All About Bedwetting
Also, you may have seen an adult who cannot hold urine during sleep. These two cases give very typical examples of what bedwetting is. In straightforward terms, bedwetting is a condition in which a person cannot control urine at night.
Typically, your brain is supposed to signal you whenever your bladder is full. This mechanism is so powerful and sophisticated that it is supposed to wake you up even when you are sound asleep.
A child who has this condition cannot tell that the bladder is full. Similarly, an adult who has the condition involuntarily passes urine while asleep at night.
The medical term of bedwetting is nocturnal enuresis – quite a mouthful. In other circles, the condition is referred to as nighttime incontinence.
The term incontinence means the inability to control urine. The other term, enuresis, simply means urination. Thus, the two words are used to describe the condition in children and adults.
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Check out our previous guide on the 7 Best Wireless Bedwetting Alarms and Solutions on the Market Today
Classification of Nocturnal Enuresis
There are two types of bedwetting or nocturnal enuresis: primary and secondary. This form of classification of the condition is based on the severity of the problem.
In general, a bedwetting condition is regarded as primary nocturnal enuresis when a child has never gained control over the bladder. Naturally, toddlers and babies cannot control their bladder; however, at some point, they manage to feel and control the urge to pee.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, children usually gain full control of their bladders when they reach the age of 4 to 5 years. However, in children with primary bedwetting, they continue to wet the bed even after they reach the age of 6 years.
If a child who has gained control of the bladder loses it suddenly, then the child has secondary nocturnal enuresis. This type of bedwetting normally occurs in older children and even adults.
An erstwhile normal child who can control the peeing process loses the ability and starts wetting the bed. In such a case, the child may wet the bed two to three times a week for several months.
Another way of classifying nocturnal enuresis is by considering the complexity of symptoms. In some cases, a child may only show the symptom of urinating in bed at night.
This type of bedwetting in which a child does not show other symptoms is called uncomplicated nocturnal enuresis. It is relatively easy to deal with this type of bedwetting, as you will learn later.
There is another complex type of bedwetting that may affect children. Children who have complicated bedwetting not only involuntarily pee in bed at night but also show many other symptoms during the day. You may realize that your kid empties the bladder during the day very many times.
In some cases, your kid may experience bouts of constipation and other related symptoms. If you have observed these symptoms in your child, then it is likely that the kid has complicated nocturnal enuresis.
Symptoms of Bedwetting
The primary symptom of bedwetting is that a child repeatedly does not control urine during the night. If a child who is supposed to manage the urination process does not do so, then the kid has a bedwetting problem.
Doctors usually use a range of symptoms to figure out whether a child has a bedwetting problem.
You should remember that in the case of uncomplicated bedwetting, a kid may only show the primary symptom, which is involuntarily passing urine at night.
If a child has complicated nocturnal enuresis, then the child may show many other related symptoms. The following is a list of some of the common symptoms of bedwetting.
- Repeated instances of involuntary wetting of the bed. If your six-year-old kid does wet the bed repeatedly, this is a sign that the child has nocturnal enuresis.
- Frequent wetting of the bed for several months. In older children, secondary enuresis is evident when the children suddenly start wetting their beds.
If a child who has not been wetting the bed does so two or three times a week for several months, then the child has a bedwetting problem. You should bear in mind that this form of bedwetting is different from the primary one.
For primary nocturnal enuresis, children never stop wetting the bed even when they get to the age at which they are supposed to show control over the process.
- Frequent passage of urine during the day. In some cases, children who have a bedwetting problem may either do not control urine during the day or feel the urge to urinate very many times. The inability to control urine during the day is referred to as diurnal incontinence.
You need to keep in mind that even when your kid shows these symptoms, there is a need for doctors to rule out all other probable causes for them to make a right diagnosis. At times, a child who has an exceptional physiological condition like an injury to the spinal cord may fail to control the bladder. Therefore, doctors must rule out any other cause during the examination process.
Causes of Bedwetting in Older Children
As it is the case with many medical conditions, there are many probable causes of nocturnal enuresis. Here are some of the most important causes of bedwetting.
- Underdevelopment of the bladder. Children manage to control the bladder because the nerves around the bladder fully develop when the kids reach a certain age. The pace of development of children varies. Whereas you may have seen that some kids reach various development milestones fast, others lag.
Some children who wet the bed may be yet to develop the functionality of their nerves around the bladder fully.
