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What is bed wetting?

Bed wetting is involuntary urination during sleep.

Children develop control over the bladder at different ages, but most children naturally stay dry through the night by age 5 or 6.

Bed wetting is the most common urological problem and one of the most common pediatric problems as well. It is considered primary bed wetting when a child has not managed to stay dry at all, and secondary when a child has started to wet the bed again after staying dry for a long time.

Wetting the bed can be an embarrassment and a very upsetting thing, especially for older children, teenagers or adults.

What causes bed wetting?

If you have recently started to wet the bed, it might be a result of these conditions:

  • Infections of the urinary tract cause secondary bed wetting and are not the cause of primary bed wetting. Urinary infections mostly cause problems during the day, when you might have an urgent need to urinate, frequent urination, pain or a burning sensation while urinating.
  • Diabetes - nocturnal enuresis can be the presenting symptom of Type I Diabetes.
  • Stress and anxiety are the main causes of bed wetting in older people. Stress is not the cause of primary nocturnal enuresis.
  • Drinking large amounts of alcohol and coffee - they increase urine production.
  • Diuretics
  • Deep sleeping

If you have always had problems with bed wetting it might be as a result of:

  • Producing more urine at night
  • Lack of muscle and nerve control
  • Attention deficit hyperactivity disorder (ADHD) - children with this disorder have a greater risk to have problems with bed wetting
  • A neurological-developmental delay is the most common cause of bed wetting among children. Most children have a delayed ability to control urine, but don't have any other development issues.
  • Genetics - children who have parents that had the same problem with bed wetting have a chance to have the same problem. Bed wetting is associated with chromosomes 13q and 12q, also possibly with chromosomes 5 and 22.

How is bed wetting managed?

Treatment usually is not needed for bed wetting in children younger than age of 7, because most will learn to control their bladder over time without treatment.

If your child is over the age of 7, if you are a teenager or an adult, treatment may help.

Treatment depends from the cause of the problem.

If you have a urinary infection you will need antibiotics.

If it is because of consumption of a large amount of caffeine and alcohol try to reduce the amount you use.

Other treatment possibilities for bed wetting are:

  • Motivational therapy - when parents and child work together on motivating the child to stay dry at night.
  • Moisture alarms
  • Tryciclic antidepressants
  • Desmopressin tablets are a synthetic replacement for antidiuretic hormones, which reduces urine production during the night.

Combined treatment is often the best resolution.

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