‐associated sleep‐disordered breathing frequently results in microarousals during sleep, decreased sleep efficiency, and change in sleep pattern and behavior. NE is a common sleep disorder in children. Hence, this study aimed to investigate the incidence and risk of NE in children with AR. Methods A population‐based cohort study was conducted among 327,928 children with AR and 327,601 non‐AR controls between 2000 and 2012 in Taiwan. By the end of 2012, the incidence of NE in both cohorts, and the AR‐to‐non‐AR cohort hazard ratios (HRs) were measured. Results The adjusted HR of NE during the study period was 1.7‐fold higher in the AR cohort compared to the non‐AR cohort. The risk was greater for boys, children younger than 6 years old, those with comorbidities of asthma, atopic dermatitis, and attention deficit/hyperactivity disorder (ADHD), and those who had more than 5 AR‐related medical visits per year. The risk of NE in the AR cohort decreased with follow‐up time and was the highest within the first year after AR diagnosis. Conclusion Children with AR had a higher incidence and subsequent risk of NE. The risk of NE was greater for boys, younger children, and those with more frequent health utilization for AR symptoms. 背景 虽然存有争议, 但过敏与遗尿 (NE) 之间存在相关性这一观点迄今已近一个世纪之久。变应性鼻炎 (AR) 相关性睡眠呼吸疾病往往导致睡眠微觉醒、睡眠效率下降、睡眠模式及行为改变。NE是儿童常见睡眠疾病。据此, 本研究旨在探讨AR患儿NE发生率及其风险。 方法 该项基于人群的队列研究, 共纳入2000年至2012年间台湾AR患儿327,928例、对照组327,601例。直至2012年底, 对两组队列的NE发生率、AR相对非AR (non‐AR) 队列的风险比 (HRs) 进行统计分析。 结果 研究期间, AR队列NE的HR为non‐AR队列的1.7倍。危险因素包括:男性患儿、年龄小于6岁、合并哮喘、特应性皮炎及注意缺陷多动障碍 (ADHD) 、AR‐相关就医次数年均超过5次。AR队列NE风险在确定AR诊断后第一年间最高, 并随着随访时间推移而下降。 结论 AR患儿NE发生率及后续风险更高。NE风险更集中于男性、年幼儿, 以及因AR症状更频繁就医者。