Bedwetting Might be Inevitable

Becky has to wake up almost every night to change her Son Oliver’s (aged seven) sheets at night, after an episode of bed-wetting. It is lot of hassle and embarrassment for her as a parent.

Out of embarrassment, Becky and her husband Mark are reluctant to discuss their problem with medical professionals.

In the meantime, Oliver feels that he is the only one who wets bed at night and strongly believes that there is something seriously wrong with him, which is having adverse effects on his self-esteem.

Sounds familiar?

You are not alone. It is more common than you think.

Some studies estimate that up to 20% kids wet the bed some or most nights — with twice as many boys wetting their bed as girls. After the age of age 5, about 15% of children continue to wet the bed, and by the age of 10, 95% of children are dry at night.

This problems of bedwetting are further aggravated by the secrecy and myths surrounding the problem.

Ever heard the claim that kids wet the bed out of laziness?

Or the idea that kids require counselling, as bed wetting is sign of psychological maladjustment or antisocial tendencies?

However, reality of the matter is that, bedwetting occurs during sleep, and research suggests that kids who wet the bed are physiologically different. They may be harder to awaken at night. In addition, their bodies produce less vasopressin, a hormone that suppresses the production of urine.

Also, the claim that bedwetting is a sign of psychological maladjustment holds no truth. It’s true that bedwetting is sometimes associated with stress. But child’s failure to awaken before urinating does not indicate that he is psychologically disturbed.

 Treatment options:

There are two approaches to the treatment. Medical or Behavioural.

1. Medical treatment:

Medical treatment consists of the use of following three drugs.

• Desmopressin

Desmopressin is a synthetic version of the hormone that regulates the production of urine, called vasopressin. It helps to reduce the amount of urine produced by the kidneys. The medication often works quickly. However, the condition may return after discontinuation of its use.

It suffers from side effects like headaches and sickness.

• Anticholinergics

Another option is to use a combination of desmopressin and an additional medication known as an anticholinergic. An anticholinergic called oxybutynin can be used to treat bedwetting.

Oxybutynin works by relaxing the muscles of the bladder, which can help improve its capacity and reduce the urge to pass urine during the night.

Side effects of oxybutynin include feeling sick, dry mouth, headache, constipation or diarrhoea.

• Imipramine

If the above treatments don’t work, a prescribed medication called imipramine may be recommended.

Imipramine also relaxes the muscles of the bladder, increasing its capacity and reducing the urge to urinate.

Side effects of imipramine include dizziness, dry mouth, headache, and increased appetite

2. Behavioural Treatment:

Behavioural treatment is often more effective and certainly is safer than medical treatment. While behavioural treatment may take somewhat longer to show results, the improvement usually continues indefinitely

some of the methods that can be useful:

• Night-lifting:

This procedure involves waking your child periodically throughout the night, walking your child to the bathroom to urinate, and then returning your child to bed. By teaching your child to awaken and to empty his or her bladder many times during the night, it is hoped that he or she will eventually stay dry.

• Moisture alarm:

Moisture alarms are considered a useful and successful way to treat bed-wetting. Medical research has shown that moisture alarms have helped many children stay dry. Moisture alarms have good long-term success and fewer relapses than medications

Over time, the child will learn to associate the feeling of a full bladder with needing to wake up and go to the toilet, and others will learn to ‘hold on’ and will continue sleeping without releasing their bladder.