- Small bladder. Some kids have smaller bladders than those of the others. If the bladder is yet to develop to its normal size, then a kid may fail to hold urine for the whole night. It is common for children who have small bladders to urinate often during the day.
- Urinary tract infection. Urinary tract infection (UTI) is an infection of the bladder or the urinary tract by bacteria. UTI occurs when unwanted bacteria enter the urinary tract through the urethra.
The bacteria may then colonize the bladder and other parts of the urinary tract. If this condition occurs in your child, it is likely that the kid may find it hard to control the bladder during the day or at night.
- Deep sleep. In some children, bedwetting may be a result of the inability of the children to wake up at night when the bladder is full. Your child is supposed to wake up at night when the bladder cannot hold any more urine.
However, some children are very deep sleepers that they cannot easily be woken up by the sensation to urinate. For such children, bedwetting episodes occur because, during the night when they are asleep, they cannot tell that they need to pass urine.
- The kid avoids urinating during the day. Some kids deliberately avoid passing urine during the day. It is common for such kids to delay going to the toilet if it is possible. You may have seen what is referred to as the ‘potty dance’ in your kid when they twist and squirm with their hands holding the groin. For such kids, it is possible for them to wet the bed at night because of their poor toilet habits during the day.
- Excessive urine production at night. Some children may produce excess urine between dusk and dawn. For such children, it is effortless to experience episodes of bedwetting.
All these factors can cause primary or secondary types of bedwetting. Also, these factors may be responsible for the development of uncomplicated or complicated forms of nocturnal enuresis in your kid. About complicated bedwetting, many factors may be responsible for the condition.
What are the Risk Factors for Bedwetting?
Not every kid develops nocturnal enuresis. In fact, statistics indicate that the rate of prevalence of the condition in Europe and North America is between 6 and 15%, which gives an average of 10%. These figures show that on average, in every ten children who are under five years of age, only 1 of them develops a serious bedwetting problem. The reason some children develop the problem lies in the effect of risk factors.
Risk factors are the conditions which predispose some people to develop conditions. You may be aware of the argument that poor eating habit is associated with cardiovascular conditions. In practice, taking excessive fats does not directly cause heart-related problems. Instead, when you always have a fat-rich diet, you expose yourself to heart conditions.
There is a similar relationship between risk factors and bedwetting. Some conditions may increase the chances of children to develop a bedwetting problem. One of the main risk factors of bedwetting is genetics.
As much as it may sound strange, it has been proven that the children of parents who had a bedwetting problem in their childhood are likely to experience a similar problem. So, if your child is having this problem, it may be prudent to dig up your history and find out whether you had it when you were a kid.
Another significant risk factor for nocturnal enuresis is the psychological state of your kid. If you subject your child to very stressful conditions, the chances are that your child may show signs of nocturnal enuresis.
Although emotional stress does not directly cause bedwetting in children, it contributes to the development of the problem because it interferes with the normal functioning of your child. As part of the process of coping with emotional stress, your kid may start to wet the bed involuntarily.
When to Seek Medical Care for Bedwetting
You should seek medical attention for bedwetting if you and your kid are in any of the following situations.
- The bedwetting problem adversely affects the emotional health of your kid. If you realize that your child feels embarrassed because of the problem, then you may have to take them to see a doctor. Some children who have this problem feel guilty and develop a low perception of self.
- If your child who has the problem is well over six years old. If your kid has never managed to control the bladder and they are past the age of 5 to 6 years, then you may have to look for professional help to address the problem.
- If your older kid who has been controlling their bladder very well starts to wet the bed. c
- If you think that the bedwetting problem may only be a symptom of another serious medical condition such as diabetes.
- If the condition interferes with the normal functioning of your child. For some children, the problem may drastically affect their interaction with others or even their approach to schoolwork. If you see either or both situations, then you should take your kid for treatment.
The Impact of Bedwetting
As it is the case with all medical conditions, bedwetting has a massive impact on individuals, families, and the society in general. The situation typically hurts the lives of the children who are affected, the family members of the children and other people who are close to the kids.
One of the biggest impacts of bedwetting relates to the psychological development of children. You know that you need to help your children develop a powerful sense of self-worth in their lives. The concept of self-esteem means the way individuals perceive themselves about the others. For children who have a low sense of worth, they may find it difficult play and interact with others.
Also, children who wet the bed may have a low sense of self-esteem. You can tell a child who has low self-esteem by watching how the kid plays with others. If a kid constantly feels embarrassed and avoids mingling with others freely, then the kid has a low sense of self-esteem.
