Bedwetting: Causes and Treatments

Many families know the frustration of waking up to wet sheets and pajamas from a child’s bedwetting. This condition, also called nocturnal enuresis or nighttime incontinence, happens when a child who’s old enough to control their bladder at night accidentally pees while sleeping.

If your child wets the bed, don’t get mad or blame them. Bedwetting doesn’t mean you did a bad job potty training them. It’s a normal part of growing up for many kids.

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Before age 7, bedwetting is usually nothing to worry about. Your child’s body might still be learning how to control their bladder throughout the night.

If bedwetting continues as your child gets older, stay patient and supportive. You can try making small changes to their routine, teaching them bladder control exercises, using special moisture alarms, or even giving them medicine prescribed by a doctor. With time and the right approach, your child can beat bedwetting and wake up to dry sheets each morning.

About Bedwetting

Bedwetting, Verified Source Medline Plus Online resource offered by the National Library of Medicine and part of the National Institutes of Health. View source or nocturnal enuresis, Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source happens when a child accidentally pees while sleeping, even after successful potty training. Many kids naturally outgrow bedwetting between ages 5 and 6, Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source but it can affect a child into their teen years.

If your child is over 12 and still wets the bed at least twice a week for three months straight, it’s considered a problem. Bedwetting isn’t dangerous, but it can cause stress and embarrassment for kids and families.

Bedwetting comes in two main forms:

• Primary bedwetting means a child has never stayed dry at night for six months straight or longer.
• Secondary bedwetting happens when a child starts wetting the bed again after staying dry for at least six months. This type usually stems from a medical issue or emotional stress.

Children who wet the bed might feel ashamed or avoid fun activities like sleepovers because they fear wetting the bed away from home.

Causes of Bedwetting

There are many potential causes for bedwetting in children and adults. Potential underlying medical conditions should be ruled out by a healthcare professional.

For children:

• Delayed bladder maturation
• Genetics
• Deep sleep that keeps the child from waking up
• Hormone imbalance from not producing enough antidiuretic hormone to reduce nighttime urine production
• Constipation, as a full bowel can put pressure on the bladder
• Urinary tract infections
• Stress or anxiety

For adults:

• Urinary tract infections
• Enlarged prostate in men
• Diabetes (both Type 1 and Type 2)
• Neurological disorders like multiple sclerosis or Parkinson’s disease
• Bladder problems such as overactive bladder or small bladder capacity
• Sleep disorders like sleep apnea
• Certain medications
• Stress or anxiety disorders
• Urinary tract stones

Emotional Impact

Bedwetting can make children and adults feel ashamed or embarrassed, even though it’s a common issue. For example, children with bedwetting tend to have lower self-esteem scores Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source compared to children without bedwetting.

A 2016 study Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source examined how urinary incontinence (bladder control problems) in childhood can have negative effects on mental health and social life during the teenage years.

Teens who had delayed bladder control as children were more likely to:

• Have lower self-esteem
• Feel more negative about school
• Have more problems with friendships

Teens who still had bladder control problems reported:

• More feelings of depression
• Being bullied more often
• Lower self-esteem
• More problems with friendships

The study suggests that children with bladder control problems might need support for their mental health, even after the physical problem is solved.

Negative attitudes and stigma around bedwetting often lead to these emotions. If you’re an older child, teen, or adult and start wetting the bed, it’s usually not your fault and could signal changes in your body.

Your healthcare provider can help you understand what’s happening and work with you to find solutions, so you can feel better and wake up with dry sheets. While you might find it awkward and shameful to talk about it with a doctor, remember that many people experience bedwetting.

Treatment Options

Bedwetting treatment Verified Source National Library of Medicine (NIH) World’s largest medical library, making biomedical data and information more accessible. View source typically involves a combination of approaches tailored to the individual’s age, symptoms, and underlying causes. Consulting a healthcare professional is crucial for developing the right plan.

Furthermore, treatment may take time to show results, so patience and consistency are key. For children, reassurance and emotional support are crucial throughout the treatment process.

Behavioral Modifications

This includes limiting fluid intake 1-2 hours before bedtime, encouraging regular bathroom visits (especially before sleep), using a bedwetting alarm to condition waking when the bladder is full, and implementing a reward system for dry nights (particularly effective for children).

Moisture Alarms

These devices detect wetness and sound an alarm to wake the child, helping them learn to recognize a full bladder.

Medications

Desmopressin can help reduce urine production during sleep. Anticholinergics may increase bladder capacity, while oxybutynin can help with an overactive bladder. Imipramine, an antidepressant, is sometimes used for bedwetting, though it’s not first-line due to potential side effects.

Antibiotics can also be prescribed to prevent or treat urinary tract infections.

Treatment of Underlying Conditions

Addressing issues like sleep apnea, diabetes, or urinary tract infections that may be causing bedwetting is crucial.

Bladder Training

This involves exercises to increase bladder capacity and control. These may include timed voiding (urinating on a schedule), double voiding (urinating twice during one visit), and pelvic floor muscle relaxation.

In rare cases, catheterization may be recommended.

Psychotherapy

This can be useful when bedwetting is linked to stress, anxiety, or other psychological factors.

Alternative Therapies

Some people find success with acupuncture or hypnotherapy, though more research is needed on their effectiveness.

Absorbent Products

While not a cure, absorbent underwear or bed pads can help manage symptoms and reduce stress.

When Is It Time to See a Doctor?

Bedwetting, while often associated with childhood, can affect individuals of all ages. Whether it’s a persistent issue in children or an unexpected occurrence in adults, knowing when to consult a healthcare professional is crucial.

Remember, bedwetting is a medical condition that can often be effectively treated, and seeking timely help can lead to better outcomes and improved quality of life.

