Bedwetting (Nocturnal Enuresis)
The good news about isolated nocturnal enuresis (or bed wetting) is that as long as it is isolated (no daytime or awake symptoms) there is nothing to worry about. It is simply a form of developmental delay that the child will outgrow. It is often inherited (Did mother/father/aunts/uncles wet the bed?), and is more common in boys.
The usual preventative methods tried by families (no drinking before bedtime, periodic awakenings during the night, etc) don’t work, because as soon as the child reaches a certain level of sleep, the bladder will empty whatever it’s holding. There is no real reason to treat before the age of 7 anyway, as it is ineffective and as many as 15% of 6 year-olds still wet the bed. Typically, after the age of 6, 15% of children will get better every year on their own.
If you would like to treat your child’s bedwetting there are two main options: Medications and the Bedwetting Alarm.
Medications for Bedwetting
There are no perfect medical therapies for bedwetting. They are for the most part less effective than the bedwetting alarm (see below), and as is the case for all medications, may have side effects. Therefore, we don’t usually recommend medical therapy for these children.
If you have a child that wets the bed, and you would like some therapy for a temporary time period (sleep over, summer camp, etc) the medication DDAVP may be helpful. This medication does reduce the number of wet episodes during use in some children, as it decreases the amount of urine produced at night, but it does not cure bedwetting, and as soon as you stop the therapy, the wetting usually returns. If you are interested in this type of therapy, see your doctor.
Bedwetting Alarm
The most effective therapy for bedwetting is the bedwetting alarm which is available for purchase online or your neighborhood pharmacy. However, the bedwetting alarm must be used correctly to work.
The device consists of an alarm that is activated when your child wets the bed. The important point is that the child must wake up when the alarm goes off. Most parents complain that their child sleeps too deeply and sleeps right through the alarm. This does happen but for this therapy to work, the entire family must be committed to using the alarm correctly. This means your child has to wake up either by hearing the alarm or by you waking them up when you hear the alarm. The child must then turn off the alarm themselves, go to the bathroom to empty their bladder, return to bed, and reset the alarm.
If you follow these steps precisely, every night, then the bedwetting will resolve faster than it would have on its own.