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Co-sleeping and childhood enuresis in China

By J. Ma, S. Li, F. Jiang, X. Jin, X. Shen, and F. Li.

Journal of Developmental and Behavioral Pediatrics, January 2014, Volume 35, Issue 1, Pages 44-49

Editor’s comments: 

Co-sleeping is a practice in which babies and young children sleep close to one or both parents, as opposed to in a separate room. It is standard practice in many parts of the world, and is practiced by a significant minority in countries where cribs are also used. Bed-sharing, a practice in which babies and young children sleep in the same bed with one or both parents, is a subset of co-sleeping. In this relative small study in China, the authors have found a higher incidence of children with bedwetting who are co-sleeping, without a theory about causal relationship.


Co-sleeping is associated with disturbance of the natural sleep pattern, including sleep fragmentation and daytime sleepiness. Nocturnal enuresis (NE) or bed-wetting, although benign, is a significant cause of distress to affected children and their caregiver(s). This study investigated the relationship between co-sleeping and NE in primary school children from China.

Data from a previous sleep study of primary school children from 8 cities across China were analyzed. Multivariable regression analysis was performed to assess the relationship between co-sleeping and NE while controlling for a number of confounding factors. The prevalence of NE in co-sleeping and non-co-sleeping children in different age groups was evaluated.

The prevalence of co-sleeping and NE in children aged 5 to 12 years was 22.8% and 4.6%, respectively. Co-sleeping was associated with a higher prevalence of NE in primary school age children (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.27-1.77; p < .001) after adjusting for confounding factors. The differences in the prevalence of NE between co-sleepers and non-co-sleepers were significant in the 9-year age group (OR, 1.49; 95% CI, 1.06-2.11; p = .025) and 11- to 12-year age group (OR, 3.16; 95% CI, 2.19-4.57; p < .001).

Co-sleeping may increase the risk of NE in primary school children, particularly in those aged 11 to 12 years.


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