Also known as: nocturnal enuresis, bed wetting, urinary incontinence, Primary nocturnal enuresis, nighttime incontinence.

What is enuresis?

Most children are dry at night by 5 years of age. Enuresis may be Primary or Secondary (will not be discussed here).

Primary bedwetting/nocturnal enuresis is the common problem (about 7-10% of children; twice as common in boys) of multiple episodes of wetting the bed, only at night when asleep, (in children who have never been dry at night), over the age of  7 years, who have no history of a urinary tract infection. Many children (15%) will outgrow their symptoms every year; some may need a little help. Very few (approx. 2%) will have symptoms to adulthood.

What causes enuresis?

The exact cause of Primary enuresis is unknown but one or more of the following appear to play a role: an underdeveloped smaller bladder, an inability to feel a full bladder, too little of a hormone (anti-diuretic hormone or ADH) that slows night time production of urine, sleep apnea where the child’s breathing is interrupted during sleep, an early sign of diabetes or a different cause for producing a lot of urine, constipation and very rarely a neurological abnormality.

There is an increased risk of Primary bedwetting at night where there is a family history of in one or more of their parents, times of stress and anxiety and in children with Attention-deficit/hyperactivity disorder (ADHD).

What are the symptoms of enuresis?

An older normal child continues to urinate in his or her bed without waking up after the age of 7years.

What are enuresis care options?

If the child is constipated or has sleep apnea, treatment of these causes will be of benefit.
Most children with primary enuresis will outgrow their bed wetting and do not need treatment. If bedwetting at night is occasional, voiding before bed time, limiting the amount of liquid taken during the evening hours or not drinking/eating foods containing caffeine before bedtime may help as will parental understanding, reassurance, and praise on dry nights.

Moisture alarms (a small battery operated device that will alarm when it senses wetness) can be valuable but may take a number of weeks to achieve dry nights; medications like those that slow nighttime urine production (DDAVP - desmopressin), or reduce bladder contractions might be appropriate.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: October 07, 2019 01:13 PM

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