Nocturnal Enuresis, ADHD, and Sudden Infant Death Syndrome (SIDS)

Subject:	Nocturnal Enuresis, ADHD, and Sudden Infant Death Syndrome (SIDS)
Date:	Sun, 24 Jan 2010 10:31:23 -0600

Nocturnal Enuresis, ADHD, and Sudden Infant Death Syndrome (SIDS)

I wrote the following to the authors of Journal of the American Academy of
Child & Adolescent Psychiatry 2009; 48: 35-41. The abstract follows below
that so you can see the connection of my response to the report.

"It is my hypothesis of sleep of 1985 (copyrighted) that melatonin and DHEA
cycle to produce sleep (high melatonin - low DHEA) and consciousness (high
DHEA - low melatonin). Therefore, sleep is a time of low DHEA. If DHEA
becomes too low, then death may occur:
http://www.anthropogeny.com/Sleep%20and%20SIDS.htm and it is called "SIDS."

However, if DHEA reaches very low levels during sleep but does not produce
death, then other adverse phenomena may occur. In fact, I state in my 1985
book, page 114, under the heading, "Nocturnal Enuresis," that "It is known
that bed-wetting (nocturnal enuresis) occurs during arousal from slow-wave
sleep (142). I suggest these people merely are a little above the SIDS
case, that is, they do not succumb during slow-wave sleep, but they do not
produce enough DHEA during the arousal stage to reach the level where
signals from the urogenital system can awaken them."

It is also my hypothesis that testosterone reduces available DHEA. This
would explain why more boys and black youth than girls exhibit nocturnal
enuresis, as blacks produce more testosterone than whites. Also, DHEA is
low during early childhood, which explains why this is a problem of younger
childhood. Please see the chart of DHEA I have enclosed.

As regards your, et al., findings, ADHD is a disorder of low DHEA. In fact
the effect of methylphenidate has been proven to increase DHEA in ADHD
(Child Psychiatry Hum Dev. 2008 Jun;39(2):201-9). I suggest the foregoing
explains your findings. Please share this with your colleagues."

Here is the abstract from "PubMed:"

J Am Acad Child Adolesc Psychiatry. 2009 Jan;48(1):35-41.
Prevalence of enuresis and its association with
attention-deficit/hyperactivity disorder among U.S. children: results from a
nationally representative study.

Shreeram S, He JP, Kalaydjian A, Brothers S, Merikangas KR.

Intramural Research Program, National Institute of Mental Health, National
Institutes of Health, Bethesda, MD 20892-3720, USA. s.shreeram@dc.gov

OBJECTIVE: There are no published nationally representative prevalence
estimates of enuresis among children in the United States using standardized
diagnostic criteria. This study sets out to describe the prevalence,
demographic correlates, comorbidities, and service patterns for enuresis in
a representative sample of U.S. children. METHOD: The diagnosis of enuresis
was derived from parent-reported data for "enuresis, nocturnal" collected
using the computerized version of the Diagnostic Interview Schedule for
Children (C-DISC 4.0) from a nationally representative sample of 8- to
11-year-old children (n = 1,136) who participated in the 2001-2004 National
Health and Nutrition Examination Surveys. RESULTS: The overall 12-month
prevalence of enuresis was 4.45%. The prevalence in boys (6.21%) was
significantly greater than that in girls (2.51%). Enuresis was more common
at younger ages and among black youth. Attention-deficit/hyperactivity
disorder (ADHD) was strongly associated with enuresis (odds ratio 2.88; 95%
confidence interval 1.26-6.57). Only 36% of the enuretic children had
received health services for enuresis. CONCLUSIONS: Enuresis is a common
condition among children in the United States. Few families seek treatment
for enuresis despite the potential for adverse effects on emotional health.
Child health care professionals should routinely screen for enuresis and its
effects on the emotional health of the child and the family. Assessment of
ADHD should routinely include evaluation for enuresis and vice versa.
Research on the explanations for the association between enuresis and ADHD
is indicated.