What is Nocturnal Enuresis?

Lainie Petersen

Nocturnal enuresis, better known as bed wetting, is a relatively common condition in young children that becomes less common as they grow up. In many cases, nocturnal enuresis in children is primarily a developmental issue that goes away as a child physically matures. Wetting the bed can nevertheless be a symptom of a medical problem in both children and adults.

Bed wetting in children is primarily a development issue that goes away as the child matures.
Bed wetting in children is primarily a development issue that goes away as the child matures.

Both babies and very young children are unable to control their bladder functioning, but eventually gain control as they mature. Some children, however, find it more difficult than others to control nighttime urination and end up wetting the bed regularly. The causes of nocturnal enuresis in children can usually be attributed to an immature nervous system that is not yet able to detect when a child's bladder needs emptying; stress; or the failure to develop anti-diuretic hormones, which help to control the urge to urinate while sleeping. In some cases, bed wetting may also occur because of a small bladder that needs frequent emptying. If a child has previously mastered nighttime bladder control but then begins wetting the bed for no discernible reason, he should be evaluated for diabetes. Finally, nocturnal enuresis in children can result from urinary tract infections or constipation that reduces bladder capacity.

Sleeping pills may contribute to nocturnal enuresis.
Sleeping pills may contribute to nocturnal enuresis.

Adult bed wetting has both similar and different causes than childhood nocturnal enuresis. Like children, adults with diminished bladder capacity or anti-diuretic hormone may experience bed wetting. On the other hand, adults are more likely to consume caffeine and alcohol, both of which can irritate the bladder and contribute to urinary incontinence. Other conditions that are more likely to affect adults and contribute to bed wetting are enlarged prostate and pelvic organ prolapse. Some drugs, including sleeping pills, may also contribute to nocturnal enuresis.

Parents should speak to their pediatrician if they have concerns about their child's bed wetting behavior. As there appears to be a genetic component to bed wetting, some parents may be counseled to expect bed wetting to cease at the same age that a bed wetting parent gained control over nighttime urination. In some cases, doctors may recommend a moisture alarm that alerts a child when he begins to wet the bed, though a routine of reducing liquid consumption in the evening and double voiding, or urinating twice before bed, is often effective at controlling or minimizing bed wetting. In more severe cases, doctors may prescribe medications that can calm the bladder, boost anti-diuretic hormone production, or change a patient's sleep cycle.

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