Question: Our son is seven years old. He was toilet-trained before he turned three. However, he is still wetting his bed almost every night. My husband said that he was the same until he turned ﬁfteen. I am frustrated; his younger sister has been dry for more than a year. When I asked my doctor, she advised that I should just wait. Is there anything that I can do to help him?
I believe your doctor is right. You have to be patient. Sooner or later, his bedwetting will stop.
Bedwetting is very common in children, especially in boys. Research has shown that 10-15% of ﬁve-year-olds wet their bed every night. There is usually a strong family history: either a parent or a close relative has the same problem growing up. There is a social stigma associated with bedwetting; it is seldom mentioned outside of the immediate family.
During the day, we have to pee every few hours, depending on the amount of ﬂuid that we drink. At night, our kidneys produce less urine because we have an anti-diuretic hormone (ADH) that slows down the kidneys. As a result, our bladder ﬁlls up slower at night.
In some children, they seem to have less ADH at night. Their kidneys continue to produce urine faster than others. These bedwetters also go into deeper sleep, not able to feel that their bladder is getting full. At last, the bladder releases the urine and soaks everything.
Many parents have tried everything to stop bedwetting. Children have been punished; but it doesn’t work. Moreover, it can be harmful and result in poor self-esteem. Parents have tried wakening their children in the middle of night to pee. Sometimes it does prevent bedwetting, but not always.
Alarms have been designed to treat bedwetting. They can detect just a few drops of urine, and make a loud noise to wake up the child. Unfortunately, many children are in such deep sleep that they don’t wake up, while the alarm wakes up everyone else. It can be useful if the whole family is motivated to try. It can ‘cure’ bedwetting in less than 50% of children after more than 3 months.
A medicine called DDAVP (a synthetic form of ADH) can be taken one hour before bedtime. It is effective as long as the child is taking the medicine, but it doesn’t cure the problem. It is useful for camping and sleepovers, when bedwetting is going to cause embarrassment and teasing.
Most of the time, I advise parents of these children to be patient; bedwetting is a maturation issue. They cannot feel their full bladder when they are in deep sleep. When they get older, their sleep is naturally less deep, and they will wake up when they feel that their bladder is full. Over time, they wet the bed less and less frequently. Finally, they are ‘cured.’
In the meantime, parents can restrict ﬂuid at and after supper. Children should go to pee before bedtime. I don’t encourage wakening children up to pee in the middle of the night, but many parents do it anyway.
In the morning, children can help to change bedsheets and blankets, take a shower, and put all these items in the washer. This will increase their sense of responsibility and be part of the solution. When he is ﬁnally cured, your family can celebrate his success.