Involuntary Urination In Kids – FAQs On Nighttime Bedwetting Parents Should Know

Involuntary Urination In Kids – FAQs On Nighttime Bedwetting Parents Should Know

Are you one of those parents whose elder children pee during the sleep? You might think that you are the only one who is going through this ordeal, but this condition affects many children. Let’s know all about bedwetting through these frequently asked questions.

What is bedwetting?

Bedwetting also known as nighttime incontinence or nocturnal enuresis is the loss of bladder control during the sleep. This can result in involuntary or unintentional urination while sleep, especially after the age when staying dry at night is usually expected.

Though bedwetting is perfectly normal, it can be an uncomfortable experience for both parents and children.

How common is bedwetting?

Most kids are fully toilet trained by the age of 5. And bedwetting till the age of 7 isn’t worrying, as at this age, your child might still be developing nighttime bladder control. According to studies, bedwetting above the age of 5 years is fairly common. It approximately affects almost 20 percent of 5-year old children and up to 2 percent of adolescent.

Though there isn’t any concrete population-based statistics in India, a study on sleep disorders reveal that there could be about 18 percent prevalence of bedwetting among children aged 3-10 years.

What causes bedwetting?

Bedwetting is typically a standard development stage for children, but in adults, it can be a sign of some underlying condition. Most common reasons behind bedwetting include:

  • Urinary tract infection
  • Small size of the bladder
  • Fear or stress
  • Enlargement of the prostate gland
  • Abnormal pauses in breathing during sleep (sleep apnea)
  • Constipation
  • Overactive bladder
  • Diabetes
  • Imbalance in anti-diuretic hormone (ADH)

What are the risk factors for bedwetting?

Bedwetting can occur in anyone, but boys are most likely to experience it as compared to girls. Other risk factors for bedwetting include:

  • Family history
  • Stress and anxiety
  • Attention-deficit hyperactivity disorder (ADHD)

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What are the symptoms of bedwetting?

There is no real specific age of developing complete control over the bladder. However, by the age of 5, most kids get fully toilet trained. After 7 years of age, it can be a cause for concern. Check for following signs and consult your doctor:

  • If the child wets the bed after the age of 7
  • If the child begins to wet the bed few months of being dry at night
  • Bedwetting accompanied by symptoms such as painful urination, pink or red urine, unusual thirst, snoring or hard stools

How bedwetting is diagnosed?

As bedwetting can be due to underlying condition, depending on the case, the doctor may perform:

  • Physical examination
  • Discussion of symptoms in detail, medical history, time of bedwetting and urinary habits
  • Urine tests for checking any signs of infection or diabetes
  • Uroflowmetry test to check the flow of urine and how much urine you make
  • Post-void residual urine test that measures how much urine is left after peeing
  • X-ray or other imaging tests for a detail look into the structure of the urinary tract

Does bedwetting causes complications?

Bedwetting typically does not cause any health risks. However, in some children, bedwetting can cause a number of issues including:

  • Rashes on genital area and the bottom
  • Guilt and embarrassment, resulting in low-self esteem
  • Loss of social activities such as camps and sleepovers

What lifestyle changes and medication are needed to manage bedwetting?

In most of the cases, children outgrow this habit on their own. However, if treatment is needed, the doctor can recommend following lifestyle and medication to treat bedwetting:

Lifestyle changes

  1. In children with small bladder, training to hold urine in the bladder can help improve its capacity. It helps strengthen the muscles in order to prevent involuntary accidents.
  2. Sometimes stressful events are responsible for bedwetting such as conflict at school or home, fear of punishment or some other major changes in routine. Talking to the child in a compassionate or praising them while they are dry can help them feel good.
  3. In adults, avoiding liquid intake an hour or two before bedtime can reduce the risk of unwillingly urinating while asleep. So make sure you empty your bladder before bedtime and avoid drinking anything after that.
  4. Avoiding or cutting on caffeinated or alcoholic drinks, especially in the evening can prevent bladder stimulation.
  5. Encourage double voiding in your child. It means urinating once at the beginning of the bedtime and again before going to sleep.
  6. Some people also use bedwetting alarm system. The device is attached to the underwear and alerts whenever the child begins to wet the bed.

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Medications

Bedwetting that arises from an underlying medical condition will require medication besides adjusting lifestyle. Based on the condition, the doctor may recommend:

  • Antibiotics for urinary tract infection
  • Anticholinergic medication such as oxybutynin, darifenacin and imipramine for calming down irritating bladder
  • For slowing night-time urine production, desmopressin can be recommended
  • Drugs that block hormone dihydrotestosterone (DHT) can reduce the swelling in the prostate gland

Besides, it is extremely important to manage chronic conditions such as sleep apnea and diabetes.

Tips on how to deal with wetness

Until you get control of bedwetting, following simple steps can be helpful in managing the condition:

  • Wear absorbent pads or underwear before going to sleep
  • Place a waterproof cover over the sheet and mattress
  • Use special lotions and skin cleansing product to prevent irritation

Most of the children will outgrow bedwetting by the time they reach the age of 7. At this age, the bladder will be fully developed and able to sustain pressure of the urine. Support from family members, teachers and friends can help a lot in overcoming bedwetting. Talk to a urologist in case for more information on this topic.

Sources

1. Bedwetting: What can make everyday life easier?(2018, April 05). PubMed Health read more
2. Bedwetting: Overview(2018, April 05). PubMed Health read more
3. Kiddoo DA(2012, May 15). Nocturnal enuresis read more
4. Bedwetting (enuresis)(2005, December). NCBI read more
5. What are the treatment options for bedwetting?(2018, April 05). PubMed Health read more
6. Treatment of Bladder Control Problems & Bedwetting in Children(2017, September). NIDDK read more