Bedwetting Store Blog » relapse

Bed Wetting Cure

Renee Mercer, Pediatric Nurse Practitioner — Mon, 15 Nov 2010 17:44:14 +0000

JS writes, “I want to share my story with other families. My 10 year old son had been on two different medications (DDAVP and oxybutinin) for his bedwetting, but he still continued to wet every night. We had taken him to two different doctors, who prescribed the medication, but did not offer much else when the medication made no difference. We were at our wit’s end and our son felt like he would wet forever. A friend told me that her son had gotten to dryness by using one of the Malem bedwetting alarms. I reluctantly bought an alarm, and truthfully, expected that it would not work for my son who is such a deep sleeper. I’m writing to tell you that he is now dry, and has been for the past two months. Some nights, he gets up and uses the bathroom and some nights, he just sleeps until morning. His self-esteem has sky rocketed and he’s anxious to stay all night with a friend. Thanks. I wish I had known about this a couple of years ago”.

Congratulations to your son, JS. The response that your son had is typical of many of the kids who have failed to get dry through the use of medications. There was an interesting study published last month in Urology. It was a retrospective study of about 100 children who had partial or no response to the medications that your son used, and/or kids who had begun wetting again after stopping the medication. Of these children, more than half got to dryness when enuresis alarms were started and importantly, up to 88.9% did not have relapse 6 months after stopping the use of the alarm. This study was reported from Samsung Medical Center in Seoul, Korea, and the conclusion was that enuresis alarms were an effective therapy for children with pharmacotherapy-resistant nocturnal enuresis.

I want to emphasize that bedwetting alarms are very effective cures for bedwetting, even in kids who have tried medication and failed. With the possible side effects and high relapse rate of medications, enuresis alarms are a much safer and more permanent cure, as well. They should be the first-line treatment for bedwetting.

Wireless Alarm for 10 Year Old

admin — Wed, 04 Aug 2010 17:35:15 +0000

My 10 year old son used a wearable bedwetting alarm when he was 8, with great success. He has started wetting again over the past few months. His doctor says his urine is fine. I walk him to the bathroom when I go to bed, which usually keeps his bed dry. I mentioned restarting the alarm to him but he is resistant, saying that he doesn’t like the feeling of having something on his shoulder. He’s become more anxious about things like that as he’s gotten older. Do you have any suggestions?

I think your idea of restarting an alarm is a good one. For some reason, he is now sleeping through the signal that he needs to wake up and walk to the bathroom. Finding an alarm that is acceptable to him is important. Both the wireless models are popular with kids in his age group. The Malem wireless and the Rodger wireless have multiple sounds to choose from. He can pick a tone that he likes (kind of like picking your ring tone for your phone) and that he most easily alerts to. The Malem wireless attaches to his briefs and the Rodger wireless comes with two pair of special briefs with the sensor built in. You might ask him which style he would prefer. Remind him that the sound will be coming from a unit across the room and not from a unit on the shoulder. This will require him to get out of bed to turn it off and he can walk to the bathroom at the same time. This should enable him to re-develop the ability to wake up and walk to the bathroom when he needs to.

Bed Wetting Medication

admin — Wed, 10 Mar 2010 14:33:17 +0000

My son is 8 and wets every night. My doctor mentioned that he can prescribe a medication to help. I’m a little nervous about giving my son medicine for this. Can you tell me more?
The most frequently prescribed medication for bedwetting is DDAVP (desmopressin). This synthetic form of the natural hormone vasopressin decreases the quantity of urine produced for the next eight to 12 hours. It begins to work quickly, usually within one hour of taking it. This medication is designed to curb bedwetting by making the urine more concentrated and decreasing the total amount of urine produced that night.

Medication often has immediate results, but when you stop it, the relapse rate is high-about 80 percent. DDAVP allows about half the children who use it to sleep dry that night, which makes it particularly useful for sleepovers and camps. DDAVP is available in two forms: a nasal spray and tablet. The tablet is now preferred because it delivers a more consistent and convenient dose. The nasal spray has a Black Box Warning because of some reported cases of seizures and death because of water intoxication. Also, children with allergic congestion can get erratic results with the nasal spray.

Dosage of DDAVP must be individualized, with one to three tablets (0.2 mg.) each night before bed as the recommended dose. The greatest number of dry nights is achieved by 0.4 to 0.6 mg. nightly. If your child is taking the medication for a situation outside of his home, such as sleepover camp, start it ahead of time to establish the appropriate dose. Your child’s doctor or nurse practitioner is responsible for determining your child’s dosage, but the general recommendation is as follows:
• If your child wets when taking one tablet, increase it to two.
• If wetting occurs with two tablets, his dosage should be three tablets.
• Three tablets is the maximum amount recommended for any age group.

DDAVP is generally safe with few side effects. Reported side effects include headache, stomach ache or water intoxication if a large amount of water is ingested after taking it. The manufacturer provides fluid guidelines, recommending no more than four ounces of water before bedtime. This medication can be safely used for three- to six-month intervals with a one week break. If wetting persists, it can be used for another interval. DDAVP is expensive, as much as $3-4 per tablet. The cost should be taken into account when considering long-term use.

