Bedwetting is considered a problem if the child is older than 7 years and continues to wet the bed twice or more times a week for three months in a row.
In 1963, a study published in the American Journal of Psychiatry claimed to link certain childhood patterns with antisocial behaviors later in life. One of these patterns was recurrent bedwetting.
Further and more extensive studies, however, have negated this claim and established there is no direct relationship between bedwetting and psychopathy. Bedwetting may be seen in certain behavioral disorders of childhood, which are associated with aggressive and violent behavior. This does not make every child who frequently wets bed a psychopath.
Bedwetting is considered a problem if the child is older than 7 years and continues to wet the bed twice or more times a week for three months in a row. Researchers believe that most cases of bedwetting or enuresis are due to stress.
Many cases are due to a dysfunctional home environment or poor coping skills in a child. More than twice as many boys as girls have enuresis. It is often seen in combination with attention deficit hyperactivity disorder (ADHD), autistic spectrum disorders, etc.
The major concern for both the child and their parents are teasing and bullying. This, along with anxiety and shame, can have a huge impact on the child’s social life and emotional wellbeing. The child may feel more anxious and helpless as the bedwetting continues. This can lead to stress that contributes to them wetting the bed more often. It is important to remember that these kids need understanding and compassion and not judgment and ridicule.
Other common causes for bedwetting are
- Developmental delays due to various reasons
- Immature bladder
- Lack of antidiuretic hormone (a hormone that slows down urine production during the night)
- Constipation
- High urine production
- Sleep issues (sleep apnea combined with deep sleep)
- Diabetes
- Extreme stress
- Conflicts in the family
What are the treatment options for enuresis?
Doctors can do several things to treat bedwetting, depending on what's causing it. If an illness is responsible, which is not very common, it will be treated. If the child’s history and physical exam do not find a medical problem and the urine tests are normal, several behavioral approaches can be used for treatment.
Limiting fluid before bedtime
- By itself, this rarely works.
- Reasonable limitation of fluids, especially drinks that have caffeine, such as colas, helps in a few cases.
Waking the child at set times during the night
- Some families find it helpful to wake the child once or twice at night to make them go to the bathroom.
- This may help keep the bed dry and, in some cases, helps a child to stop bedwetting.
Moisture alarms
- These alarms often can condition the child to learn to feel when the bladder is full and when wetting is just about to happen.
- The alarm consists of a moisture-sensing device attached to the pajamas that wake the child with a loud signal or vibrating alarm.
- If parents are certain that the child will wake up, the alarm may be successful.
- While it may take several weeks or months for the child to stay dry on their own, moisture alarms have the highest long-term success rate.
- The success rate of moisture alarms increases significantly when used with a well-designed behavior modification program.
- The doctor may recommend a combination of medications and other treatment methods. Not all children respond to these medications.
- Imipramine has been used for many years to treat bedwetting. Because this medication is an antidepressant, it can affect mood or behavior in some patients.
- Studies have found that conditioning techniques are significantly more effective than imipramine.
Desmopressin
- This is a man-made form of the hormone (antidiuretic hormone) that causes most people to make less urine during sleep.
- It works by decreasing the urine produced by the kidney, resulting in less urine filling the bladder.
Anticholinergics (oxybutynin, hyoscyamine)
- These are medications that relax the bladder and allow it to hold more urine.
- They are often used to help children who also have daytime wetting problems.
- They alone are usually not effective for bedwetting unless the child has daytime wetting.
Hypnotherapy
- Limited studies have shown that hypnotherapy helps some children. Further scientific study is needed in this area.
Other treatment options
- Herbal, acupuncture and chiropractic therapies may help, but they should be in combination with other therapies as recommended by the doctor.
- Indeed, bedwetting is sometimes associated with stress. Also, kids with certain behavior problems are more likely to experience bedwetting. Bedwetting is neither violent nor voluntary. There is little or no empirical support linking it with psychological maladjustment.