Children and Bedwetting – Enuresis

By Clinton Marquardt - Sleep & Fatigue Specialist

August 18, 2008

children's sleep


As every parent quickly learns, bedwetting is common. It occurs in as many as 30% of all 4 year-olds. At the first appearance of bedwetting, some parents become disappointed because it seems like their child is taking a backwards step in development. Many even suspect that the child is wetting the bed voluntarily for attention or that their child is lazy and unwilling to get up and go to the bathroom at night. These parental reactions are hard to understand because the same parents were often bedwetters themselves and they should know that their little boy or girl has no control over the bedwetting; it’s not the child’s fault.

Bedwetting, also known as enuresis, occurs during very brief awakenings or partial arousals from the deepest stages of sleep and primarily during the first 1/3 of the night. Children sleep much more deeply than adults do and consequently, it is much more difficult for the sensation of a full bladder to wake them up so they can run to the bathroom.

Happily, enuresis is usually outgrown and decreases in frequency after the age of 5. However, the reprieve can be brief in a limited number of cases. Some children will go several months without an incident and then experience a relapse and start wetting the bed again. In these cases, the cause may be a psychological stressor, such as the arrival of a new sibling or even a new pet. Bedwetting can also be a symptom of a physical problem such as a urinary tract infection, kidney problem, small bladder or a hormonal upset.

Here are a few tips to help parents through the wet nights:

  • Talk to your doctor about medications that may help and medical conditions that may be contributing to the bedwetting. After this step, try the suggestions that follow.
  • First and foremost, never punish, tease or make your child feel bad for wetting the bed. This will only make the problem worse.
  • Limit how much your child drinks in the late afternoon and evening. Be sure they get enough to drink, but don’t let them gulp down any more than they really need.
  • Build a bathroom break into your child’s bedtime ritual. Make sure they at least try to empty their bladders just before bed every night.
  • Consider interrupting the bedwetting before it happens. To do this, wake your child up just before his or her usual enuresis episode and take them to the bathroom. This approach works well because your child’s brain will learn to sense the full bladder and mid-sleep bathroom breaks will become automatic. Remember, children are deep sleepers so it is important to make sure they are fully awake when trying this tactic. Otherwise, you will be teaching your child to urinate while sleeping and the problem will become more difficult to overcome.
  • Consider purchasing an electronic alarm-type device. These units detect when your child has wet the bed and then wake him or her up with sound or vibration. Eventually your child will begin to awaken in response to the full bladder instead of the alarm.
  • Practice makes perfect. Have your child lie down in bed for a few minutes and then at the word “go”, have them get up and go to the bathroom. Then at night wake them every hour or so for the first few hours and have your child go to the bathroom. Gradually extend the time between awakenings until you reach a whole night of sleep.
  • Another technique can be practised during the day. Have your little girl or boy drink as much as they can, then ask them to hold it for as long as possible. Reward them with lots of love every time they hold it in for another 15 minutes. Bladder muscle control can also be strengthened with urine stream-interruption exercises. Ask your child to stop urinating mid-flow. Make it a game and see how many times they can do it with every pee. Of course, they need a reward for each extra interruption.
  • Another great technique is to add a night-light to your child’s bedroom. This little bit of light can help your child break out of deep sleep much more easily when their brain senses a full bladder. If they can break out of deep sleep, they will be able to run to the bathroom in time.

If these techniques do not help, be sure to talk to your doctor again. Don’t give up on your child, and support them with lots of love through this period of their young life.

Thanks to L. Orr, BA, RPSGT for her help with this article.

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