DDAVP does not stop wetting in every child. Increasing the length of time taken will not make it work. The expected results should be seen in a week or two. Parents should realize that this medication does not provide long-lasting effects, but it does provide short-term dryness for many children. For long lasting results, getting to dryness by using a bedwetting alarm has a more permanent response.

How to Stop Bed Wetting Relapse

admin — Thu, 18 Feb 2010 22:38:07 +0000

SH writes, My son age 11 has used the wetting alarm and seemed to be cured. He stopped wetting the bed and didn’t get up to pee. He just held it till morning. Once in a while he would have a wet night. We just assumed it was from drinking too much late at night. Recently he has started having basketball practice at night which makes him drink fluids more. He has had several wet nights this month. When he has a wet night he does not realize that he has wet himself until he is cold and wet. It is quite alot of pee. Does this mean he is actually not trained and needs to start all over again after a couple years of sucess?

I do occasionally see relapses just like you’ve described. It sometimes does occur in kids who mostly just sleep through until morning dry. Because he has more fluid in his system before he goes to bed, his bladder isn’t able to hold it all night and he must get up to urinate. For some reason, the ability to wake to a full bladder isn’t there and he wets. I recommend restarting the alarm as soon as possible so that he can be alerted when the wetting is occurring. Over time, his body should be able to put together the sound with getting up. If he doesn’t respond to the loud sound, you go to his room and remind him what he should be doing. Most of the kids can get back on track by doing this. It’s better to restart the alarm for a few weeks and conquer the problem again than wait longer, hoping it will just go away.

Sleepwalking and Bedwetting

admin — Mon, 25 Jan 2010 15:54:08 +0000

My 7 year old son has a Malem Ultimate alarm he’s been using for 5 months. We’ve had success with it in that he has gone from nightly heavy wetting to being dry many nights. Though he has not yet had a full 14 days of his alarm staying silent, he was waking to the alarm, or self-waking and we thought we were well on the road to being done with this issue. The last 2 months however he has completely slid backwards. His alarm has gone off almost every single night.
The only other thing I can think of that might be meaningful is the fact that he gets up almost every night without fail and moves from his bed to ours. That usually happens around 1:30 – 2 a.m., and then the alarm goes off around 3 (but on some mornings, it goes off at 6 – and it’s usually just those two times, oddly enough.) I wonder if he’s waking up because he feels like he needs to go (but is choosing not to because he’s tired….)

You have brought up a couple of good points. He may certainly be getting
partial messages from his bladder but he isn’t quite interpreting them as
such. Instead, he’s finding his way into your room and not the bathroom. I
know that many nights you may not even know that he’s coming into your bed.
Is there any way that he could be prompted to use the bathroom on his way to
your room? One family that I worked with put a baby gate across the door to
their room. It was enough to signal their child that he needed to stop and
go to the bathroom before he walked in his sleep to his parents’ room. This
gentle reminder broke his pattern of getting into their bed without first
stopping at the bathroom.

Illness and Bedwetting

admin — Mon, 21 Dec 2009 15:51:40 +0000

My son is using his Malem alarm. We make sure he double voids before bedtime. He is on a 5 day course of Amoxicillin 3x a day. He was having longer stretches of dryness- a couple of days at a time. Since he has started the Amoxicillin, he is wetting every night- sometimes really small and sometimes a medium spot. Is this typical when a child is on antibiotics?

I do see this phenomenon regularly in the kids that I work with. I don’t know of a medical explanation, but I do see more wetting in children who have colds, ear infections, flu etc. and who are on medications such as antibiotics, cold medicine, and acetaminophen. It seems like the body is working hard to fight off the virus or bacteria, and cannot attend to the alarm or other bodily messages. Some parents discontinue the alarm for a few nights when the kids are most ill, then restart it when he feels better. That is perfectly fine.

The good news is that once the kids are off the medication and feeling better, dryness patterns do return. Working around challenges that face families is part of getting to dryness. Ultimately, your son will be able to stay dry, no matter what the challenges are.

7 year old’s success, now how long to use the alarm

admin — Thu, 03 Sep 2009 14:01:20 +0000

RT’s 7 year old daughter has been using the bed alarm for a month now. After 11 days, she has not had an accident at all. The alarm hasn’t even sounded. So for 15 nights, she’s been waking on her own or going all night without using the bathroom. Tonight, she’s going to not use the alarm, but mom is curious about the course of action they should take going further – do they stop the alarm all together or should they do every other night? She’s not a fan of the alarm and is dying to not use it, but parents want to make sure they don’t sabotage the last month’s work by taking it away too soon.

At this stage, I recommend using the alarm every other night for 14 more nights. I think this is an effective way to help her body continue to react in the right way. After 14 dry, she can discontinue using it. Take the batteries out and store it away. In the future, don’t get concerned if there is an isolated wet night. If, however, you see 2 wets in a one week period of time, she would restart the alarm for a week or so. This will prevent her from having relapse to nightly wetting.