If your child wets the bed, the kid may feel that he has a severe problem, and this may interfere with their sense of worth and self-esteem. More importantly, if you happen to reprimand your kid for wetting the bed, you may subject your kid to severe stress.
When you subject your kids to immense stress at home, they may adapt strange behaviors to cope with the stress. Statistics indicate that more than 60% of sociopaths were subjected to stress in their home environments and develop maladaptive practices such as bedwetting and others to cope.
Moreover, research indicates that bedwetting has far-reaching consequences on families. For example, the siblings and other family members of an affected child usually have feelings of anxiety because of the condition.
Also, it is pointed out that the parents of children who have this condition may feel that they have failed in their roles as parents. Some parents wrongly associate bedwetting and poor toileting manners.
Although at times children who experience the problem usually have lousy toileting habits, you should not believe that every bedwetting child was taught how to use the toilet properly. If parents feel that they did not show their children the right toilet manners, they may think that they need to discipline their children to help them learn.
In some cases, parents may feel that their children have a severe problem that needs to be addressed. Although bedwetting may be associated with other medical conditions, on many occasions, you may only have to deal with it as a stand-alone problem.
Bedwetting in Children
Bedwetting is one of the most common problems that affect children, with 16% of children under the age of five years experiencing it. Many people consider it a big problem because of the way interferes with the development of the kids who are affected. If your child has the problem, you will realize that they appear frustrated and ashamed.
Every kid who reaches the age of 5 years never wishes to wet the bed. Therefore, if it happens that your kid wets the bed, the child will feel remorseful. It is the feelings of remorse and shame that may impair the psychological development of your child.
Studies show that bedwetting is common in boys and girls at the first stages. All children who are under the age of five cannot control their bladders. However, when they reach this age, they are supposed to be able to control their bladders and only pee voluntarily.
For some children, however, they do not develop this vital ability, leading to instances of involuntary urination. For such kids, there is a need for parents to help them overcome the problem.
For some older kids, it happens that occasionally, they lose control over their urine at night. If your kid urinates in bed once or twice in a long time, you may not have to consider it a big issue. You may have to be concerned if you notice that your older kid repeatedly wets the bed.
If this is the case, then your kid, who was able to control the bladder, has developed the problem of nocturnal enuresis.
For children your doctor will likely recommend a range of home-based remedies to help your kid. Moreover, the doctor will ask you to use some drugs on your kid if the situation is severe. In such circumstances, the doctor may ask you to give your child some drugs and help the kid master a few important behavioral changes to overcome the condition.
Bedwetting in Older Children and Adults
If you think that bedwetting is a problem of children, then you must think again. Some adults experience episodes of wetting their beds. As it is the case in children, nocturnal enuresis is adults comes with unintended and repeated instances of wetting the bed at night. In other cases, adults may experience situations of being unable to control the flow of urine during the day.
Unlike the situation in kids, bedwetting in adults does arise because the adults are not fully developed. In general, bedwetting in adults is associated with underlying medical conditions. If you discover that you cannot control your urine at night repeatedly, then the chances are that this may only be a tip of the iceberg.
The failure to control urine may be a symptom of many other underlying illnesses. For example, the enlargement of the prostate in elderly male, a condition medically referred to as BPH, usually leads to episodes of bedwetting.
If you have diabetes insipidus, a type of diabetes that causes your blood sugar to spike always, you may experience nocturnal enuresis. There is compelling evidence to show that diabetes insipidus causes adult bedwetting in many people. The mechanism by which this type of diabetes causes nocturnal enuresis in adults is based on the production of a hormone called ADH.
The hormone, which controls the functioning of your kidneys, may be insufficient in your body if you have diabetes insipidus.
Low ADH levels lead to constant feelings of thirst. Thus, a diabetes insipidus patient is likely to take copious amounts of water and other fluids during waking hours. Because of the abnormal intake of fluids, such a patient may wet the bed repeatedly.
Nocturnal enuresis may have adverse effects on the lives of adults, just as it may do on the lives of kids. Adults who mistakenly wet their beds usually feel embarrassed. If the condition is a symptom of another medical condition, a person may feel that they are suffering from severe illnesses.
The feelings of guilt and panic that individuals who experience bedwetting experience may affect their psychological well-being and compound their health problems.
Before doctors try to treat bedwetting in adults, they must be certain of the cause of the condition. If bedwetting is caused by the kind of drugs that a person is using, then doctors will use a specific approach to correct it. However, if the problem is a sign of another medical condition, then doctors may have to use a different approach to help you.
