Nighttime Incontinence is also termed as nocturnal enuresis or nighttime bed wetting. Nighttime incontinence or nighttime bed wetting when occurs in kids that are less than 7 years is not problematic as the bladder control is under development.

Medication, moisture alarms and bladder training can help in reducing the frequency of nighttime incontinence or nighttime bed wetting.

Nighttime Incontinence or Nighttime Bed Wetting

The Causes of Nighttime Incontinence or Nighttime Bed Wetting

The exact cause of nighttime incontinence or nighttime bed wetting is not yet known, but the following factors may play a role in causing nighttime incontinence or nighttime bed wetting:

  • A tiny bladder. The bladder of your child may be under developed to store enough urine that produced at the night time.
  • If the nerves that are responsible for sensing a full bladder are not developed, the child may not wake especially when he or she is in a deep sleep.
  • Hormonal imbalance. Anti-diuretic hormone (ADH) is not produced in enough quantities in kids during the nighttime which slows the urine production at nights.
  • Undergoing stress. Various stressful events like beginning a new routine at a new school, staying away from home may give rise to nighttime incontinence or nighttime bed wetting.
  • Infection in the urinary tract. The infection may make it difficult for the kid to control urination. Daytime accidents, painful urination, pink or red urination and frequent urination may be some of the signs and symptoms of a UTI (Urinary Tract Infection).
  • Sleep apnea. Nighttime incontinence or nighttime bed wetting is also considered as a symptom of obstructive sleep apnea. In this condition, the child has trouble breathing due to enlarged tonsils. Other signs may include frequent sinus or ear infection, daytime drowsiness and sore throat.
  • Diabetes. Nighttime incontinence or nighttime bed wetting may be a sign of diabetes, if your kid usually does not urinate during the night time. Some other signs may include, weight loss, increased thirst, urinating in larger amounts.
  • Chronic constipation. Urine and stool are eliminated using the same muscle control. When constipation is prolonged, the muscles may fail to function and this may lead to nighttime incontinence or nighttime bed wetting during the nighttime.
  • Structural dysfunction in the nervous system or urinary tract. In rare cases, nighttime incontinence or nighttime bed wetting is a result of neurological defect or some dysfunction in urinary system.

Symptoms of Nighttime Incontinence or Nighttime Bed Wetting

There are no early signs and symptoms for nighttime incontinence or nighttime bed wetting. Nighttime incontinence or nighttime bed wetting is urinating involuntarily while sleeping after a certain age during which staying dry is expectable.

Almost all kids are completely trained for toilet by the age of five but some may need more time for developing a complete control over the bladder.

Risk Factors for Nighttime Incontinence or Nighttime Bed Wetting

There are various factors that can be linked with frequent nighttime incontinence or nighttime bed wetting and these include:

  • Being a male. The frequency of being affected by nighttime incontinence or nighttime bed wetting is more in boys as compared to girls.
  • Family background or history. The child can be susceptible of nighttime incontinence or nighttime bed wetting if his or her parents have a history of wetting the bed as kids.
  • Attention-deficit/hyperactivity disorder (ADHD). Kids who suffer from ADHD show significant chances of suffering from frequent nighttime incontinence or nighttime bed wetting.

Tests for Nighttime Incontinence or Nighttime Bed Wetting

The child may need physical examination. Based on the situation, the doctor may suggest the following tests to diagnose nighttime incontinence or nighttime bed wetting:

  • Urine examination for determining the signs of diabetes or an infection.
  • Bladder or kidney imaging test and X-rays, if the doctor sees any structural abnormalities in the urinary tract of the child.
  • Other kinds of assessments may also be done if there are several health issues observed.

Treatment for Nighttime Incontinence or Nighttime Bed Wetting

Bed-wetting stops when the child attains a certain age. If there is a history in the family with regards to bed-wetting, the kid may probably stop wetting the bed at the same age.

Home remedies may work if the child is not embarrassed or bothered by occasional Nighttime Incontinence or Nighttime Bed Wetting. However, if your kid is terrified about it, you can adopt other methods to help them in getting over it. Selection and success of the treatment can be impacted by the child's and his or her parents' motivation.

If other symptoms like sleep apnea or constipation are seen, it should be treated at the earliest.

