Bedwetting, also known as nighttime incontinence or nocturnal enuresis, is involuntary urination during sleep in anyone over 5 years of age. This sleep disorder falls under the category of parasomnia, which involves unusual and undesirable physical events or experiences that disrupt your sleep. Bedwetting is a common occurrence in children, but when they fail to grow out of it in typical developmental stages, it becomes classified as a sleep disorder.

Risk Factors For Bedwetting
There are two forms of bedwetting, known as primary and secondary bedwetting. Primary bedwetting is classified as someone who has never regularly stayed dry during sleep for six straight months. Risk factors for this form include gender, as boys are more likely to experience this than girls, and genetics, since children are more likely to have it if their parents and/or siblings had it as children. Primary bedwetting also occurs more often in people with attention-deficit/hyperactivity disorder.

Secondary bedwetting is classified as someone who developed the ability to stay dry at night and has done so for at least 6 straight months, then began bedwetting again at least twice a week for at least three months. This form is typically due to social or mental stress, so risk factors may include anxiety, parental divorce, physical or sexual abuse, and neglect.

Causes Of Bedwetting
There is no one cause that leads to bedwetting, and many instances of bedwetting have no underlying cause and are simply due to a failure to wake up from sleep when the bladder is full or a failure to prevent a bladder contraction during sleep. However, potential causes may include a small bladder, inability to recognize a full bladder, the person’s diet (certain food and drinks known as diuretics cause the body to produce more urine), chronic constipation, deep sleeping, and urinary tract infections (UTIs).

Bedwetting may also be the result of medical conditions such as obstructive sleep apnea, hormone imbalances like ADH insufficiency, diabetes, kidney issues, or a structural problem in the urinary tract or nervous system. Other potential causes of bedwetting include medication use, mental health disorders such as anxiety, or substance abuse.

Symptoms Of Bedwetting
Symptoms of primary bedwetting include accidental urination during sleep at least twice a week, and never having at least six months of staying dry during sleep. Symptoms of secondary bedwetting are similar, yet the difference is that there was a six month period of staying dry before symptoms resumed.

Although this sleep disorder can affect the person’s self esteem, it is usually not a cause for concern unless it comes along with painful urination, unusual thirst, pink or red urine, hard stools, snoring, daytime incontinence, constipation or lack of bowel control, or sleep issues such as being unable to be woken up. Bedwetting may also cause rashes on the genital area if the person continues sleeping in their soiled underwear.

Diagnosing Bedwetting
Diagnosing bedwetting is fairly simple, as the evidence is hard to miss. However, your doctor will want to determine if there are any underlying causes or medical problems contributing to the sleep disorder. Your doctor will ask when the bedwetting started, along with how frequently it occurs. Your doctor will also ask about any sources of stress in your life, as well as your medical history and any past or present drug or medication use.

If you or any family members have any other sleep problems, your doctor will want to know about that too. They may recommend that you fill out a sleep diary for two weeks to understand your sleep patterns. Additionally, you will be given a physical exam and a urine analysis. Your doctor may also ask that you participate in a sleep study to see if the bedwetting is related to any other sleep disorders.

Treatment Of Bedwetting
Simple methods of treating bedwetting include behavior medication techniques, such as periodic waking to use the bathroom during the night, fluid restriction to reduce the amount of fluid intake in the late afternoon and early evening, and alarm therapy. This form of treatment, where a moisture-sensitive pad with a bedwetting alarm is placed under the person and goes off if the pad becomes wet, is shown to be highly effective.

If bedwetting is related to other medical conditions such as sleep apnea, heart block, or ectopic ureter and other structural abnormalities in the urinary system, you may require surgery. In cases where behavioral modification has not improved symptoms, doctors may prescribe medications such as anti diuretics to reduce urine production, oral antibiotics to treat urinary tract infections, or anticholinergic medication to reduce muscle contractions in the bladder.