It was commonly believed that children with sleep apnea had more bedwetting than the average child. However, in the newest research from Hong Kong, published in J of Peds online, 14 March 2011, the results suggest something different.
The parents of a total of 6147 children aged 6 to 11 years completed a questionnaire about sleep-related symptoms, family and medical history. Those children with a high risk for obstructive sleep apnea (about 400 children), along with a chosen low-risk group (about 200) underwent overnight sleep studies. They found that about 9 kids out of 100 in each group wet the bed. Children without obstructive sleep apnea wet as much as children with sleep apnea. They also observed that about twice as many boys as girls wet their beds.
Sleep apnea is suspected when children have loud snoring, large tonsils, mouth breathing, and excessive daytime sleepiness. Allergies and being overweight are contributing factors. Children suspected of obstructive sleep apnea should be evaluated by a Pediatric ENT specialist and may be tested using a pediatric sleep study. This study confirms the presence of sleep apnea, where breathing stops temporarily during sleep. About 2% of children are affected. Although snoring is a common symptom in children with obstructive sleep apnea, it is important to remember that between 10-20 percent of normal children snore (primary snoring) on a regular or intermittent basis.
So it seems that a combination of snoring and bedwetting is not enough to recommend removing tonsils without further testing to confirm sleep apnea. Treating allergies with nasal steroids and losing weight are conservative treatments for some children with continuous snoring and obstructive sleep apnea. Treating sleep apnea may or may not make any difference in the frequency of bedwetting. Bedwetting alarms continue to be the treatment of choice, even in this group of children.