Why do some children wet the bed at an age where many others have long been able to sleep through the night without accidents?
There are several theories, and no one single answer to this question. Different circumstances can impact different individuals and while many children won’t ever have a bedwetting problem, for those who do it can become a significantly distressful situation both for your child, and for the whole family who will grapple with how to fix this issue and restore confidence and calm into what is likely to be an anxious and upset child.
The longer the bedwetting goes on for, the more severe impact it’s going to have on the entire family.
In kids and adults who don’t have a bedwetting problem, a strong urge to urinate during the night will result in waking up and being able to visit the bathroom without any accidents.
Bedwetting sufferers don’t wake up – the message isn’t getting from the bladder to the brain. The result is wet sheets and morning distress for both child and parents.
Overactive bladder is another potential theory behind bedwetting in some children, as well as teens and adults. Overactive bladders result in a more regular and more urgent need to urinate – even if the bladder is not full.
Medical experts also believe a chemical called vasopressin can be connected to bedwetting in some cases. Vasopressin is produced in the brain and it sends a message to the kidneys to produce less urine.
Normally, higher levels of vasopressin will be present during the night, resulting in less urine production by the kidneys at that time. In children (or adults) who wet the bed, this doesn’t happen and as a result, excess urine is being made during the night while sleeping.
Older kids who are experiencing bedwetting – those aged 9 and over – can experience significant distress and a feeling as though this problem is never going to go away and allow them to live a normal life.
A 10+ child who is still wetting the bed is in the minority, but it by no means indicates that there is anything seriously wrong.
Once medical causes have been ruled out as a cause of bedwetting in a child of this age, other possible reasons can be considered and addressed.
In some cases there may be an obvious trigger or underlying reason for the child still wetting his bed at this age. At other times, it could be something that runs in the family.
That doesn’t mean it’s untreatable; it just means you will need to look into the various training techniques available until you find something that works for your child. As in most causes, bedwetting alarms provide the quickest, most accessible and most effective home treatment for bedwetting for children and teens of any age.
Any child who wets bed every night is going to experience a high degree of anxiety and stress – taking care of a child’s mental health in this situation is vital.
As they get older, they will be wanting to attend camps, sleeping over at friend’s house, and other social events that he may be too nervous and embarassed to attend because of nocturnal enuresis.
The effect on the psychology of a child in these circumstances is quite negative, and can result in them becoming withdrawn and depressed. Needless to say, focusing on both getting to the bottom of halting the bedwetting, plus instilling a positive frame of mind in the child is so vital at this stage.
Some of the reasons why a child will wet the bed include:
Like many disorders, bedwetting can indeed run in the family. If either parent had a bedwetting issue when they were a child, then there is a chance that your child can also experience the same problem. There is nothing you can do about genes, but there are certainly things you can do to essentially train your child to stop their bedwetting. This can include behavioral therapy as well as effective devices like bedwetting alarms.
Smaller than normal bladder capacity or increased urine production
A child with a small bladder capacity will have trouble holding in what would normally be considered a normal amount of fluids. On the flip side, even if the bladder capacity is a normal size, some kids have a low level of a particular hormone (vasopressin) which works to concentrate and reduce urine volume at night so these kids end producing twice the amount of normal urine each night – something even a normal bladder capacity will struggle to contain.
Heavy sleeping is a trait that can often be seen in children who wet the bed. These children are often more difficult to wake up, and parents may have noticed this being the case over the years. While having a good sleeping child is every parent’s dream, if it comes with an issue of bedwetting and this is believed to be a contributing factor, steps may need to be taken to in order to help the child develop a habit of being able to wake when their bladder is full.
Can sleep apnea cause bedwetting?
There is a known link between sleep apnea and bedwetting.
While not every person with sleep apnea will wet the bed, and not every person who wets the bed will have sleep apnea, a relationship has been found between the two conditions which had led experts to be confident that a sleep apnea problem can directly influence bedwetting.
A person who has sleep apnea suffers from difficulty in breathing whilst asleep.
This leads to disrupted sleep patterns as well as a shifting of focus for the brain.
Where normally the brain would be at rest when a person is sleeping and thus able to direct resources to controlling bodily functions like bladder control, the brain’s of people with sleep apnea are working overtime just to take in oxygen.
This removes the brain’s energy away from basic bladder control and can bring about a resulting loss of control of the bladder; or a wet bed.
Sleep apnea and bedwetting in children
Sleep apnea is often seen in adults who are overweight.
However this is not the only cause of this all too common sleep condition.
In children, sleep apnea and snoring can come about if the adenoids or tonsils are enlarged, because the airways become blocked. Your doctor can advise whether these common issues are contributing to sleeping difficulties in your child.
A common procedure carried out on children is a removal of the enlarged tonsils and adenoids so that the airways can be cleared.
This not only improves the breathing of the child, but can bring about a total end to bedwetting if the cause of bedwetting was directly related to sleep apnea and breathing difficulties during sleep.
These two procedures are called a tonsillectomy (tonsil removal) and adenoidectomy (removal of the adenoids).
These procedures are not carried out solely to stop a bedwetting problem, but instead to resolve a sleep apnea problem. This may or may not improve the situation with a child wetting the bed, but is a first step to take in the process (and important for overall health).
Your doctor will be able to conduct diagnostic sleeping tests on your child to determine whether there is in fact sleep apnea occurring, and whether it could be a contributing factor – or even a direct cause – of your child’s bedwetting problem.
