What is Bedwetting?
Bedwetting (nocturnal enuresis) is when a child loses bladder control during sleep and generally urinates in their bed.
It can have different causes, typically it’s due to the fact that the child’s brain can’t yet detect or process nerve signals from the bladder. Other children may not have developed muscle control of the bladder, or have enough capacity to store the urine produced overnight. (1)
Bedwetting is a very common issue among young children. It’s estimated around 16 percent of five year olds wet the bed. (2)
Bedwetting is not an unusual problem, yet many parents find it a taboo subject to discuss or approach. However, it is important to remember most children don’t do it intentionally. (3)
Fortunately, many children will outgrow this issue, yet there are a small percentage who continue bedwetting into adulthood. (4)
In younger children the issue is generally slow development, lack of antidiuretic hormone (ADH), a hormone telling the kidneys to make less urine or it could be caused by genetics.
There is even the possibility some children have inherited the problem from either one or both parents who had the same issue. (5)
Wetting the bed has also shown connections to attention deficit hyperactivity disorder (ADHD), nocturnal disorders like sleepwalking and obstructive sleep apnea (OSA) or anxiety. (6)
Bedwetting is more commonly seen in boys, whereas daytime wetting is more prevalent among girls. (7)
It can also have other causes such as: lower spinal lesions (abnormal changes in the spine), a birth defect, urinary tract infections or diabetes.
Bedwetting can be determined under two different categories: primary and secondary
Primary bedwetting is when a child cannot keep dry throughout the night, whereas secondary relates to a child who begins to wet the bed after a six month period of no issues.
Secondary bedwetting is usually caused by emotional issues. (8)
Signs of a bedwetting problem generally means finding urine in the bed or underclothes. However, the frequency or pattern in which it occurs can help pinpoint the cause and whether there’s a need for concern.
This is a sign of primary bedwetting, it’s where the child is unable to remain dry at night. (9)
Generally the main reason for this could be slow development. The kidneys produce too much urine due to a lack of ADH and the bladder is still too small to hold the amount. Problems also arise if signals from the bladder are not detected, they don’t cause a natural wake-up call, resulting in a wet bed. (10)
As a rule children will tend to outgrow this issue.
Bedwetting (Frequency Greater than Twice per Week)
If your child wets the bed two or three times a week during a period of three months or more it’s another sign of primary bedwetting.
Sometimes children who are fully bathroom trained can begin to wet the bed again. If this suddenly occurs after six months of dry nights, it’s a sign of secondary bedwetting. (11)
This could point towards emotional issues, but it can also have other causes such as: diabetes, constipation or a bladder or kidney infection.
Other symptoms can include:
Symptoms of a bladder infection can include: pain while urinating, a child might also cry or scream while on the toilet. Urine which appears dark or cloudy, even bloody and has a foul smell to it. Your child may even develop a fever or pain in the lower abdomen, or seem restless.
If you suspect your child has a bladder infection it’s important to seek medical advice.
If you notice that your child sometimes dribbles pee or has a weak flow while urinating, it may be due to a birth defect in the urinary tract. (13)
This is a typical cause of daytime wetting, but can also cause trouble at night.
Doctors typically don’t stage bedwetting, instead they classify the cause into two categories: (14)
Children will have what is called nocturnal polyuria. This is where most of the urine is produced during night time as supposed to during the day.
The child will also have a slight malfunction in signals from the bladder. The body should instigate a biological wake up call, yet in this scenario it doesn’t.
Children classified here will show an overactive detrusor, which is the muscle controlling bladder movement. If this is too active, the child will urinate more frequently.
The youngster will also have an issue with their own body alerts. This error fails to wake them when they need to urinate, resulting in bedwetting.
Treatment for bedwetting is fairly simple and many children stop wetting the bed as they age.
