NOCTURNAL ENURESIS

Nocturnal Enuresis also known as bedwetting is the involuntary wetting during sleep after the age at which bladder control is normally obtained. It is normally found in children ages 5 years or older who has never achieved consistent night-time dryness. At five years of age, 15 to 25 percent of children wet the bed. With each year of maturity, the percentage of bed-wetter’s declines by 15 percent. Hence, 8 percent of 12-year-old boys and 4 percent of 12-year-old girls are enuretic. Children with nocturnal enuresis may have excessive nocturnal urine production, reduced bladder capacity, poor sleep arousal or any medical condition. It’s a common problem affecting an estimate 5 to 7 million children in United States alone and the number is higher worldwide. Nocturnal enuresis occurs three times more often in boys than in girls. Unfortunately, only about one third of the families of children with this frequently troubling problem seek help from a physician or use an enuresis alarm.

There are two kind of nocturnal enuresis. Primary Enuresis and Secondary Enuresis.

Primary nocturnal enuresis

Persistent Primary Nocturnal Enuresis is a condition which starts during childhood when child is 5 years or older where night time dryness has not been achieved for longer than six months. This may further be subdivided into children who have enuresis only at night and those who also have daytime symptoms. This is the most common form of nocturnal enuresis. To know this situation if your child has primary nocturnal enuresis know the following,

• How many times a night and how many nights a week your child has wet the bed?
• Is there a large quantity of urine in the bed?
• Does the child wake after wetting the bed?
• Does the child have easy access to a toilet at night?
• What is the daytime pattern of toilet use?
• Is there also constipation or soiling?
• Is there adequate fluid intake during the day?

In addition, for children with day time symptoms find out,

• Child’s pattern of daytime symptoms. Consider whether they are situational like avoiding going to the toilet at school.
• Assess for chronic constipation
• Assess for chronic/recurrent urinary tract infection (UTI)

Secondary nocturnal enuresis

Secondary Enuresis is defined as nocturnal enuresis in which night time dryness has been achieved at some point in life. Dryness may have occurred for many years but then night time wetting suddenly begins during sleep in children, teens or adults.  To know this situation if someone has secondary nocturnal enuresis know the following,

• Find out when it started or how long it has been going on and whether it relates to a specific change.
• Is there any pattern – what time does bedwetting occur?
• How many times a night and how many nights a week?
• Does the wetter wake after wetting the bed?
• Behavioral and emotional difficulties.
• Check for causes like Constipation, UTI, Diabetes mellitus.

Some theories may contribute to individuals developing an enuresis condition.

Neurological-developmental delay-Studies suggest that bedwetting may be due to a nervous system that is slow to process the feeling of a full bladder

Anti-diuretic hormone (ADH)– insufficient production of ADH, or insufficient response to ADH, leads to an overproduction of urine, often beyond the capacity of a child’s bladder.

Constipation-When the bowels are full, it can put pressure on the bladder which causes bed wetting.

Sleep apnea– stemming from an upper airway obstruction has been associated with bedwetting.

Sleepwalking-Sleepwalking can lead to bedwetting.

Stress-Stress is not a cause of primary nocturnal enuresis, but is well established as a cause of secondary nocturnal enuresis

Improper toilet training-This is another disputed cause of bedwetting

Heavy sleeping– bedwetting children are heavy sleepers.

Type 1 Diabetes Mellitus-Nocturnal enuresis could be the presenting symptom of type 1 diabetes mellitus.

Best Nocturnal Enuresis Alarms

Stop Bedwetting Permanently