My son does not wake up at night but just wets the bed when sleeping. Is he a deep sleeper?
It is well known that children with bedwetting are unable to wake up when they pee
at night. It has been believed for many years that the sleep of bedwetters is too deep
but recent research has indicated that bedwetters have poor sleep quality with many
incomplete arousals (awakenings). They also seem to have many ‘periodic limb
movements’ during sleep, a sign that may be related to the arousal attempts.
My 6 year old grandchild has always wet the bed and his parents had the same problem - is bedwetting a genetic disease?
Bedwetting is clearly an inherited disease and in approximately 70% of cases there is
at least one other family member who has or had the same problem as a child. For
example, if a mother was a bedwetter as a child, there is a 7 times increased risk that
her children will also suffer from enuresis. A specific gene that causes enuresis has
not been identified yet but current research is focusing on this assignment.
I was told by my neighbour that my child’s bedwetting is caused by psychological disturbances. Is it true?
Normally, enuresis is not caused directly by psychological disturbances but having enuresis
may cause psychological problems, especially affecting quality of life and self-esteem. These changes
normalize after successful treatment of enuresis.
What are the most common causes of bedwetting and is it
possible to identify the underlying cause in my child?
Increased night-time urine production (=”nocturnal polyuria”) and reduced night-time
bladder capacity are the two most common causes of bedwetting. It is important to
know that these two causes may occur at the same time in a child. It is possible to
recognize which of these two factors play a role in your child by simple home
recording tools. By identifying the largest voided volume on a home diary
(="frequency-volume-chart") it is possible to ascertain whether a child is suffering
from ‘reduced bladder capacity’ (by comparing with published normal values).
By home recording of nocturnal urine volume it is possible to evaluate whether
the child has nocturnal polyuria. With this method, diapers are weighed at bedtime
and again the following morning. The difference in diaper weight plus the volume of
any urine produced during the night plus the volume of the first urine produced in
the morning constitutes the total night-time urine volume. Also, there are internationally
accepted normal reference values for nocturnal polyuria.
Why do we have to see our family doctor for this condition?
Although most children with bedwetting since infancy have no underlying disease in
either the nerve system that controls bladder function or in the anatomy of the urinary
tract, this should be ruled out by a visit to your doctor. Also, the doctor will determine
whether bedwetting is the only problem or if there are other issues that need to be
addressed. This could be wetting during day-time, signs of ‘overactive bladder’
(frequent and strong sensation to void), faecal incontinence and constipation,
and recurrent urinary tract infections. If these conditions are present they should be
treated before any treatment for bedwetting is initiated.