Bedwetting - Nocturnal Enuresis

BED WETTING: HOPE FOR EMBARRASSED KIDS

OVERVIEW: The term "bed wetting" refers to a condition in which a child who stays dry during the day involuntarily urinates during sleep at least once a month or more. Secondary bed wetting refers to wetting the bed after 6 months or more of staying dry at night. If the child has never been able to stay dry at night, it's called primary bed wetting. By the age of 6, only about 10 per cent of children still wet the bed. Most of these are boys. Another name for bed wetting is nocturnal enuresis. While old wives' tales might suggest that it stems from psychological problems, in reality, bed wetting causes psychological problems instead of the other way around.

CAUSES: Several factors contribute to a child being a bed wetter. There is a strong genetic predisposition to the condition, so if one parent was a bed wetter, the child is more likely to have the problem. Basically, the child cannot recognize and wake up to the sensation of a full bladder while asleep. In some ways it is a maturational problem, since babies urinate all the time, but most adults don't need to urinate during the night. A child who is a bed wetter might have a smaller or weaker bladder than others, or they might drink too much late in the day.

SYMPTOMS: The primary symptom of nocturnal enuresis is that the child wets the bed after the age that most children have learned to stay dry at night. This condition leads to other symptoms, however, particularly psychological ones. Children who wet the bed often have low self esteem. If the parent or caretaker is impatient, child abuse is sometimes the result. If the child happens to have diabetes, bed wetting can be more likely because diabetes makes people need to urinate more frequently. In many cases, though, children who wet the bed are simply very sound sleepers, and spend too much time each night in Stage 4 sleep, which is the deepest kind.

DIAGNOSIS: A good child's physician will investigate a parent's claim the first time it is reported in the office. The doctor will find out if there is a family history of bed wetting. A thorough analysis of the child's eating and drinking habits should be done. Often, it is found that the child drinks a lot of caffeinated drinks like cola during the day. These drinks not only fill the child's bladder with fluids, but also work as diuretics. The physician should also evaluate the emotional adjustment of the child, and whether there is evidence of verbal or physical abuse.

TREATMENT OPTIONS: Bed wetting almost always cures itself if you give it enough time. This answer does not meed young people's needs, though, when they are in late childhood and want to stay overnight with their friends. Eliminating diuretic drinks can help control the problem. There are a number of books and methods on the market. Many people have found success by using an alarm to wake the child during the night and establish a more normal cycle of sleep stages.