{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T19:07:04Z","timestamp":1785179224468,"version":"3.55.0"},"reference-count":59,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,18]],"date-time":"2023-06-18T00:00:00Z","timestamp":1687046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The correlation between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) was reported. We aim to determine whether there is an association between NE and SDB in children and to assess the prevalence of SDB and NE in primary school children aged 6\u201312 years in Saudi Arabia. A cross-sectional observational study was conducted among the caregivers of children aged 6\u201312 years in all Saudi Arabia regions. The data were gathered through a self-administered online questionnaire. It included demographic information, weight and height, and associated comorbidities, in addition to the weekly frequencies of snoring symptoms and of enuresis, as well as of unrefreshing sleep using Likert-type response scales. Counts and percentages, the mean \u00b1 standard deviation, chi-square test, independent samples t-test, and regression analysis were used in the statistical analysis using R v 3.6.3. The questionnaire was completed by 686 respondents. Most respondents did not report any comorbidities in their children (77.1%). Asthma and adenotonsillar hypertrophy were reported in 16.2% and 15.6% of children, respectively. Unrefreshing sleep, mouth breathing at night, snoring, chronic nasal obstruction, and difficulty breathing while asleep were reported once or twice per week in 38%, 34%, 28%, 18%, and 18% of children, respectively. The prevalence of NE was 22.3%, with about 36.6% of children having NE two or more times per week. Significantly, NE was reported in 26.6% of children who slept before 10 PM compared to 19% of children who slept after 10 PM; in 28.6% of children who snored or loudly snored (57.1%) three times or more per week; and in 51.2% and 27.5% of children with difficulty breathing while asleep and who breathed through their mouth at night for one or two nights per week, respectively. A multivariable regression analysis showed that male gender (OR = 1.52, p = 0.010), obesity (OR = 1.24, p = 0.028), early sleeping time (OR = 1.40, p = 0.048), loud snoring for three or more nights per week (OR = 1.54, p = 0.001), difficulty breathing for one or two nights per week (OR = 1.85, p = 0.010), and mouth breathing at night for one or two nights per week (OR = 1.55, p = 0.049) were associated with higher odds of NE. Our study revealed that 22.3% of primary school children reported suffering from NE. SDB is a common problem among children with NE. The exact mechanism that links SDB to the increase in the risk of NE is unknown. Male gender, obesity, early sleeping time, loud snoring, difficulty breathing, and mouth breathing at night are potential independent risk factors of NE in school-age children.<\/jats:p>","DOI":"10.3390\/children10061074","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T01:31:14Z","timestamp":1687138274000},"page":"1074","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Sleep-Disordered Breathing and Its Association with Nocturnal Enuresis at the Primary Schools in Saudi Arabia: A Cross-Sectional Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9344-3825","authenticated-orcid":false,"given":"Ali Abdullah","family":"Alshehri","sequence":"first","affiliation":[{"name":"Department of Surgery, College of Medicine, Najran University, P.O. Box 1988, Najran 11001, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4662-1913","authenticated-orcid":false,"given":"Mohamed Soliman Hassan","family":"Zaki","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo 11651, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6076-8615","authenticated-orcid":false,"given":"Sameh Osama","family":"Nour","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo 11651, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2147-542X","authenticated-orcid":false,"given":"Wala H.","family":"Gadi","sequence":"additional","affiliation":[{"name":"College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9141-5583","authenticated-orcid":false,"given":"Basem A.","family":"Zogel","sequence":"additional","affiliation":[{"name":"College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5320-3600","authenticated-orcid":false,"given":"Samar M.","family":"Alfaifi","sequence":"additional","affiliation":[{"name":"College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4902-0136","authenticated-orcid":false,"given":"Enas M.","family":"Masmali","sequence":"additional","affiliation":[{"name":"College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2999-8030","authenticated-orcid":false,"given":"Amani B.","family":"Aburasain","sequence":"additional","affiliation":[{"name":"College of Medicine, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5741-8913","authenticated-orcid":false,"given":"Mohamed Osama","family":"Nour","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Damietta 34511, Egypt"},{"name":"Faculty of Public Health and Health Informatics, Umm Al-Qura University, P.O. Box 715, Makkah 21955, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2147\/NDT.S43673","article-title":"Primary nocturnal enuresis as a risk factor for sleep disorders: An observational questionnaire-based multicenter study","volume":"9","author":"Gallai","year":"2013","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_2","first-page":"67","article-title":"Prevalence of nocturnal enuresis among children in eastern region in Saudi Arabia","volume":"25","author":"Alhifthy","year":"2021","journal-title":"Med. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1111\/ped.13703","article-title":"Nocturnal enuresis and poor sleep quality","volume":"60","author":"Tsuji","year":"2018","journal-title":"Pediatr. 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