For Children

Most children naturally outgrow bedwetting as they age, but others might need additional help. In some cases, bedwetting can be a warning sign of a health problem that requires medical care.

Contact your child’s pediatrician or healthcare professional if:

• Your child is over 7 years old and still wets the bed.
• Your child starts bedwetting again after being dry at night for a few months.
• Your child has other symptoms along with bedwetting, such as pain while peeing, feeling very thirsty, having red or pink urine, difficulty pooping, or snoring.

Don’t wait to get medical help if your child is in any of these situations. A doctor can identify the root cause of the bedwetting and recommend the best treatment to solve the problem.

For Adults

Occasional bed-wetting in adults, while not exactly common, is not necessarily a cause for immediate alarm. However, it’s important to understand when it might signal a need for medical attention.

Adults should consider seeing a doctor about bed-wetting in the following circumstances:

• A sudden onset in adulthood, especially if you’ve never experienced it before
• Increased frequency, usually more than once a month
• Accompanying symptoms such as pain or a burning sensation during urination, blood in urine, increased thirst or frequent urination during the day, difficulty starting or maintaining urine flow, unexplained weight loss, lower back pain, fever
• An impact on quality of life, such as significant distress, anxiety, depression, or otherwise affecting your relationships or daily activities
• Persistent issues and self-management strategies (like limiting fluid intake before bed) failing to reduce the frequency of bed-wetting after several weeks
• A family history of bed-wetting or urological issues
• Recent medication changes
• Neurological symptoms like weakness, numbness, or changes in cognition
• Other sleep issues, such as loud snoring, gasping for air during sleep, or excessive daytime sleepiness, consult a doctor. These could indicate sleep apnea, which can sometimes contribute to bed-wetting.

Gender can play a part, too. Men who are experiencing bed-wetting along with difficulty urinating or incomplete bladder emptying should see a doctor to rule out prostate problems. Women who have given birth or are experiencing pelvic organ prolapse symptoms along with bed-wetting should consult a healthcare provider.

Remember, bed-wetting in adults is a medical issue that can often be treated effectively. Don’t let embarrassment prevent you from seeking help.

Healthcare providers are professionals who have seen many cases like yours and are there to assist, not judge. Early intervention can lead to better outcomes and improved quality of life.

When you do see a doctor, be prepared to discuss:

• The frequency and pattern of your bed-wetting episodes
• Any other urinary symptoms you’re experiencing
• Your medical history, including any medications you’re taking
• Your fluid intake habits, especially in the evening
• Any lifestyle factors that might be contributing (e.g., stress)

Your doctor may perform a physical exam, order urine tests, and possibly recommend further urological or neurological evaluations to determine the underlying cause and best treatment approach for your specific situation.

FAQs

What is the most common cause of bedwetting?

The most common cause of bedwetting is a delay in the development of bladder control. As children grow, their bodies learn to send signals to the brain when the bladder is full, but some kids take longer to develop this ability.

Other factors, like deep sleep, stress, or genetics, can also contribute to bedwetting.

Is bedwetting a sign of a medical condition?

In some cases, bedwetting can be a sign of an underlying medical issue, such as a urinary tract infection, diabetes, or sleep apnea.

If other symptoms accompany bedwetting, such as painful urination, excessive thirst, or snoring, consult a doctor. They can help identify any potential health problems and recommend appropriate treatment.

Can stress or anxiety cause bedwetting?

Yes, stress and anxiety can sometimes lead to bedwetting, especially if someone has recently experienced a significant life change or traumatic event. For children, stressful situations like starting a new school, moving to a new home, or losing a loved one can trigger bedwetting episodes.

If you suspect stress is causing your child’s bedwetting, talk to them openly and offer emotional support.

Can bedwetting be treated with medication?

In some cases, doctors may prescribe medication to help manage bedwetting, particularly for older children or those with persistent issues. Common medications include desmopressin, which reduces urine production at night, and imipramine, which relaxes the bladder muscles.

However, medication should only be used under the guidance of a healthcare professional, as it may have side effects and is not always the most appropriate solution.

Are there any effective home remedies for bedwetting?

While there’s no guaranteed home remedy for bedwetting, some strategies may help reduce incidents. Encourage your child to use the bathroom before bedtime, limit fluid intake in the evening, and wake them up to use the toilet during the night.

Positive reinforcement and rewards for dry nights can also help boost your child’s confidence and motivation. Remember, stress and such can exacerbate bedwetting, so have patience and give reassurance as needed. A supportive, non-punitive approach is crucial in helping children overcome bedwetting.

How can I support my child emotionally when they’re struggling with bedwetting?

Bedwetting can be emotionally challenging for children, so it’s crucial to offer support and understanding. Reassure your child that bedwetting is not their fault and that many kids experience the same issue.

Avoid punishing or shaming them for wet nights. Instead focus on praise and encouragement for progress and effort. Help them manage any anxiety or embarrassment they may feel, and remind them that they’re not alone.

At what age should I be concerned about my child’s bedwetting?

Bedwetting is common in children under the age of 7, and most kids outgrow it naturally. However, if your child is still regularly wetting the bed after age 7, it’s a good idea to consult a pediatrician.

They can help rule out any underlying medical issues and suggest appropriate treatment options, such as bedwetting alarms or medication.

Conclusion

Bedwetting is a common issue that many children face, and it’s essential for parents to approach it with patience, understanding, and support. While most kids outgrow bedwetting naturally, some may require additional help from a healthcare professional to address underlying causes and find effective solutions.

By working together and maintaining a positive attitude, families can help children overcome bedwetting and build confidence in their ability to stay dry at night.