Bedwetting in Older Children

An article from The Conversation, looking at health conditions in children, recently caught my interest. The author discusses bedwetting in older children and young adults. She suggests that associated stigma causes few to seek professional help despite successful treatments being available.

Some interesting facts include:

-About 0.5-3% of teenagers and young adults wet the bed at night.

-Most of them have always wet, but 20% start after being previously dry (secondary enuresis). Reasons for secondary enuresis identified in young people include post-traumatic stress disorder and anorexia nervosa (with resolution of bed-wetting when their weight increases).

-Although effective treatments are available, most adults erroneously believe their problem is not treatable.

-Some 20-50% of young adults have never sought professional help about their problem, and continue to suffer in silence.

Treatment

Conservative treatment consists of reinforcing good bladder and bowel habits, drinking enough during the day, minimizing caffeine and alcohol, toileting regularly and managing constipation. Most people have tried part of this already but should do so in a systematic fashion.

The medication desmopressin has been used successfully in some young people. Desmopressin decreases the amount of urine produced at night, increasing the likelihood of sleeping dry all night. It does not work in all users, however, and has no sustained effect. Wetting usually recurs when medication is stopped.

Bedwetting alarm training is the most effective treatment for bedwetting and the only one that has a sustained effect. Alarms sense moisture and alert the user when wetting occurs. Over time, the individual wakes to urinate when their bladder is full and withholds urination at other times.

If the individual cannot wake up to the sound, a family member must alert them when the alarm sounds. Waking to the alarm and going to the toilet at that point is essential for treatment success.

A wireless alarm can be purchased with a second sound receiver for the parent's room, and solves the problem of parents' not hearing the alarm from their room. Becoming dry while using a bedwetting alarm usually takes two to three months.

The alarm is stopped after 14 consecutive dry nights are achieved. It does take patience and persistence, but has a low relapse rate. It's time for families to realize that bedwetting in older children, teens and young adults a common, but treatable condition, which should not be ignored.