Nocturnal Enuresis

Bedwetting

 Nocturnal enuresis refers to the involuntary passage of urine in a child while sleeping, who is past the age when voluntary bladder control should have been acquired. As age increases the prevalence of enuresis decreases, the majority of children have managed to gain bladder control by the age of 4 years.

Children who have remained continent for a number of months may have lapses and become enuretic again, without any obvious cause being found. Other relapses may occur after a long period of dryness when a new sibling arrives on the scene, or some other emotionally charged event takes place.The occurrence of nocturnal enuresis is equally balanced between the sexes in the earlier years, but males predominate amongst older children.

Enuresis is more common in children who have undiagnosed urinary tract infections.  Bladder control is acquired gradually over time and involves many factors such as  environment , genetic factors, as well as neuromuscular and cognitive development.

Many theories exist as to a possible cause of nocturnal enuresis, sleep studies have managed to discredit the previously held one that enuresis occurred only in deep sleep, these studies have found that enuresis can occur at any stage of sleep. Other studeis have found that nocturnal enuresis occurs as the child moves from the ddeper stage of NREM stage of sleep into the REM stage. Although some studies have found that enuresis may occur when the child is dreaming, generally it would appear that the instances are too small in number to be considered important.

Organic causes of enuresis may include urinary tract infections, neurologic disturbances, congenital defects of the meatus, urethra and bladder neck, diabetes, or diseases which impair the ability to concentrate urine.

Nocturnal enuresis is not uncommon amongst adults figures indicate that 1 in 100 have bed wetting problems, and may have suffered with the symptom for most of their adult lives. If no organic problem exists which would contribute to the enuresis, finding causation may be a most difficult task.

Treating nocturnal enuresis in adults may involve dietary measures, limiting fluid intake at night, eliminating alcohol, drinks containing caffeine, such as coffee, tea, sodas, and  especially diet sodas.  Setting the alarm to awaken every couple of hours to empty the bladder is another possibility, although this may be very disruptive to your sleep.

Nocturnal enuresis  in children tends to remit spontaneously without the necessity for treatment, however, for children who regularly wet the bed at night, waiting for the condition to resolve may be a very costly and stressful option. The condition may need the assistance of behavioral therapy or hypnosis, both of which have produced positive results in children with nocturnal enuresis. Witholding fluids, sleep interruption, diet therapy and other conditiong devices may provide help, and of course eliminating sodas of all kinds, for they tend to cause bladder irritation.

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