Bedwetting (Nocturnal Enuresis) - Pediatric
What is bedwetting?
Bedwetting (nocturnal enuresis) is the nighttime release of urine by children older than 6. Nearly 90 percent of children who wet the bed have always done so. Some children may have at least six months of nighttime dryness and then start wetting again.
How common is it?
Wetting the bed is a common problem. It affects about 5 to 7 million children in the United States. It occurs three times more often in boys than girls. At 5 years of age between 15 to 25% of children wet the bed nightly. About 15% of children will stop wetting the bed with each year they age. By the age of 12, eight percent of boys and four percent of girls are still wetting the bed at night.
What causes bedwetting?
The cause is not known. Recent studies suggest there may be many reasons for a child to wet the bed. Wetting the bed often runs in families. If both parents wet the bed when they were children, there is a 77% chance their child will wet the bed. If one parent was a bedwetter, the child has a 44% chance. If neither parent wet the bed, there is still a 15% chance.
Although children who wet the bed are very deep sleepers, this is not a sleep disorder. For reasons that are unclear, children who wet the bed do not wake up when their bladders are full. This may be due to the arousal center of the brain being slow to mature.
Diet can play a role. For instance, we know that caffeine irritates the bladder. It also causes more urine to be produced. Constipation and infrequent stooling will also play a role in nighttime bedwetting. A large amount of stool in the rectum will push on the bladder, making the bladder smaller and making it contract before it is full.
Wetting the bed is not a sign of a mental problem. Children who wet the bed are not lazy or bad. They have little control over this problem, and they should not be punished. With patience, knowledge, and positive reward for success, bedwetting can be managed and controlled.
How is bedwetting treated?
Bedwetting can be treated by being supportive, and using alarm therapy or medicines. In many cases, your doctor or nurse will suggest treatment that may include all three. Parents should restrict how much the child drinks two hours before bedtime. Children should not drink things with caffeine. Also, children who wet the bed should be advised to go to the bathroom before going to sleep.
Alarm therapy has a success rate of about 70%. A child will wear the alarm at night. A small clip is attached to the underwear. When a child begins to wet, the alarm goes off. This type of treatment requires a commitment from the family and child. It can have great success, but may take up to twelve weeks to work. Many insurances will provide payment for this type of alarm.
Your doctor or nurse may suggest a trial of medicine to control bedwetting. DDAVP (desmopressin acetate) is a form of a natural hormone produced by the body. It lowers the volume of urine produced at night. This drug works well in 50-70% of children who use it. Imipramine is also used to treat bedwetting. It belongs to a class of drugs called tricyclic antidepressants. How it works is not fully known, but it is thought to work in as many as 50% of children who wet the bed. Imipramine does have some side effects, but when used properly it is very safe.
What do I do if I have more questions?
Call the Urology Clinic between the hours of 8 – 4:30, Monday – Friday at (608) 263-4757.
If you live out of the area, call 1-800-323-8942. Ask for the Urology Clinic.
For more information:
The websites listed below provide good information about bedwetting, as well as how to order the bedwetting alarm.
The Bedwetting Store
Medication for Bedwetting – DDAVP by Aventis
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/06/2010
Copyright © 05/06/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6103
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