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.

I frequently get questions from adults who are experiencing nighttime wetting. These people fall into several groups: those who have never achieved nighttime dryness (like RS above), those who have begun wetting as a result of a medical condition or surgery and those who have gradually started wetting as they get older. We have products that can help persons in each of these groups.

Some adults just want to be alerted when wetting is occurring. They want to prevent skin breakdown, being uncomfortable and associated odor. Bedwetting alarms are all moisture sensing devices and can be used for just that purpose. A Malem wireless alarm can be used with your own underwear and the volume control on the receiver allows the tone to be lowered if bothering another household member is a consideration. The first drops of moisture would be detected so a caregiver or the affected person would be alerted. Pad type alarms could also be used but only if the user preferred thin or no underwear in the nighttime.

Waterproof overlay pads, breathable waterproof mattress covers, absorbent waterproof mattress pads, urine stain removers and disposable and washable underwear are all products that can make your life easier. If wetting is an ongoing problem, investing in a few convenient items like these can make the difference between copious amounts of laundry and ruined mattresses and a clean, fresh-smelling room. I also want to recommend www.NationalIncontinence.com for a full line of adult incontinence products.

Bedwetting can be so frustrating at times. It sounds like you have explored many avenues to get your son to dryness. Since it sounds like his daytime voiding is inefficient, working on that a little more may help. Did the urologist recommend a timed voiding program in the daytime? The kids wear a vibratory wristwatch that discreetly reminds them to go to the bathroom about every 2 hours, even if they don’t feel like it. If he hasn’t tried this yet, it may help to empty his bladder more efficiently during the day. I use the Vibrowatch for my patients because it can be set to precise times. I like to set times that do not require the kids to leave the middle of class, and allow them to start the bus ride home at the end of the day with an empty bladder. Taking a water bottle to school helps to assure that they are adequately hydrated during the day and not thirsty late in the day. Once he’s done this for a few months, he could restart the alarm at night.

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.

The good news is that bedwetting alarms work as effectively in teens as they do in younger children. It usually takes teens a little longer to get to complete dryness, but a few extra weeks to change a behavior that has been going on for years is quite tolerable. I’ve found that the key to success for teens and older children is to use an alarm that is easy to use and acceptable to them.

The wireless alarms (such as the Rodger and Malem Wireless) are my recommendations for teens for a couple of reasons. One, wearable alarms require that the user wear a shirt so that the alarm unit can be attached. Many teen boys sleep without a shirt so that could be a roadblock to consistent use. Two, many tech savvy teens quickly disconnect the sensor from the wearable alarm unit and roll over and go back to sleep. They rarely remember this is the morning and wonder why their alarm is disconnected but their bed is wet and they don’t remember getting up. A positive feature about the wireless alarms is that the teen must get out of bed to turn off the alarm. Since the receiver is located in an outlet or on a dresser, it will continue to sound from that location until it is turned off.

A third reason why wireless alarms are recommended is that there are few steps to attach them. The Rodger alarm comes with two pair of specialized briefs. (More can be purchased). The teen simply puts these on when getting in bed. The transmitter stays plugged in the wall or on the nightstand. The Malem wireless alarm fastens to underwear he or she already owns (close fitting, not boxers) and can be an advantage if your family doesn’t do laundry very often. If there is no wetting, the underwear go back in the drawer. If wetting occurred, the underwear is laundered with the sheets. I have all my patients sleep on a waterproof, absorbent overlay on top of their sheet. When the alarm sounds, it’s easy to remove the wet overlay and go back to a dry bed.

Even with teens, the parent’s role is important initially. Listen for the alarm and make sure that your son or daughter is getting out of bed and walking to the bathroom as the correct response. The quicker they learn how to respond to the bedwetting alarm, the more quickly they will be on the road to dryness.