There are medical treatments available for bedwetting, however it’s only a temporary solution and is not considered an option for children under the age of seven. (15)
General treatment of bedwetting consists of motivational therapy and will require commitment from both parents and child. The most important thing to keep in mind is to encourage your child and to ensure them that it’s not their fault and they shouldn’t feel ashamed.
It’s also a good idea to limit the child’s intake of sodas and sugary drinks closer to bedtime. Instead try to give your child most of the necessary fluids earlier during the day, the last two hours before bed, water consumption should be limited. (16)
This form of treatment should work to help your child gain a sense of awareness and control over bedwetting. (17)
It’s basis works upon communicating with your child in order to develop a set of tasks. When your child has completed them rewards will be given.
For example, when your child remembers to go to the bathroom before bed, helps clean the wet sheets or has a dry night a reward would be given. This could be anything that your child likes. One idea would be to create a calendar and use stickers as a way to keep track of the progress.
One thing parents should never do is make the child feel ashamed or embarrassed for a relapse. Punishing or taking back any rewards if your child suddenly has an accident during sleep is also not recommended.
This is a type of device which sits on the child’s clothes or sheets and can detect slight moisture. When this occurs an alarm will sound to wake the child so they can reach the bathroom in time.
A moisture alarm has proven to be a very successful way of treating bedwetting. However, it may require parents intervention to help wake the child for the first few days or weeks, depending on how well the child responds.
This concept is not a fast solution, and usually takes a few months to train your young one to recognize a full bladder. However, the outcome should result in the child waking up on his/her own. (18)
Doctors typically recommend medicines in cases where all other options have failed to work.
The most commonly used drug is desmopressin. It works by slowing down the night time production of urine. As long as your child takes this medicine bedwetting is highly unlikely to occur. However, once the treatment is stopped, bedwetting will more than likely resume. (19, 20)
This treatment can be used long term, although it’s often suggested for shorter time periods, such as sleepovers or camps.
What is bedwetting? Bedwetting is when someone unconsciously wets the bed during their sleep. It mostly affects children, who generally outgrow it.
What are the signs of bedwetting? The obvious sign is a wet sheet. Other symptoms such as pain, fever or a change of color in the urine can be an indicator of an underlying issue like an infection.
How do you develop bedwetting? It’s generally due to slow development which causes issues with bladder control and signals during sleep. Other reasons lead to a small bladder or an increased production of urine. It can even be inherited from a parent. There can also be other causes such as: ADHD, diabetes, sleep disorders, urinary tract infections or emotional stress.
How are you diagnosed for bedwetting? Doctors will ask about the frequency of the occurrence. If it happens more than once a week for three months and the child is over five years of age it’s considered bedwetting. Your doctor will then try to rule out underlying issues by asking if other symptoms occur, how often you pee, its appearance and if wetting occurs during daytime. A rapid urine test can be used to check for diabetes or infections in the urinary tract. (21)
What is the best treatment for bedwetting? The best treatment is motivational therapy, this helps the child gain awareness to better understand the issue. It can also be used alongside a moisture alarm which can provide extra assistance during the night. (22)
What are the long term complications of bedwetting? Long term complications can involve self esteem issues, especially if bedwetting continues into adulthood. Many adults have reported feeling discouraged and embarrassed and so their social, work and family life has suffered. (23)
Is bedwetting considered a disability? Bedwetting in itself is not considered a disability.
Is there any cure for bedwetting? Yes, both motivational therapy and moisture alarms have shown to successfully help stop bedwetting.
Is bedwetting life threatening? No, bedwetting in itself is not life threatening.
Bedwetting can be described as when a child or adult urinates during sleep. It’s very common among young children and is generally an issue they will outgrow.
In many cases it’s due to late development, incorrect signals from the bladder to the brain, an overactive muscle, or it could be a parental trait passed down.
It can be both an embarrassing and inconvenient issue to experience especially if it continues into adulthood. However, there are treatments available which can help make night time much easier to cope with for both child and parents.