The uncontrolled urination that occurs while a person sleeps is called nocturnal enuresis. In childhood, it is usually referred to as bedwetting. Usually, by the age of 4, a child can control their bladder. It is estimated that about 10% of children aged 6 to 7 still do not have this ability. They have accidents during the day, at night, or both. If this happens, it’s worth a consultation with a pediatric urologist.
What You Should Know about Bedwetting
There are primary and secondary forms of nocturnal enuresis. Primary nocturnal enuresis is when a child has never achieved full bladder control since potty training. Secondary nocturnal enuresis is when a child had been dry for at least six months but has begun having nighttime accidents. Fortunately, both types of enuresis are treated similarly.
It is important for parents to understand that, if their child wets the bed, it is not because they are lazy or willful. It rarely has to do with general behavior. There are usually other factors at play. These include:
- Genetic influence. If a child’s parents both experienced enuresis as children, their risk for this problem is 75%. Scientists have dubbed this as having a “bedwetting gene.”
- Deep sleep. Children who wet the bed often sleep very deeply. This can affect the communication between the bladder and the brain. When the bladder is full, the pelvic floor muscles relax and the bladder empties instead of the bladder signaling the brain to wake up.
- Low bladder capacity. Some children have small bladders that cannot hold much fluid, resulting in enuresis.
- Too much urine production. Some children’s kidneys work hard at night, making more urine than the bladder can hold. This relates to the natural production of a hormone called antidiuretic hormone, which usually increases at night. Another reason for increased urine production at night is drinking caffeinated beverages.
- Type 1 diabetes. This condition is caused by a lack of insulin. This hormone regulates the body’s use of sugars. Without it, sugar is lost in the urine and may increase urine production. Bedwetting may be an early indicator of this illness.
- Sleep disorders. A child who sleepwalks or has obstructive sleep apnea may be more likely to wet the bed. Obstructive sleep apnea deprives the brain of oxygen for up to several seconds, which can result in the production of atrial natriuretic peptide, a chemical that causes extra urine production at night.
- The rectum is located adjacent to the bladder. If the stool is stored in the rectum due to constipation, the bladder may be compressed and less capable of holding urine.
- Emotional or physical stress is a relatively common cause of bedwetting. Wetting the bed can exacerbate stress, creating a vicious cycle for the child.
There are several ways to approach childhood bedwetting. All include a heavy dose of compassion. If your child wets the bed, talk with their pediatrician, or schedule a consultation with us. We can help. Call UT Urology at (423) 778-5910 to schedule an exam for your child.