Bedwetting during the night, called nocturnal enuresis consists in the involuntary urination during sleep.
Bedwetting is a very common thing in infants and small children but it is considered a problem when it appears in boys over 6 years old and girls over 5 years old.
Enuresis affects 15-20% of the 5 years old population, 7% of the 7 years old one and 1-2% of the teenagers and adults. Boys are twice more affected than the girls. Primary enuresis consists in bedwetting by a child who has always done that
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It is considered to be a delay in growth. Rarely, the cause is a urological disorder from the area of internal or neurological medicine in a child who presents primary enuresis and does not wet the bed during the day. Secondary enuresis appears in a child who has been dry for a period of time which precedes the bed wetting manifestation.
Bedwetting can be frustrating for the child and parents, causing low self-respect for the child. As in the case of pottie training, parents should never be upset or angry with the child who wets the bed. They must understand that the child does not deliberately do so.
More cases of nocturnal enuresis can be encountered in the members of the same family (more cases among 1st and 2nd degree relatives). Research showed that if the dad wetted the bed as a child, there are 39% chances for the child to wet the bed as well and if the mother had a history of bedwetting, there is a 23% higher possibility. If both parents have a bedwetting history, there is a 77% chance for the baby to wet the bed as well.
It was suggested that some children might have a sleep disorder which makes it difficult for them to wake up. However, no scientific research studied this theory and the majority of children have a profound sleep whether they have enuresis or not.
In some children, the cause of bedwetting is urine formation during the night. Normally, a hormone release during the night reduces the urinary flux, but this hormone can be absent in some children.
Enuresis can be of several types:
- § primary – the child lacks sphincter control over a period of 3-6 months
- § secondary – the child involuntarily urinates after a period in which she/he had sphincter control
- § nocturnal – the child involuntarily urinates during sleep more often than once a month
- § diurnal – the child involuntarily urinates during the day
Causes are various:
- Heredity (the disorder can be genetic)
- Sometimes a normal ADH (anti-diuretic hormone which controls water absorption in the body) secretion increase does not take place and so there is a bigger quantity of urine in the body than the functional capacity of the urinary bladder
- There can appear infections at the level of the kidneys or urinary bladder
- Constipation
- Delays in growth and development, especially in the nervous system
- Profound sleep (nocturnal enuresis)
- Ingestion of a lot of water before going to sleep
- Various undiagnosed diseases: diabetes,
- Posttraumatic stress disorder
- Hyperkinetic syndrome
- Malformations or tumors of the spinal cord
- Sleep disorders
- School related concern
- Change of habitation or kindergarten/school
- Parents divorce
- Frustrations or failures