Occasional Bedwetting in Adults
Occasional bedwetting in adults is not a severe problem. Only 1.5 to 3% of the adult population get affected every year. It happens at times that some adults may wet the bed during their sleep. Although these occurrences are uncommon, you may not have to undergo a medical examination if it occurs. The reason for you not to worry very much about wetting your bed once in a very long time is because such an occurrence may not be a sign of another more profound problem.
Some adults may experience bedwetting occasionally because of the medications that they may be using. Some drugs like those which are used to treat psychoses may cause you to wet your bed at times. These and many other drugs cause occasional bedwetting because they usually irritate the bladder.
Your bladder is very sensitive to pressure. When you take these drugs, you may experience bedwetting episodes because one of their main side effects is that they irritate the bladder.
Regardless of the main cause of occasional wetting of the bed in adults, you may still have a tough time if you ever experience it. You may get embarrassed for wetting your bed during sleep. However, if you can accurately pinpoint the main cause for the occurrence, then you may not have to be worried about it.
How to Stop Bedwetting Naturally?
Research shows that the use of bladder training technique to help kids overcome bedwetting can be practical if it is used with other useful methods. The underlying mechanism of bladder training is that you have to slowly help your kid learn how to hold urine in their bladder.
For the technique to be effective, you should ensure that you understand the cause of bedwetting in your kid. If the cause is because of conditions associated with a small bladder of excessive production of urine at night, then the chances are that you may succeed by using this method.
Bladder training can help your kid learn how to control their bladder because the training helps to expand the size of the bladder. When you subject your kid to the training exercises, you support them also to be aware of the urge to urinate and suppress it if it is desirable. Thus, the method not only helps your kid develop a sense of self-control but also enables the expansion of the bladder of your kid.
For ideal bladder control, the size of the bladder should be equal to the number of years of your kid plus 2. For example, if your kid is seven years old and they cannot hold their urine at night, then you may have to confirm if the size of the bladder is 9 ounces. You can do this by measuring the amount of urine that they void from their bladders on one night.
If this is not the case, you may have to subject them to the training exercises for several weeks. Remember to watch their performance during the period so that you may be sure of the impact of the training on their bladder sizes and ability to control urine.
Check out our guide on the 7 Best Wireless Bedwetting Alarms and Solutions on the Market Today
Nocturnal Enuresis Treatment
If your kid has been showing the main symptoms of nocturnal enuresis that have been highlighted in this post, then you may have to take them to see a doctor. In practice, doctors are cautious when making any diagnosis. Doctors always want to be certain about the condition that they treat. The case is not different when you have a kid who repeatedly wets their bed, and you take them to a doctor.
The following is an outline of the procedure that doctors use to diagnose bedwetting in children. You should remember that in general, the process is also used to diagnose bedwetting in adults. However, in adults, the doctor may ignore some aspects of the procedure which are typical in children and not in adults.
- Confirmation of the condition. The first thing that doctors do to diagnose nocturnal enuresis is to confirm that indeed, the patient is showing signs and symptoms of the condition. For your doctor to do this, they usually carry out a physical examination on the patient.
- Ruling out other medical conditions. It is possible that enuresis may be a symptom of another sickness. That is why doctors ensure that they rule out the presence of other illnesses such as diabetes. For doctors to be sure about this, they may subject your kid to a series of tests to determine the overall health of your kid. Some of the tests include urinalysis, kidney function, and blood sugar levels.
- Determining the specific subtype of the condition. Doctors must decide if your kid has a primary or secondary form of bedwetting. For your doctor to determine this, they must carry out some tests and have extensive discussions with you and your kid. Although you may think that is easy for doctors to determine the subtype of the condition, this is not usually the case. The situation may be very complicated for some kids, and this may call for a degree of expertise in your doctor.
- Rule out other complications such as UTI. In some cases, your doctor may recommend imaging studies for your kid. Medical images may be taken to help the doctors determine whether your kid has a complication in their UTIs. In most cases, doctors do not have to take pictures of the lower abdomen of your kid as part of the bedwetting diagnosis process.
This procedure is used to diagnose bedwetting even in adults. However, in the case of adults, doctors may focus on some of the most common causes of the condition such as medication, BPH in men and diabetes insipidus.
Also, as part of the process of evaluating the condition in adults, doctors may not focus on determining whether the bedwetting is primary or secondary. Once doctors subject an adult patient to rigorous physical examination to figure out the presence of the primary symptoms of the condition and they rule out other potential causes, they can easily make a diagnosis.
