Narayana Health Care

Bedwetting or nocturnal enuresis is the involuntary urination while sleeping. It is common in young children and discontinues automatically without causing any seriousness.

Urine incontinence in children mainly occurs due to developmental issues. A child’s bladder is not matured-enough to store urine throughout the night. Sometimes, children have not yet developed the ability to wake themselves up when their bladder fills in the night. The bladder is a muscular sac that expands to hold the urine and contracts after urination.

What is the average age when bedwetting stops?

The age varies and is different for every child. In general, a child becomes toilet trained between 2-4 years. Most children can stay dry at whole night when they are 5-6 years old, but some children wet the bed occasionally until they are 10-12 years old. When a child’s body matures and nighttime bladder control starts, they are less likely to wet the bed at night. Till when the children reach their teen years, they outgrow bedwetting problems. But, if the problem persists after the maturation of their bladder control, the doctor defines it as primary enuresis.

We assume that bedwetting happens only in young children, but it can also occur in grown-ups. Nocturnal enuresis in teens or adults is due to depletion of bladder control during the night. Secondary enuresis happens when nocturnal enuresis reappears in teens after at least six months of bed wetting free period. It can be due to various diseases and should be the prime concern for parents.

Causes of bedwetting

Primary enuresis or urine incontinence during the night after the age when a child learns to control their bladder is a problematic situation. Diurnal enuresis is involuntary urination during the daytime. Secondary enuresis in teens can be due to various reasons. Some of the causes of bedwetting are:

• Relatively small or underdeveloped bladder in children that unable to hold all urine produced during the night.
• The nerves controlling the bladder are not fully mature in children, which fail to awaken the child at night for urination.
• A developmental or structural defect in the urinary system or nervous system can cause bedwetting in children.
• The hereditary pattern can be a cause of enuresis. If one of the parents has urine incontinence in early adolescence, their children have a higher chance of getting the same problem.
• Antidiuretic hormones (ADH) play a crucial role in producing less urine during the night. But in some children, their bodies don’t make sufficient hormones, which leads to too much urine production during sleep and bedwetting.
• Too much water intake during evening or nighttime can also cause enuresis.
• Over-consumption of caffeinated drinks causes a person to pee often.
• It is also a symptom of obstructive sleep apnea in children.
• Infection in the bladder and urinary tract makes it difficult to control the emptying of the bladder.
• Frequent bedwetting can be the first sign in children with diabetes.
• Chronic constipation, as the same muscles control urination and stool expulsion and constipation can cause dysfunction in muscles and nocturnal enuresis.
• Neurological conditions, such as after a cerebral stroke
• Benign prostate hyperplasia
• Psychological problems, such as stress, anxiety, and attention deficit hyperactivity disorder (ADHD), can cause bedwetting.

When to see a doctor

Bedwetting is common in young children, and they get rid of it on their own or with little help from parents or family members. Sometimes, bedwetting is a symptom of an underlying disease, which requires medical intervention. Consult a medical health provider if your child:

• Still pee in bed after the age of 7 years
• Start urinating in bed again after a few months of being dry at night
• If bedwetting accompanies by pain, red or pink urine, unusual thirst, snoring, or constipation

Treatment of bedwetting

The doctor recommends various treatment approaches depending on the underlying cause, including:

• Lifestyle change: Limiting fluid and caffeine intake in the evening may help in some cases. A habit of going to the toilet before sleeping reduces the bedwetting chances. Avoiding situations, such as watching horror episodes at night or family tension, may also be helpful.
• Encouragement: Throughout the whole day, motivate your child to use the toilet, so they can avoid a feeling of urgency and break the habit of wetting the bed.
• Motivate double voiding before sleeping: It is a reliable method in which urinating at the starting of the bedtime routine and then again just before sleep. It helps your child immensely if bedwetting is not due to any underlying cause.
• Talk to them: Sometimes, stress or other depressing situations can cause bedwetting. Talking to them and relieving their stress improves the enuresis.
• Bedwetting alarms: The doctors recommend these alarms to treat teens with nocturnal enuresis. A buzzer goes off when a person starts to wet the bed then the child can turn off the alarm and go to the toilet without wetting the bed too much. It can take a few weeks for the body to learn a new habit, and eventually, you can train your child to get up from sleep for urination without the help of an alarm.
• Medications: The healthcare provider prescribes medicines according to treat the underlying diseases. These drugs are very effective, and your child will have relief from the bedwetting situation.

With the assurance and support from you and family members, your child can easily prevail against bedwetting and have dry nights.