Nocturnal enuresis - bedwetting and sleep

Nocturnal enuresis (Bed wetting)

What is enuresis?

Enuresis is the medical term for bedwetting. Up to the age of five, bedwetting is a normal occurrence due to the fact that the child may not yet have obtained full bladder control. However, enuresis which persists later in childhood and even into adult hood may require further investigation.

In most cases, bedwetting does not have a medical cause and 90% of cases are caused by psychological or unknown reasons. Nevertheless, enuresis can have a significant mental impact causing a great deal of embarrassment and stress particularly in adults and older children. Whilst bedwetting is generally thought of as a childhood problem, it can occur in people of all ages and both sexes.

Bedwetting in children

It is extremely common for children to wet the bed in the night, and most children will have grown out of bedwetting by around the age of 10. Occasional accidents are very common amongst children of all ages, with enuresis only being considered regular if it occurs on at least two occasions each week.

It is important to stress that wetting the bed poses no threat to a child’s physical health, although it may have an impact on their confidence and self-esteem.

In many cases, bedwetting is the result of a simple delay in achieving full bladder control. Occasionally nocturnal enuresis will persist into the teenage years, most often in boys. It is important not to punish or humiliate a child who wets the bed as this can exacerbate the problem. Reassure the child that this is an extremely common problem and that there is no need for embarrassment.

Interestingly, research has found that bed wetting often runs in families and it is not uncommon for siblings to share the same problem. In many cases, a parent will also have a history of bedwetting in their formative years. Secondary nocturnal enuresis is the term used when a child who has previously been dry for several months suddenly starts to wet the bed.

The most common reason for this is some kind of psychological stress for example bullying or family problems. If your child suddenly begins to wet the bed when they had previously been dry, some gentle questioning may reveal a hitherto undisclosed concern or issue. Paradoxically, secondary nocturnal enuresis can also occur when the child feels under pressure not to wet the bed.

Bedwetting in adults

Bed wetting in adults occurs in around 2 % of the population and mainly affects males. As in children, stress and anxiety can significantly contribute to the problem. Other causes include bladder infections, problems with muscle and nerve control, excess intake of coffee or other diuretics late at night, diabetes, prostate problems, sleep apnoea or medications such as sleeping tablets which may deaden some of the signals that generally wake us when we need to urinate.

Excess alcohol can also cause such a sound sleep that the sleeper does not recognise the need to urinate. Occasional bed wetting does not generally signify a problem but when it starts suddenly or occurs regularly, it is best to seek medical advice as it may reveal an underlying medical problem.

One common scenario in adults is a when the sleeper dreams that they are urinating and they wake to find they have urinated in the bed. This type of bedwetting is not generally associated with any medical problem and may be down to a disturbance in REM sleep.

Treatment for enuresis

In children, enuresis is generally short lived and often does not require any special treatment other than reassurance. However, there are options for treating bed wetting should it become a problem. Simple measures such as restricting fluids prior to bed time and ensuring the bladder is fully empty before sleep can be an effective first step. A moisture sensitive bed wetting alarm is effective in up to 75% of patients, sounding a warning buzzer or alarm the moment the user starts to urinate.

In more severe cases medication such as Darifenacin can be prescribed which works by decreasing the acetylcholine receptors which control the desire to urinate. In children, a drug called Desmopressin which reduces the amount of urine produced can be very helpful. Whilst, enuresis can be an embarrassing and distressing condition, there are many effective treatments for it, and your doctor will be able to advise you on the best course of action.

  1. I have had bed wetting problems since childhood and they have gotten worse in past years,at 38 years old what used to be once a month now is nearly every night and I have tried everything! I have come to conclude that a diaper at night is the only solution. Most all morning’s I wake with the diaper soaked and no knowledge of it happening but at least it isn’t the bed soaked.. this has ruined my relationships and seems no woman will understand. I wish people were more compassionate

  2. I too had a dream where I had to go into the men’s room to pee, strangely enough, I’m not a man….. Which really threw me off. Anyways, I did get to go finish peeing.

  3. Hi,!i have a bed wetting problem for a long time and it happens some tims

  4. I been having this problem as long as I can remember but now its different I’m having dreams I’m going and I get up the bed is wet my girlfriend said she ok with it but I feel like she is just saying that to make me not feel bad but I hurts me everytime it’s not all the time it happens maybe once every 3or4 months and idk what to do I dont drink before bed and it still happens I tried so many different things and nothing is working this is so embarrassing like idk what to do this is very upsetting like I feel like I can even sleep over because I’m afraid of this happening this is ruining my life I need help

  5. Am so embarrassed about my present situation right now because am so afraid associating myself with people. Am 23yrs old and still bed-wet, I have tried several means to stop bed-wetting but to no avail. It mostly comes with dreams or when am very cold, please i need help urgently.

  6. I am 62 years old and I have been having bedwetting issues most of my life. When I was younger, it happened if I drink too much alcohol but now. It usually happens when I dream I am on the toilet or searching for a toilet. I am supposed to wake up at that time but I don’t. Once I start using the toilet, and it seems as though I can’t stop in my dream. Once the toilet starts to overflow, I am already starting to go for real. I jump up to go to the bathroom. Sometimes I make it and sometimes I have started going in the bed. My husband is very understanding but I am embarrassed. I usually have that dream when I am stressed but not all of the time. I really need help.

  7. I can’t find anything that’s really helpful it happened literally once! I dreamed I was peeing woke up like instantly I stopped it and started to walk to the bathroom when it started again I thought “woah wtf am I pregnant, cause this was just like when my water broke” but nope I got to the bathroom and released a lot and I mean A LOT of urine… idk if I should be concerned about this or not….

  8. Only time I wets the bed when my ex boyfriend yells at me. It started after 4yrs of our relationship he beats and yells at me. We dated for 13yrs. I finally stop wetting the bed after we broke up. Start dating someone else and a year went by no bed wetting, until I ran into my ex we started sneaking around with each other and once again the fighting and yelling start again and once again I start wetting the bed but this time I almost did it with my current boyfriend but he woke me up in time cause he said I was tossing and turning like I was fighting with someone but I made it to the bathroom in time. I’m starting to believe I don’t need to be messing around with my ex anymore. That wasn’t the first time my boyfriend than woke me up cause of my nightmares he say and he wakes me up before I went myself.

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