Medications for Treating Nighttime Incontinence or Nighttime Bed Wetting

When all the attempts fail to work, the doctor may prescribe specific medications to prevent bed-wetting. Some kinds of medications have the ability to:

  • Slow nighttime urine production. The level of hormones like ADH (anti-diuretic hormone) can be boosted by the drug desmopressin (DDAVP, other) as it will force the body to produce less urine during the night time. However, the sodium levels can be affected when huge quantities of liquids are being consumed. So, it is recommended to drink only 8 ounces of fluids after the medication is being prescribed. Desmopressin may be used in cases when the kid is staying away from home.
  • Calming the bladder to solve nighttime incontinence or nighttime bed wetting. If the kid has a tiny bladder, oxybutynin (Ditropan XL) which is an anticholinergic drug will help in reducing the bladder contractions and increasing its capacity. The medication is used with other medicines and is recommended when all the other means have failed.

Using a combination of various medications can prove to be effective. The cure for the problems cannot be guaranteed. Nighttime incontinence or nighttime bed wetting will resume when medication is not continued.

Lifestyle Changes for Resolving Nighttime Incontinence or Nighttime Bed Wetting

There are certain changes that can be made at home which may be of great help for treating nighttime incontinence or nighttime bed wetting.

  • Limit the liquid consumption of your child in the evening. Do not limit your kid to drink the fluids during the daytime as there should be enough fluid content in the body. Encourage your kid to drink liquids in morning or afternoon as it may reduce him or her feeling thirsty in the evening. Do not limit the liquid consumption if your kid participates in games or sports.
  • Avoid foods and beverages that contain caffeine. Caffeine has the ability of stimulating the bladder and this is why, one should not encourage the kids to drink caffeine.
  • Encourage the child to double void before bedtime. Double voiding means asking your kid to urinate before going to bed or before feeling sleepy. Ask your kid that it is alright to use lavatory at night if necessary. Implant night lights at home so that the kids can find a way to use the bathroom from their bedroom.
  • Motivate your kid to use toilet regularly during the daytime. Suggest your kid to urinate every two hours so that he or she is able to avoid urgent urination.
  • Seek treatment for constipation. If your child is suffering from constipation, seek a doctor so that a stool softener can be prescribed.
  • Avoid rashes. Help your kid in keeping his or her genital area clean if there are rashes developing due to wet underwear. Using a moisture barrier cream or ointment may help in treating the affected area. When necessary, take product recommendation from your pediatrician.

Alternative Treatment Options for Nighttime Incontinence or Nighttime Bed Wetting

Several therapies, like acupuncture and hypnosis, consist of limited evidence about its effectiveness and it does not have evidence related to its use in treating nighttime incontinence or nighttime bed wetting.

  • Hypnosis. Small sessions or trial of hypnosis along with the suggestions to wake up in the dry bed can help kids stay dry throughout the night.
  • Acupuncture. It is the treatment involves the insertion of the fine needle within specific parts of the body. It may be effective for some kids. However, it requires more research.
  • Diet. Few people believe that some foods affect the function of the bladder and removal of such foods from the diet can help to reduce of nighttime incontinence or nighttime bed wetting. The evidence related to it is uncertain which establishes the need for research.
  • Chiropractic therapy. The reason behind this therapy is that if even if the spine is out of the alignment, then the normal functions of the body will be affected. However, there is less evidence supporting the use of chiropractic therapy in the treatment of nighttime incontinence or nighttime bed wetting.
  • Herbs and homeopathy. Even though some people are interested in the remedies of homeopathic and other herbal products, but none of these products have proven effective in clinical trials for treating nighttime incontinence or nighttime bed wetting.

You should talk to the kids' doctor before starting any complementary or any other alternative therapy for it. If you opt for the non-conventional approach, then asks the doctor if it is safe, your kid and ensure that is will not interact with the medications that your kid might take.

Coping with Nighttime Incontinence or Nighttime Bed Wetting

Kids do not wet their bed to irritate their parents. You need to be patient and work on the problem that your child is facing.

  • Be sensitive to your kid's feelings. If you find your child stressed or anxious, then encourage him or her so that the child can express his or her feelings. Provide encouragement and support if your kid has anxiety related to the stressful events. Make your child feel calm and secure. You can ask the doctor about the additional strategies that calm helps your child to deal with stress.
  • Plan out easy cleanup. You can cover the mattress of your child with plastic cover. Use thick and absorbent underwear during the night which helps to contain the urine. Keep extra pajamas and bedding handy. However, avoid the use of disposable pull-up underwear or diapers for a long time.
  • Enlist your kid's help. Perhaps your child can place the wet underwear in the specific container for cleanup or rinse it themselves. Taking the responsibilities related to bed-wetting may help your kid to feel more control of their situation. Your support, reassurance, and understanding can make your child look forward to the dry nights ahead.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: June 1, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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