Causes of bedwetting include:
Developmental delay in brain arousal to signals from the bladder during sleep
All children with nocturnal enuresis have an arousal disorder that interferes with their ability to wake to a full bladder.
All children with nocturnal enuresis have an arousal disorder that interferes with their ability to wake to a full bladder.
Studies show bedwetters have similar sleep patterns to non-bedwetters.
However when arousal levels are compared, bedwetters generally do not
"come to the surface" to the same level as non-bedwetters.
Treatment with a bedwetting alarm is very effective. The alarm will
sound at the moment of wetting, alerting the sleeping brain. Gradually
the brain is trained to respond to bladder signals and dryness results.
Even the deepest sleepers can learn to hear an alarm.
The key is motivation and understanding.
Large volume of urine produced during sleep
A hormone is normally produced during sleep which reduces the volume of urine. This is called anti-diuretic hormone (ADH).
Small bladder capacity
In addition to the arousal disorder which affects the brain response to
bladder signals, some bedwetters have a small bladder.
Emotional upset and stress
Can trigger bedwetting as a symptom.
Production of large volume of urine during sleep
A hormone is normally produced during sleep which reduces the volume of urine. This is called anti-diuretic hormone (ADH).
In addition to the arousal disorder which affects the brain's response
to bladder signals, about 60% of children with nocturnal enuresis or
bedwetting do not make this hormone. Therefore they produce a large
volume of urine during sleep, which exceeds their bladder capacity.
However, once the bedwetter has trained their brain with a bedwetting
alarm to wake to bladder signals during sleep, they can stay dry - they
just need to go to the toilet more often than someone who produces ADH.
Once night control is established, ADH production is often activated.
In addition to the arousal disorder which affects the brain response to
bladder signals, some bedwetters have a small bladder.
A small bladder cannot hold as much urine as a normal sized bladder.
Nor can a bladder which has a tendency to go into muscular spasms
(irritable bladder).
A child with a small or irritable bladder will also need to urinate
frequently during the day, often with urgency. A medical assessment
should be made if the child suffers from day-wetting.
Once the bedwetter has trained their brain to wake to bladder
signals during sleep with a bedwetting alarm, they can stay dry - they
just need to go to the toilet more often than someone with a normal
sized bladder.
Once night control is established, bladder size will often increase as a consequence.
Emotional Factors
Emotional upset or stress can bring on bedwetting as a symptom.
Someone who has previously been dry may start to wet the bed. This is called a relapse. Often there is no obvious explanation for this.
Emotional factors can range from a relatively minor event, such as a child starting school (and possibly being more tired), through to major events, such as abuse, or loss of a parent.
Once the distress has been removed or adjusted to, the continuing symptom of bedwetting can be treated.
Definitions of bedwetting
Wetting during sleep occurs within all cultures
and races. There are different perspectives on when this is a problem
depending on the environment of the child.
Thus the age that parents start to become concerned about their child's bedwetting varies, depending on the frequency of the problem, and the level of their concern. Generally speaking, parents start seeking assistance when their child is still wetting during sleep more than once a week and they are older than six years of age.
Incidence of bedwetting
Approximately 15% of bedwetters become dry
spontaneously each year. Your dilemma is that there is no way of
knowing when this will happen.
Percentage range of children and adults affected by bedwetting
| Gender |
5 years |
7 years |
9 years |
>16 years |
| Male |
15-22% |
15-19% |
9-13% |
1-2% |
| Female |
9-16% |
7-15% |
5-10% |
1-2% |
Adult bed wetting, continuing on from childhood bedwetting, is estimated at 1-2% of the population.
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