Bed-wetting or enuresis is an embarrassing and uncomfortable problem for children. It's considered normal up to and including the age of four. It's when it continues into school age and even adulthood that the embarrassment and discomfort escalates.
Bed-wetting may occur every night, a few nights a week or even only occasionally. It usually occurs during the first few hours of sleep, but can occur any time during the night.
Bed-wetting has many causes, one of which may be psychological problems. Recently, however, thought on this has been reversed. With the socially embarrassing implications of enuresis, it's quite possible that the bed-wetting causes the psychological problems, not the other way around.
Enuresis is a common childhood sleep disorder. In fact, it's estimated that, by age five, when children should have gained complete bladder control, 1 in every 6 children still suffers from nightly bedwetting. This gradually diminishes to 1 in 10 at age seven, 1 in 40 for teenagers, and even continues into adult life where approximately one in every 100 people still has the problem.
There are two types of enuresis, primary and secondary. In primary enuresis, control of the bladder has never been attained. In secondary enuresis, control the child once has is, for some reason, lost. The causes of enuresis can be either physical or psychological.
- Neurological (nervous system) disorders - Examples: ADD or ADHD, Epileptic seizures
- Urinary tract infections - common in children and adults, with its accompanying burning sensation and the constant need to void urine.
- Anatomical problems - This would include any deformity of the bladder or of the outflow tract.
- Metabolic conditions - Example: Diabetes, constipation
- Stress - Examples: The loss or a parent or someone else close to the child, a divorce or marital strife, a serious illness of someone close to him
- Repressed anger: The inability to express his anger because of fear he will be punished. Sibling rivalry.
- Achievement concerns - Is he being pushed too hard to achieve good grades? Another example is a parent who is urging his/her child to excel in a sport in which he is not really proficient.
Enuresis can also be an inherited trait. If one or both parents or even grandparents suffered from the problem, then it is common for a child to also suffer from the disability.
And it is indeed a disability, both uncomfortable and humiliating. It's especially humiliating if the child's peers should discover the bedwetting. Therefore, things like sleepovers and weekend camping trips with friends have to be avoided.
Another common cause of bedwetting is another sleep disorder called "deep-sleep disorder." This causes the child to sleep so soundly that he is not aware that he has to go to the bathroom and doesn't have the ability to wake up and get out of bed. Indeed, he sleeps so soundly that, when he does wet the bed, he isn't aware of it. The child usually outgrows this disorder and is able to control his bladder.
- Adjusted bedtime regime - Make sure the child makes a bathroom visit before going to bed. it's also a good idea to rouse him two or three times a night and take him to the bathroom. Eventually, this should become habit forming and he will get up on his own. Also, restricting liquid intake for a few hours prior to bedtime is sometimes beneficial.
- Moisture sensitive devices - These are devices that sound an alarm at the first hint of moisture. Then the parent can get the child up and take him to the bathroom.
- Medication - Some success has been reported with the use of ADD/ADHD medication, which is not surprising as there is sometimes a connection between these disorders and enuresis. Antidepressants have had some success as have bladder antispasmodics. Another possibility, still in the testing phase, is DDAVP, a synthetic form of the hormone varapressin that helps control the amount of urine returned to the bloodstream.
It is important to do all that you can to help a child, teenager or adult who suffers from enuresis. As well as being unhealthy and uncomfortable, the disorder is also depressing and demoralizing. By all means, try some of the suggestions above, but also seek medical advice.
Published On: July 07, 2007