A health condition in which urine passes without intending during sleep is called bed-wetting, nighttime incontinence, or nocturnal enuresis. In most cases, it happens in children under 7 years old. It is recommended not to get upset if your child wets the bed, especially before the age of 7, because it does not indicate a problem. Generally, bed-wetting is a normal part of a child’s development because they develop nighttime bladder control.
When the child continues to wet the bed, he/her may need treatment with patience and understanding. Commonly, physicians recommend lifestyle changes, bladder training, moisture alarms, and medications (sometimes).
Symptoms
Usually, all children at least 5 years old are toilet-trained and do not have this problem. However, nighttime incontinence remains a problem in some children between 5 to 7 years old.
While many children outgrow this condition on their own, some of them may need to see a doctor. Rarely, nocturnal enuresis is a symptom of an underlying condition. Contact your healthcare professional if any of the following cases occur. For example:
- The child experiences this problem after 7 years
- Bed-wetting happens after months of being dry
- Your child experiences the following symptoms along with bed-wetting. Examples include pain during urination, extreme thirst, pink or red urine, hard stools, or he/she snores.
Causes
While healthcare providers cannot identify what exactly causes bed-wetting, they think the following things could play a role. Check some examples below:
- Small bladders – Sometimes, the child’s bladder is not fully developed to hold all urine during the night.
- No awareness – When the nerves that control the bladder develop slowly, it may lead to this condition. It is especially true when the child is a deep sleeper.
- Hormonal imbalance – Some children may not produce enough anti-diuretic hormone (also known as ADH) that slows the amount of urine that is produced during nighttime.
- Urinary tract infections (UTIs) – These infections can make it hard for the child to control the urge to pass urine. The most common symptoms include nighttime incontinence, daytime accidents, frequent urination, pink or red urine, and pain.
- Sleep apnea – In rare cases, bed-wetting indicates obstructive sleep apnea. When it occurs, you may notice interrupted breathing during sleep. Mostly, it occurs due to enlarged adenoids or tonsils.
- Diabetes – This is a chronic (long-term) health condition that may cause bed-wetting. Other symptoms of diabetes include extreme thirst, fatigue (extreme tiredness), weight loss, appetite changes, and others.
- Constipation – Long-term constipation may cause problems with the muscles involved in urination.
- Urinary tract or nervous system issues – In rare cases, a structural change in the urinary or nervous system may lead to nighttime incontinence.
Risk Factors
While this condition can affect anyone, it mostly happens in boys then in girls. Check below some factors that could elevate your risk of developing bed-wetting:
- Stress and anxiety – This is one of the biggest triggers of nighttime incontinence. For instance, a new baby in the family, a new school, or sleeping away from home.
- Family history of this condition – If you have a parent or sibling that have had nighttime incontinence, the risk of developing in your children significantly increases.
- Attention-deficit/ hyperactivity disorder (ADHD) – This condition is more common in children with this mental disorder.
What Are The Potential Complications of Nighttime Incontinence?
While this condition causes discomfort and frustration, it does not result in other health problems without a physical cause. Check below some complications that may occur in children with this condition:
- Embarrassment and guilt frequently lead to low self-esteem
- Loss of opportunities for social activities
- Rashes on the bottom part of the body and the genital region
Diagnosis
Physicians usually perform tests to check for underlying conditions. For example:
- A physical examination
- Questions about the symptoms, family history, and bowel and bladder habits
- Urine tests are often done to check for diabetes and urinary tract infections
- Imaging tests to look at the kidney and urinary tract structure
Treatment
While most children outgrow the condition on their own, some of them need treatment. Discuss with your healthcare professional about ways to treat this problem.
For children with occasional nighttime incontinence, doctors may recommend limiting liquids in the evening. When lifestyle changes are not effective, and the child is concerned about bed-wetting, physicians may prescribe additional treatments.
Some children may get treatment if nighttime incontinence is caused by another health problem. Check below the most common treatments prescribed by doctors for people with bed-wetting:
Moisture Alarms
These are specific battery-operated devices that are connected to a moisture-sensitive pad on the child’s bedding or pajamas. The alarm is triggered when the pad senses wetness. In general, you can buy these devices over-the-counter (OTC) at most pharmacies.
Usually, this alarm helps wake up the child and stop the urine stream. When children and deep sleepers, another person may need to listen for the alarm and wake them. You will notice improvements with this device within 1 to 3 months.
Moisture alarms are very effective in most children and have a low risk of adverse reactions compared to medications.
Medications
The following medicines are often prescribed by doctors when lifestyle changes do not work. For example:
- Desmopressin – This medicine is often recommended to reduce urine production during nighttime. However, drinking too many fluids may cause certain problems if you take this medicine. It is not allowed to give your child this medication if he/she has fever, diarrhea, or nausea. According to the FDA (Food and Drug Administration), Desmopressin can be given to children over 6 years old.
- Anticholinergic drugs – In most cases, doctors recommend Oxybutynin to reduce bladder contractions and increase the amount of urine the bladder can hold. These medicines are effective even for people who experience daytime wetting. However, doctors may recommend other medicines along with Oxybutynin.
While medicines are effective to treat nighttime incontinence, they cannot cure the condition. Usually, when you interrupt these medications, bed-wetting recurs.
Home Remedies
The following tips may help improve nighttime incontinence symptoms. Examples include:
- Limit liquids in the evening
- Do not drink beverages or eat foods that contain caffeine
- Use the toilet before you go to sleep
- Prevent rashes
Frequently Asked Questions
At what age is bed-wetting a concern?
Do not hesitate to see a doctor if nighttime incontinence happens in children over 7 years old. While there are a lot of causes that lead to bed-wetting, most of them are treatable.
What is the cause of bedwetting?
Sometimes, children experience this condition due to an underlying condition. Check below some examples:
- Diabetes
- Urinary tract irregularities
- Constipation
- Urinary tract infections (UTIs)
- Psychological problems
Consult with your healthcare provider for more details.
Do kids naturally stop wetting the bed?
Yes, in most cases, children outgrow the condition without treatment. Usually, they stop wetting the bed between 3 to 5 years old. Ask your healthcare provider if you have additional questions.
