What is Bedwetting?It can be an embarrassing experience for children to wake up in bed feeling wet from urination. It can also be very painful for parents to see their children go through this experience. The bedwetting experience is a common condition that is not just physiological but has a psychological impact as well.
Bedwetting or enuresis is a condition where children beyond the age of five years involuntarily urinate in the night. This condition is not accompanied by any disease and affects 15% to 20% of children, 2% to 3% of teenagers while 0.5% to 2% of adults also suffer from this condition.
Bedwetting normally occurs at night during sleep. In general, children with nocturnal enuresis (nocturnal for night) do not have daytime enuresis. However it is estimated that almost 10% of children can have daytime wetting symptoms in addition to nocturnal enuresis.
Causes of BedwettingChildren, who have a tendency to wet their bed, rarely realize the involuntary urination. This occurs due to various factors. Some of them are:
- Inability to wake up from sleep
- Overactive bladder
- Delayed control of the bladder
- Consumption of caffeinated drinks like coffee or tea
- Psychological issues
- Genetic factors
- Nasal obstruction, sleep apnea
- Incontinence with no control on defecation or urination
Home Remedies for BedwettingBehavioral remedies and educational strategies should be tried before resorting to any medication. There maybe also be role for complementary therapy to prevent bedwetting.
The following are some of the home remedies for bedwetting -
There are preventive measures that can be adopted to restrict the habit of bedwetting. Some of the measures include:
Reward program: This is one of the initial measures adopted during the training young children for bedwetting. Children are rewarded when they have a dry night, which makes them feel encouraged to continue this positive progress. However, the downside is that children may feel disappointed and discouraged if they regress and have a wet night that makes them lose out on their reward.
Urinate twice before going to bed: The child is asked to urinate just before getting ready to go to bed. After the child is in the bed, the child is made to urinate again just before sleeping.
Reduce liquid consumption in the evening (deprivation): The child is encouraged to drink a lot of fluids during the day. However, the consumption of liquids is restricted by evening. This allows the child to empty the bladder before going to bed.
Improve bladder capacity - Reduced capacity of bladder may render the bladder incapable of holding the overnight urine leading to bedwetting. Increasing the bladder capacity may help the child overcome bed-wetting. During the daytime the child is made to hold the urine a little longer to increase the bladder capacity.
Use of a night lamp: Children can be encouraged to use the toilet in the night by keeping a night lamp on. This can help dispel fear of darkness that prevent children from accessing the toilet.
Timed urination: Following a schedule - the child is made to wake up in the night to urinate. This helps create a body clock for the child to get into a routine for urination and prevent bedwetting. This can also help older children, teenagers, and adults to wake up and urinate. Some parents use a code word with the child while waking them up to ensure the children are awake when they urinate.
Alarms: Children are made to sleep on mattress pads or mats that have electrical alarms set in them to detect urine that falls on them. There are also alarms that are attached to the body with sensors in the underwear. The alarms are either light devices or alarms with vibrations or sounds.
Overtraining: Individuals start to drink excess fluids to fill up the bladder before bedtime and utilize the alarm to understand the need to empty the bladder. The alarm training is performed for two weeks to get the body to recognize the change in bladder retention.
Carrying the child: Parents try to get the child to urinate and empty the bladder while asleep thus avoiding the consequence of bedwetting. This procedure is known as ďLiftingĒ.
Behavioral and educational strategies in the management of bedwetting
Dry bed training: In this training, on one night, children are woken every hour during the night to urinate. In the case of an accident, 45 minutes is spent in cleaning up (cleanliness practice) and positive training is implemented, where the child goes nearly nine times to urinate. The subsequent days involve waking up the child only once or twice during the night.
Complete home training: This involves a combination of the alarm, overactive training, cleanliness practice, and dry bed training.
Diet, Psychotherapy and Complementary or Alternative therapies for bed Wetting
Diet: Avoid drinks that contain caffeine. Caffeinated drinks cause a greater chance of bedwetting as they work as stimulants. More research data is required to understand the effect of some foods on bladder retention. Constipation can also be an underlying cause of bedwetting and the use of stool softeners is recommended.
Psychotherapy: Children, who have psychological issues, are subjected to psychotherapy. The therapist tries to understand the emotional disturbance that causes the child to persistently wet the bed. Measures are taken to modify the factors that may cause this emotional disturbance.
Homeopathy: Children may be treated with homeopathy to relieve the symptoms of bedwetting but clinical research needs to verify the effectiveness of this therapy. Homeopathic medications act by controlling the musculature of the bladder, managing the function and the control of the bladder. This eliminates involuntary urination and reduces the anxiety in a child. Homeopathic medications are an attractive alternative as they are sweet, natural, and safe to give to children.
Acupuncture and chiropractic are other forms of therapy that may be given to deal with bedwetting. However, the effectiveness of such therapies needs to be verified with more research trials.