Illnesses & Symptoms
Bedwetting occurs in 16% of children at 5 years of age, 5% of children at 10 years, and 1 to 2% at and above 15 years of age, but it can cause considerable distress and inconvenience among families.
Bedwetting, also called nocturnal enuresis, is more common in boys. It's not abnormal during younger ages, but later on may suggest another sleep disorder or late development of the ability to wake up when the bladder is full. In other words, young children are usually very sound sleepers, but when older children continue to be sound sleepers they don't wake up to go to the bathroom when their bladder is full.
Sleep problems, ranging from not enough sleep to poor sleep due to enlarged tonsils or adenoids, can cause deeper sleep and therefore bedwetting. Signs of poor sleep can be grinding the teeth, snoring with pausing of breathing, daytime tiredness, and restless sleep. These signs can be from associated conditions, such as enlarged tonsils or adenoids, and should be ruled out, since treatment often ends the bedwetting.
If your child also has daytime urine leakage, frequency, or other daytime urine complaints, please schedule an appointment for a history and exam.
Constipation is frequently linked to urinary symptoms, and is often underestimated by children and their parents. Chart stooling patterns for a week or two if you have urinary symptoms. Talk to your doctor if bedwetting, constipation, or sleep issues continue to be a problem.
If your child was previously dry at night but is now wetting the bed, this can be a sign of a medical problem, such as a urinary tract infection, and should be discussed at a visit with your physician.
Ways to help prevent bedwetting:
- Avoid drinking a lot at night and go to the bathroom before bed. A general rule is 2 oz. or less in the 2 hours before bedtime.
- Drinking a lot of fluids earlier in the day and trying to hold urine as long as possible during the day can stretch the bladder and might offer benefit.
What to do before the bedwetting is outgrown:
- Monitor for subtle (or not so subtle) signs of constipation. Treat constipation.
- Wearing pull-ups or using a cover for the sheets can help with bedsheet changes until the problem is outgrown.
- Alarms: About 50-75 % of children over 6 years who use an alarm 12-16 weeks will stop bedwetting. Alarms can be purchased from a bedwetting supplier and cost $50-100.
- Medications: Medications are considered second choice treatment after alarms. Desmopressin (antidiuretic) will reduce wet nights in 50% of children. Imipramine is less commonly used and should be used only when other methods fail.
- Develop a routine for washing sheets that does not embarrass your child, but might include having your child help in age appropriate ways. For instance, younger children can help put their clothes and sheets in a hamper, older children can put the clothes and sheets in the washer and help make the bed.
- Keep the area from the bed to the bathroom clear of toys and other obstacles and well lit so a child can easily get to the bathroom if child does wake before wetting.
- Ensure a good night's sleep. Being tired increases the risk of deep sleep and bedwetting. Many kids don't get enough sleep. Click here for sleep requirements by age.
What not to do:
- Awakening the child to toilet in the middle of the night may be counter-productive, since the child may then be more tired, sleep more soundly, and be more likely to have an accident.
- Punishing the child or belittling the child is counter-productive. It lowers self esteem and the behavior is NOT controllable by the child, so the child cannot avoid wetting the bed and being subjected to more punishment and embarrassment.
When to see us:
- All children who were previously dry at night and start wetting the bed
- Children who are upset because they wet the bed and want treatment
- Children over 12 years of age who wet the bed
- Children who have daytime accidents
- Children who constantly leak urine
- There are signs of sleep apnea, snoring, tooth grinding, or other sleep disturbances
- Signs of infection
- Other behavioral changes or concerns of abuse