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Nocturnal Enuresis: Understanding Bedwetting in Children

Nocturnal Enuresis Header

Nocturnal enuresis is the technical term for bedwetting. It occurs in children who cannot control their bladder while they sleep. This control develops in children at different ages and before the age of five, bedwetting is so common it isn’t actually considered a condition. However, some children still wet the bed at age 6 or 7 and some even have the problem at age 10 and older. In fact, even a small number of adults have episodes.

Nocturnal enuresis can cause a child to feel embarrassed and anxious. It is detrimental to both their self-esteem and self-perception, which can in turn affect interpersonal relationships and school performance. A child with the condition may be uncomfortable with or unable to spend the night at a friend’s house, and when confronted by the issue they may feel compelled to lie in fear of being picked on.

A child who wets the bed occasionally is not said to have nocturnal enuresis. The statistic given for the condition is wetting the bed more than twice per month. With many cases, it occurs every night or most nights. The only reliable diagnostic test for nocturnal enuresis is a urinalysis. 75% of nocturnal enuresis cases are what is known as Primary Nocturnal Enuresis. These children have never been known to have consistent dry nights. Nocturnal enuresis is thought to be genetic as about half of the children who wet the bed have parents or other family members who had the same problem in their youth.

There is also a condition known as Secondary Nocturnal Enuresis that develops after a child has kept a dry bed for at least six months. In some cases, Secondary Nocturnal Enuresis is caused by psychological trauma. Television drama shows often point to abuse as the cause for this trauma, but other problems such as divorce, death of a loved one or bullying are common. There is also the instance of an over-active bladder. One sign of this condition is if your child urinates frequently during the day. In rare cases, SNE is caused by a bladder infection or sleep apnea.

Why is nocturnal enuresis more common in children? A child’s brain is still developing. The fully-grown brain is trained to wake the body when the bladder is full, however this reaction does not usually develop until a few years into a child’s growth. With this in mind, it is not a child’s fault if they wet the bed. They simply have not developed the trigger to wake them up when they need to use the bathroom. It is important that parents take a positive and progressive approach to bedwetting. A child cannot help wetting the bed, so they should not be punished. While it is certainly not a guaranteed cure, making sure your child keeps from drinking fluids within the few hours before bed can keep them from urinating in their sleep. It may also help to make sure a child uses the bathroom before they go to sleep. There are medications available, but should only be used after consulting a doctor.

Bed Sheets drying on a Clothesline

Embarrassed Little Boy

There are treatments that serve as alternatives to medication. A more recent development is the bedwetting alarm, a moisture-sensing device that attaches to pajamas and will wake a child when they begin to urinate. This will train the child’s brain to respond to a full bladder by waking up. The recommended approach for using a bedwetting alarm is for a child to continue using it until they have three straight weeks of dry nights and then use it for two weeks more. Many bedwetting alarms have cords and while they are designed to prevent strangulation, the risk is always present. Some parents choose to combine medicine with the bedwetting alarm, which produces the best results. Even though a child cannot help bedwetting, it is a nice treat to reward them when they have a dry night. It is unlikely to solve the problem, but it may cause the child to take extra precaution to use the bathroom before bed and it may result in a few more dry nights each month. It will also give the child precious moments of positivity and optimism.

  • Pediatric Urology: Nocturnal Enuresis (PDF)

  • Bedwetting

  • Bedwetting info from Stanford

  • Bedwetting info from KidsHealth (a great site to share with your child!)

  • Wet Buster (another fun site for kids!)

  • Evidence-Based Pediatrics

  • What is Nocturnal Enuresis?

  • Urinary Incontinence

  • Understanding Enuresis (PDF)

  • Bedwetting & Types of Enuresis (PDF)

  • Bedwetting Health Information

  • A Case Study on Enuresis


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