Bedwetting is the loss of bladder control during the night. The medical term for bedwetting is nocturnal enuresis or enuresis. Bedwetting can be an embarrassing issue, but in many cases, it is perfectly normal. The American Academy of Child and Adolescent Psychiatry (AACAP) estimates that 15 percent of children over the age of three wet the bed (AACAP, 2011).
Bedwetting is a normal developmental stage for some children. However, it can be a symptom of underlying illness or disease in adults. About two percent of adults suffer from bedwetting, according to the National Association for Continence (NAFC, 2012).
Physical and psychological conditions can lead to bedwetting in some people. Common causes of bedwetting among children and adults include:
- small bladder size
- urinary tract infection (UTI)
- stress, fear, or insecurity
- prostate gland enlargement
- sleep apnea (abnormal pauses in breathing during sleep)
Hormonal imbalances can also cause bedwetting in some people. Everyone makes a hormone called antidiuretic hormone (ADH). ADH tells your body to slow down the production of urine overnight. The lower volume of urine helps a normal bladder hold urine overnight. People who do not make sufficient levels of ADH may experience nocturnal enuresis because their bladder cannot accommodate higher volumes of urine.
Diabetes is another disorder that can cause bedwetting. Patients who are diabetic do not process glucose (sugar) properly and may produce larger amounts of urine. The increase in urine production can cause children and adults who normally stay dry overnight to wet the bed.
Gender and genetics are among the risk factors for bedwetting. Both boys and girls may experience episodes of nocturnal enuresis during early childhood. However, boys are more likely to wet the bed when they get older. The Mayo Clinic estimates that up to 50 percent more males than females wet the bed (Mayo Clinic, 2012).
Family history plays a role, too. You are more likely to wet the bed if a parent, sibling, or other family member has had the same issue.
Bedwetting is also more common among children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The relationship between bedwetting and ADHD is not fully understood by researchers.
Certain lifestyle changes may end bedwetting. Setting limits on fluid intake plays a large part in controlling bedwetting. Try not to drink water or other liquids within a few hours of bedtime to reduce the risk of having an accident. Drink the majority of your daily fluid requirements before dinnertime. This will ensure that your bladder is relatively empty before bedtime. Cut out caffeinated or alcoholic drinks in the evening because caffeine and alcohol are bladder irritants, and may cause you to urinate more.
Devise a voiding schedule to help you stay dry overnight. A voiding schedule simply means that you urinate on a regular timetable, such as every one to two hours. Use the bathroom right before you go to bed to empty your bladder fully before sleep.
Bedwetting can sometimes occur during a stressful event in a young person’s life. Conflict at home or school may cause your child to have nightly accidents. The birth of a sibling, moving to a new home, or another change in routine can be stressful to children and may trigger bedwetting incidents. Talk to your child about how they are feeling. Understanding and compassion can help your child feel better about his or her situation, which can put an end to bedwetting in many cases.
Refrain from punishing bedwetting incidents. Praise your child when he or she stays dry. This will help him or her feel good about not wetting the bed.
Bedwetting that stems from a medical condition requires treatment beyond just lifestyle adjustments. Medications can treat a variety of conditions of which bedwetting is a symptom. For example:
- antibiotics can eliminate UTIs
- anticholinergic drugs can calm an irritated bladder
- desmopressin acetate increases levels of ADH to slow nighttime urine production
- DHT-blocking medications reduce swelling of the prostate gland
It is also important to control chronic conditions, such as diabetes and sleep apnea. Bedwetting associated with underlying medical issues will likely resolve with proper management.
Most children outgrow bedwetting by about seven years old. By this age, bladder control is stronger and more fully developed. Lifestyle changes, medical treatment, and support from family and friends can help children and adults overcome bedwetting.