One last point is to make sure the alarm is worn long enough. Having 14 consecutive nights of dryness is important before beginning to use the alarm every other night for 14 nights. Often, my teen patients are so excited to have 4 or 5 dry nights in a row that they stop their alarm use prematurely. Wet nights begin occurring sporadically and further progress is delayed.

Wireless bedwetting alarms can be used for any age child but they are particularly well-suited for teens. Persistence and patience will help insure success.

Children are all so different in their response to new situations, new sounds, and new feelings. I want to offer you some tips if the loud sound is a concern to your daughter.

• Describe the bedwetting alarm in a different way, perhaps a bedwetting alert or a bedwetting reminder.
• Let her listen to the sounds, both on-line as well as when you receive it.
• Play with the alarm, turning it on and off many times, so that she can get used to the sound it makes. Have her hold it in her hand and turn it off and on herself.
• Attach the alarm to a dry pair of panties. The alarm is silent. Then attach it to wet panties. Let her observe how the alarm works to let her know in the nighttime that wetting is occurring.

When she uses her bedwetting alarm:

If the loud sound is still a concern, you can offer the turn down the volume (on the wireless alarms) or position the alarm further from her ear (with the wearable models).

Her actual response in the nighttime has to do with the time in her sleep cycle that the alarm sounds. Early wettings, within a couple of hours of going to sleep, are common when first starting an alarm. During this phase of sleep, it’s common for kids (as well as some adults) to be disoriented, possibly combative, say things that don’t make sense, cry or not know the way to the bathroom. Many of the kids have no memory of this in the morning. If she remembers this as being scared, remind her that it’s just a sound and her brain isn’t quite used to that noise yet. After using the alarm for a few nights, her brain begins to figure it out.

In my practice, I see that wetting early in the sleep cycle usually stops after a few weeks. When the wetting takes place later in the sleep cycle, a much different response is observed. Closer to morning, your daughter most likely will know what the sound means, know what to do next or at least be able to reason with you.

Anticipate her nighttime response and reassure her that you will be there to help her if she can’t remember what to do when the alarm sounds. If your reassurance isn’t enough right now, maybe this is not the right time to begin using the alarm. Let her know that you and her bedwetting reminder will be ready to start when she is.

Dear Bedwetting Store,
It only took me five nights for having a dry night. I have been dry for the last forty five nights. I used the Rodger wireless alarm. I am six and a half years old. I am so happy because now I wear underpants and don’t pish out. Thank you!
Love,
H.P.

And Thank You, H.P. for taking the time to write this thoughtful letter. Your parents have to be so proud of you. Now you can move on to tackle other things and not let pesky bedwetting stand in your way.

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.

This alarm comes with 2 pair of specialized underwear that have the sensor built into them. There are no cords or anything that has to be attached to the shoulder. I have found this alarm to be especially useful in older boys who prefer not to wear a shirt to bed or in children who do not feel comfortable with anything positioned on their shoulder. Extra underwear can be bought separately if you have trouble getting the laundry done frequently.

This alarm offers another choice for kids who would like the option of picking their own tone to wake up to. Just as we all have ring tone preferences for our phones, this alarm allows you to choose your own sound.

I can enthusiastically answer, “Yes, there have been many positive changes in the mechanics and styles of bedwetting alarms over the last few years”. First, wearable alarms are more popular now. Rather than using a pad that the child lies on, a small sensor that attaches to the underwear senses moisture. The advantage of this style of alarm is that it moves as your child rolls around in the night. The older pad style alarms only work if the child is lying on it when the wetting occurs.

Another advance comes with wireless technology. With a wireless bedwetting alarm, such as the Rodger Wireless or Malem wireless, no cords or wires are necessary. Once the transmitter detects wetness, it transmits to the sound unit, which can be across the room or on a bedside table.

The sounds that the alarms make are kid friendly and resemble sounds that their toys make. Multiple color choices and sound selections enable kids to pick something that they like. They can think of their bedwetting alarm as a comfortable bedwetting treatment that helps them get to dryness.