Sleep Apnea and Bedwetting in Adults
Sleep apnea has the effect of sending a signal to the brain to jolt the body awake, because the bloodstream and the brain are not receiving enough oxygen due to a blockage of the airways during sleep. This “flight” response then results in the brain receiving a signal to empty the bladder of fluids. What results then, is involuntary urination just before waking up.
If you suffer from sleep apnea, or suspect that you or your child does, seeing a doctor and arranging a sleep diagnostic test is the best place to start.
Because sleep apnea can have such a negative effect on all aspects of life (without quality sleep, mental and physical health suffers), getting a diagnosis and treating the problem is vital. Fixing a bedwetting problem that is being brought upon by sleep apnea is of course a motivating factor – but so should be the rest of your or your child’s health.
There are many treatment options for sleep apnea in both adults and children, ranging from lifestyle improvements such as exercise to reduce weight, to devices that can be worn while sleeping which help to open the airways.
The path you take to fix your sleep apnea, or to stop it happening in your child, will depend on how severe the problem is as determined by your doctor.
Outcomes For Bedwetting When You Treat Sleep Apnea
The good news is that if you believe your child’s bedwetting problem is being caused by sleep apnea, addressing the underlying sleep disorder problem will go a long way to potentially permanently curing the bedwetting issue as well.
If a child is still regularly wetting the bed after a sleeping disorder or physical health issue is diagnosed and treated, then it’s time to take additional steps to address the bedwetting issue directly.
This can include trialing the use of a bedwetting alarm, which is a simple, affordable and non-invasive way of training the brain to wake up during the night when a person has the urge to urinate.
It is certainly worth a try, with millions of people using these low cost alarms and seeing success at permanently eliminating bedwetting within 4-12 weeks.
ADHD and Bedwetting
Bedwetting and ADHD are two common conditions that can affect young people.
Statistics show that children who suffer from ADHD or ADD have a higher rate of enuresis (bedwetting).
Most children with a history of bedwetting will no longer experience the problem by the time they are 18 years old, those who also have ADHD have a higher rate of enuresis after they are 18.
Is there a relationship between these two conditions?
Experts don’t believe that one condition causes the other. More research is needed to find out just why there is an increase in clinicians reporting incidences of bedwetting in children with ADHD.
However, bedwetting could sometimes be a result of the stress and negative social effects that children with ADHD experience. Then, once bedwetting becomes a regular problem this can then cause the symptoms of ADHD to worsen due to the anxiety and embarassment surrounding the problem of wetting the bed.
This leads to a cycle of effects on the child whereby two different conditions are negatively contributing to each other.
Those with attention deficit disorder may have poor control of their impulses which can make some of the treatments for wetting the bed difficult to implement or maintain. Behavior modification and psychotherapy, for example, require the child to be able to participate and focus which can be difficult for those with ADHD.
An additional complication can relate to medication that ADHD sufferers may be taking, and whether these could be contributing to a worsening of the enuresis problem.
One of the medications that may be prescribed to children with a chronic bedwettign problem is DDAVP or Desmopressin Acetate. This medication requires the child to not overdo their fluid intake when using the medicine. For children with ADHD, controlling their often impulsive behavior can present some challenges when it comes to monitoring how much they are drinking.
Because serious effects can come about when intaking too much fluid when using DDAVP, such as seizures, extra care needs to be taken if a child with ADHD has been prescribed this medicine.
Your doctor will be able to explain any potential risks, and whether he or she believes that this medicine is suitable for bedwetting in the event that your child has also been diagnosed with ADHD.
Bedwetting and Diabetes – Is There a Link?
People with diabetes who also experience bedwetting are right to wonder whether there is a link between the two. Can diabetes be a cause of bedwetting in adults?
The short answer is: yes, diabetes is a known cause of adult bedwetting.
Healthline notes that Type 1 Diabetes is the third most common cause of enuresis or night time incontinence (what we simply call bedwetting).
Because glucose isn’t being processed correctly in the body of someone who is diabetic, increased urine production is often the result. This is the underlying cause of what can make a diabetic person start wetting the bed.
Managing diabetes is the key to eliminating bedwetting in this situation.
When an underlying medical condition is the likely or certain cause of a bedwetting issue, then the main focus should be on managing the cause, rather than the symptom.
Naturally, you will still want to take all possible actions to cope with bedwetting while it’s occurring, and minimizing its impact upon your life. This can include making use of a waterproof mattress or bed pad.
Diabetes insipidus and bedwetting
One type of diabetes – diabetes insipidus – brings about a need to pass much more urine than a normal person, as well as excessive thirst. In extreme cases this can make a sufferers have an urge to urinate as often as four times per hour – or every 15 minutes. Clearly this can cause a major disruption to normal life. It can also make sleeping difficult. See your doctor to confirm or rule out diabetes insipidus, or any other form of diabetes or other medical condition before you embark on a treatment plan for nocturnal enuresis.
Bedwetting can come about as a result of diabetes for obvious reasons: an excessive amount of urine is being produced and excessive amounts of liquid are being consumed because of increased thirst.
This can affect both children and adults: anyone who is a diabetic may be at risk of nocturnal enuresis or urinary incontinence.
Studies have found a definite link between bedwetting or incontinence and diabetes. For example, a study in the International Urogynecology Journal and Pelvic Floor Dysfunction that was undertaken on 1381 adult women who have diabetes mellitus concluded that “diabetes mellitus is an unarguable independent risk factor for urinary incontinence”. The study focused on several forms of incontinence.