Objective sleep parameters in children with nocturnal enuresis: a scoping review of polysomnographic evidence.

Nocturnal enuresis (NE) is a common condition in childhood, yet the role of sleep in its pathophysiology remains unclear. While failure to awaken during sleep is a key feature, objective evidence from polysomnography (PSG) has yielded inconsistent results. This scoping review aimed to systematically map studies reporting objective sleep parameters in children and adolescents with NE. The review followed the PRISMA-ScR guideline and was preregistered on the Open Science Framework. PubMed EMBASE, and Web of Science, were systematically searched for peer-reviewed English-language articles reporting objective sleep measures in participants under 18 years, evaluated for NE. Eighteen studies using PSG were included, most employing hospital-based recordings. Findings on sleep architecture in children with NE were heterogeneous. Several studies reported alterations in sleep stage distribution, including reduced slow-wave sleep, whereas others found no differences compared with controls. Periodic limb movements were elevated in some cohorts, particularly in treatment-refractory cases, but were not consistently reported. Some studies suggested a higher prevalence of obstructive sleep apnoea. Treatment studies indicated that successful therapy may be accompanied by changes in sleep stage distribution, cortical arousals, and limb movements. Conclusion: Evidence suggests that alterations in sleep regulation and fragmentation may be present in at least a subset of patients with NE. Although the evidence remains heterogeneous, emerging patterns indicate that sleep physiology could play a role in the pathophysiology of enuresis. The data suggest that disturbed arousal regulation and PLMS may be related to NE, underscoring the need for standardised, multimodal sleep assessments. What is Known-What is New: • Children with nocturnal enuresis fail to awaken to bladder signals during sleep. Prior polysomnography studies have produced inconsistent findings on sleep stages, cortical arousals, and periodic limb movements. • This scoping review synthesises 18 polysomnographic studies and highlights heterogeneous yet suggestive evidence of altered sleep regulation, fragmentation, and limb movements in children with nocturnal enuresis. The findings underscore the need for standardised PSG studies and indicate that sleep physiology may represent a relevant target for future phenotyping and research.