Sleep Enuresis

Last updated: May 31, 2019

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The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

Sleep Enuresis is another term for bedwetting or urinary incontinence. This is a common condition in young children and is a sign of a developing bladder. According to estimates it affects 15 percent of children over the age of three. It also affects 10 percent of children over the age of five. It is so common that doctors don’t consider bed-wetting in children as a disorder.

Bedwetting is only a problem if the child is over seven years old. It is also a problem if a child begins bed-wetting after six months of being able to control his bladder overnight.

In adults bed-wetting is an embarrassing condition. It can also be a symptom of another medical condition. An adult who frequently wets the bed should consult a doctor. Common causes of sleep enuresis include:

  • Genetics. A member of a family with a history of bed-wetting is more likely to experience bed-wetting.
  • Urinary tract infection
  • Diabetes
  • Kidney disease
  • Prostate cancer
  • Bladder cancer
  • Neurological disorders
  • Stress, anxiety, and other mood problems
  • Small bladder
  • Imbalance of the antidiuretic hormone (ADH)
  • Sleep apnea

How is it diagnosed?

During a diagnosis the focus is on what causes the bed-wetting. A doctor will most likely focus on an underlying medical condition that’s causing the bed-wetting. In order to determine what’s causing the bed-wetting a doctor may order one or more of the following tests:

  • Physical examination
  • Neurological examination
  • Urologic examination
  • Urine test
  • Ultrasound of the kidneys
  • Ultrasound of the bladder

How do you treat sleep enuresis?

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

There are lifestyle changes that can help reduce or eliminate episodes of bed-wetting. These include:

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  • Limiting fluid intake close to bedtime
  • Reducing caffeine and alcohol intake
  • Setting a bedtime routine that includes urinating before going to bed
  • Urinating every one or two hours throughout the day
  • Setting a nighttime bathroom alarm

There are also medications that might help prevent bed-wetting:

  • Anticholinergic drugs to treat an irritated bladder
  • Drugs to treat urinary tract infections
  • Desmopressin acetate to increase ADH levels
  • DHT-blockers to reduce the swelling of the prostate

There are also surgeries that can help adults if non-invasive treatments are unsuccessful. These include:

  • Sacral nerve stimulation. Sacral nerve stimulation increases the external sphincter tone. This causes the detrusor muscle neurons to stop the activity. Decreased activity of the detrusor muscle neurons can lead to a decreased frequency in urination.
  • Clam cystoplasty. This procedure reduces bladder instability. It also increases bladder capacity.
  • Detrusor myectomy. In this procedure surgeons remove a portion or all of the exterior muscles surrounding the bladder. This leads to stronger bladder contractions. It also reduces the number of bladder contractions. Bladder contractions lead to frequent urination.

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