Bed-wetting, also called enuresis, is a condition in which a person urinates while in bed, usually during sleep. Physicians only consider it to be a medical condition in an older child or adult; it is considered normal up until the age of 6 or 7. While bed-wetting is generally a harmless medical condition, it is psychologically difficult for many children and adults, who feel embarrassment, shame or dread regarding their condition. Over time, this can lead to anxiety and poor self-esteem. Several treatments for enuresis are available; if one treatment isn't successful, another can be attempted.
Moisture Alarm
A moisture alarm is a device consisting of a pad connected to an alarm, which sounds off when moisture strikes the pad. The pad is placed on the bed or in the child's pajamas. This device allows the child to awaken just as he begins to void and to go to the bathroom to continue voiding. Treatment often takes 12 to 15 weeks. In an article in "American Family Physician," author C. Carolyn Thiedke, M.D., reports that bed-wetting alarms have a 75 percent success rate.
Bladder Training
Bladder training involves helping the child to hold urine in her bladder during the day. The child can be encouraged to hold her urine for two to four hours during the day, depending on the physician's recommendation. This may stretch the bladder, allowing it to retain more urine at night.
Limiting Fluids and Caffeine
The child may benefit from limiting fluids during the three-hour period before bedtime. To use this method, the parent gives the child no more than 1 cup of fluid during this time. Caffeinated products can be withheld at all times, as they can irritate the bladder. Children who are highly active in sports should not use this method as they may need more evening hydration. In all cases, fluid limitation should only be conducted with physician guidance and consent.
Positive Reinforcement
Many children benefit from a program of positive reinforcement. Parents can use colorful stickers on a chart, with one sticker being awarded for each dry night. When the child has a certain number of stickers, he receives a prize. This can be continued for several months, culminating in a larger prize and "graduation."
Double Voiding
MayoClinic.com relates that double voiding is effective for some children who wet the bed. To use this method, the parent encourages the child to void at the onset of the nighttime routine. The child is then asked to void just before going to sleep. He is reminded that he can get up to use the bathroom during the night.
Medication
Medications are available for older children who have not been helped by non-drug treatments. The most common medicine for enuresis is desmopressin. It is available as a nose spray or tablet that is given prior to bedtime. Desmopressin reduces the amount of urine produced at night. Normally, the child only benefits when she takes the medicine and relapses when it is discontinued.