Medical Treatments for Bedwetting
There are many treatment strategies that doctors use to manage bedwetting. Some of the strategies that are usually used include medication, bladder training, general measures and the moisture alarm. These treatment strategies may be categorized as either behavioral or pharmacological.
Your doctor may prefer to use medications to treat bedwetting in your kid if the doctor is convinced that the situation is serious and that it is necessary to intervene. In general, bedwetting usually ends after your kid attains the age of 6 years.
However, if you feel that the condition is negatively affecting your kid, you may consider asking the doctor to use drugs to treat it. Moreover, doctors may choose drugs to treat the condition in adults.
When doctors decide to treat bedwetting in your child using the pharmacological strategy, they are likely to use a type of drug called desmopressin. Desmopressin is a synthetic form of ADH, a critical hormone in the body.
The work of ADH is to control the functioning of the kidney and, in effect, the process of urine production. If copious amounts of ADH are produced in the body, the functioning of the kidneys is inhibited. In other words, when the levels of ADH in the body rise, a person does not feel the urge to urinate.
Desmopressin works by suppressing the production of urine. If doctors choose to use this drug on your kid, they will instruct you to administer it at night before the kid goes to bed. Kids who have nocturnal enuresis as supposed to take about 200 to 400 micrograms of the compound every night for 14 days. The drug efficiently reduces the amount of urine that kids produce at night, thus preventing them from wetting the bed during the night.
However, you need to bear in mind the findings of studies that the use of the drug may cause adverse side effects on children. For example, it has been proven that if the drug is used by children who have diarrhea or are vomiting, it may cause adverse effects on their health.
The negative impact of the drug on the health of patients is associated with its substantial impact on the fluid balance in the body. If a kid who is already losing water because of vomiting or diarrhea takes the drug, the kid may be dehydrated.
Also, the drug may be administered through the nose. However, studies indicate that delivering the drugs to children via the nose may be harmful. The adverse effect of nasal administration of the drug is common in children who have breathing problems.
If your kid has any breathing problem and the doctor would wish to use this drug to deal with bedwetting, remember to mention the breathing condition to the doctor.
Doctors typically tell parents of children who have nocturnal enuresis to stop using the drug after two weeks. After the period, you may allow your kid to use the drug occasionally. For example, you may administer it to your kid when your kid goes to a new place. You may also use it when you feel that it is necessary to augment any other treatment methods that you may be used to help your kid overcome bedwetting.
Bedwetting in Adults Home Remedies
If you feel that you do not have to see a doctor help your kid overcome nocturnal enuresis, you may use specific home-based remedies. There are many home-based remedies from which you can choose what you think may be the best for your kid.
Some of the most common strategies include the following: bladder training, behavioral training, and moisture alarm.
Bladder training is one of the most effective methods that can be used to treat bedwetting in kids. The effectiveness of this strategy lies in the fact that it helps to increase the ability of your kid to control the bladder. If you choose this method, you will have to set aside a considerable amount of time to train your kid how to hold urine for long. You may also have to measure the amount of urine that your kid voids at night and track it for some time.
In general, you should use bladder training as one of the methods that you employ to help your kid. This treatment strategy is highly effective when it is combined with any other recommended way such as the use of drugs.
The behavior-based approach entails adopting a series of measures to help prevent your kids from wetting the bed. The essence of the method is that if you identify specific practices that either enhance or inhibit bedwetting in your kid, you can efficiently control the accidents.
If, for example, you realize that your kid takes a lot of fluids at night, you should limit the fluid intake at night as the first step of the process of helping your child. Also, you may observe the moments that your kid wets the bed and start waking them up before the time.
The following is a summary of some of the behavior-based tactics that you can use to help your kid avoid wetting the bed at night.
- Avoid reprimanding your child when the accidents occur.
- If your kid wets the bed, remember to wash them in the morning to ensure that they are fresh and ready for the day ahead.
- Do not limit the total amount of fluids that your kid would like to take.
- Focus on rewarding instances in which your kid does not wet the bed but do not punish them when they do so.
You can also use the moisture alarm to help your kid overcome nocturnal enuresis. The moisture alarm goes typically off the moment your child wets the bed. You can use this mechanism to wake up the child and enforce the ability to awaken when they feel the urge to urinate. Moreover, you can carefully adapt the strength of your kid to control the bladder by gradually increasing the number of fluids that they take and using the alarm.