Bedwetting (Nocturnal Enuresis)
Bedwetting, also called nocturnal enuresis, is the involuntary passing of urine while asleep. It’s a very common issue, especially in young children, and is usually a developmental phase and not a serious medical problem.
Who Does It Affect?
- It’s normal for children under 7 years old to wet the bed occasionally.
- About 15% of children still wet the bed by age 5.
- About 5% of children still wet the bed by age 10.
- Most children naturally stop bedwetting by their teenage years.
If a child has never been consistently dry at night, this is called Primary Nocturnal Enuresis (this is the most common type). If a child has been dry for at least 6 months and then starts wetting the bed again, this is called Secondary Nocturnal Enuresis.
Why Does It Happen?
Bedwetting is rarely caused by stress or intentional behavior. It’s usually due to one or more of these factors:
- Too Much Urine Production at Night: The child’s body may not produce enough of the Anti-diuretic Hormone (ADH), which normally slows down urine production during sleep.
- Bladder Not Storing Enough: The bladder capacity might be smaller than average, or the bladder muscles might be overactive, causing contractions that release urine.
- Difficulty Waking Up: The child is a very deep sleeper and doesn’t wake up to the sensation of a full bladder.
Other Contributing Factors:
- Genetics: Bedwetting often runs in families. If one parent wet the bed, the child has a chance to also wet the bed; if both parents did, the chance the child will becomes even higher.
- Constipation: A full colon can press on the bladder and reduce its capacity.
- Underlying Medical Conditions (Rare): Conditions like a urinary tract infection (UTI) or diabetes can occasionally cause new-onset bedwetting (Secondary Enuresis).
When Should I See a Doctor?
It’s often best to talk to your child’s provider if:
- The bedwetting is causing distress or anxiety for the child (e.g., they are embarrassed or avoiding sleepovers).
- The child is age 7 or older and wetting the bed often (more than a couple of times a week).
- The child was dry for months and then started bedwetting again (Secondary Enuresis).
- There are new symptoms like burning during urination, daytime wetting, or sudden excessive thirst.