Predicting Success

February 17, 2023 2 min read

An interesting study from Sweden was recently published in the Journal of Pediatric Urology*.The authors were interested in learning if there are any predictive factors that could determine whether a child would become dry using a bedwetting alarm. Children with bedwetting were provided an alarm linked to a smartphone app, which recorded the wetting event. To participate in the study, the parents agreed to use the alarm every night for at least 8 weeks or until 14 consecutive dry nights had been achieved.

Factors Making No Difference in Success

The researchers looked at age, sex, wet nights per week before starting therapy, daytime wetting, previous alarm therapy, previous desmopressin therapy, and parents’ report of difficulty to arouse from sleep. None of these things were statistically significant in predicting success in becoming dry with the use of the alarm.

Significant Difference by Weeks 2-3

63% had a full (100% dry) or partial (>50% dry) reduction in the 8 weeks of the study. 22% had no response (<50% reduction). As treatment progressed, there was a significant reduction in the frequency of wetting for responders versus nonresponders at week 2 and at week 3 and onward. Already from the second week, children unable to complete the full treatment had more nights where the alarm was not used.

Drop-Outs

Of interest, 38% dropped out and only 120 of the 196 that started actually finished the study for the entire 8 weeks. Only the ones who completed the study were included in the results. No reason was suggested for this high dropout rate.

Responders

This study found that alarm responders already started to decrease their wetting frequency during the first month of therapy, often in the first 2-3 weeks. Would this also contribute to the motivation of the parents and children to continue to use the alarm for the entire study period? If the parents did not see progress in the first couple weeks, were they less motivated to continue?

We advise families that the first two weeks are the hardest when starting to use a bedwetting alarm. This study suggests that families will already begin to see some changes in the first few weeks if their child will become dry using the alarm.

*Journal of Pediatric Urology, S1477-5131 (22) 00512-5 Nov 17, 2022