What Is the Main Cause of Bedwetting?

Reviewed on 7/10/2021

Facts you should know about bedwetting (nocturnal enuresis)

Sometimes the passage of time is all that's needed for children to overcome bedwetting.
Sometimes the passage of time is all that's needed for children to overcome bedwetting.

Nocturnal enuresis, also known as nighttime incontinence or bedwetting, refers to the involuntary voiding of urine during sleep. Many parents expect children 5 years of age and older to be dry at night. Many children, however, continue to wet the bed until the 7 years of age because their bladder is still developing by this age. Enuresis may be primary or secondary. Children who have no history of sustained dryness are considered to have primary (persistent) nocturnal enuresis. The recurrence of nighttime wetting after 6 months or longer of dryness is referred to as secondary (regressive) nocturnal enuresis. Enuresis can occur in teens and adults, as well; however, it is more common in young children. There are several causes of bedwetting (nocturnal enuresis). It could be due to medical, physical, and psychological conditions.

What causes bedwetting in children?

The main cause of bedwetting may vary in different age groups. Generally, in young children, bedwetting may be caused by a small bladder that cannot hold urine formed at night. The following are common causes of bedwetting in children:

  • Time: Some children need extra time to develop control of their bladder.
  • Genetics: Children who wet their beds tend to have a parent, aunt, uncle, or grandparent who wet the bed until a late age.
  • Sleep: Children who have sleep apnea may wet the bed. Children who are deep sleepers or those whose nerves that carry sensations of a full bladder are not well developed may wet their beds. The brain and bladder communicate to control urination. In some children, this connection may develop slowly. During deep sleep, children may not recognize the need to wake up to empty their bladder.
  • Stress or life changes: Going through big changes, such as moving to a new place, starting school, having a new sibling, or other stressors, can lead to children wetting their beds after being dry for a long period.
  • Medical: Medical reasons, such as having a urinary tract infection, constipation, or differences in the way the body is built or functions (for example, a small bladder or making too much urine), could be the cause. Other structural abnormalities in a child's nervous system or urinary tract may cause bedwetting. In addition, type 1 diabetes can also first show up as bedwetting along with increased thirst and urination.

What causes bedwetting in adults?

Nocturnal enuresis in adults could be due to the following.

How do doctors diagnose the cause of bedwetting?

Depending on the signs and symptoms and medical history, health care professionals may recommend the following to identify any underlying cause of bedwetting and help determine treatment.

  • Physical exam
  • Discussion of signs and symptoms, fluid intake, family history, bowel and bladder habits, and problems associated with bedwetting
  • Urine tests to check for signs of an infection or diabetes
  • X-rays or other imaging tests of the kidneys or bladder to look at the structure of the urinary tract
  • Other types of urinary tract tests or investigations, as needed

What are treatments for bedwetting?

Treatment of bedwetting in children will depend on the underlying cause. People may want to try a bedwetting alarm, which sounds when it detects wetness. Common treatments include the following:

  • Limit fluid intake in the evening or 1-2 hours before bedtime.
  • Avoid caffeine and carbonated drinks because these can stimulate the bladder.
  • Encourage children to use the bathroom at night and make it easy for them to access, using nightlights if this helps.
  • Encourage children to use the bathroom at the beginning of their bedtime routine and just before they get into bed to empty their bladder.

Bedwetting in adults may be a symptom of an underlying condition that will require treatment. Successfully treating or managing that condition should resolve any bedwetting behavior.

QUESTION

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References
Kiddoo, Darcie A. "Noctural Enuresis." CMAJ 184.8 May 15, 2012: 908-911. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348193/>.

Thiedke, C. Carolyn. "Nocturnal Enuresis." Am Fam Physician 67.7 Apr. 1, 2003: 1499-1506. <https://www.aafp.org/afp/2003/0401/p1499.html>.

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