For some teenagers and their parents, every morning starts with the same routine. Up early to change the sheets. It isn’t easy and it is an issue that can really impact on the life of a young person. Teen bedwetting, or nocturnal enuresis as it is known medically, is fairly common in young children, but for a small percentage it can continue into their teen years and beyond. Around one adult in every 100 remains affected by it. What does it mean to have nocturnal enuresis? And how can it be treated?
Around 4% of boys and 2% of girls will continue to wet the bed at night into their adolescence. This drops to 1.5% and 0.5% respectively by the time they reach the age of 18 according to research conducted by the American Academy of Child and Adolescent Psychiatry and published in their journal in 2003.
This isn’t a serious disorder, but its effects can be far reaching and have a huge impact on the wellbeing of the teenager, as well as putting stress on the family. It’s not a pleasant way to start every day, and can also cause a lot of embarrassment at a crucial time in their lives. Bedwetting at this age is also restrictive, often stopping teens from participating in school trips with their peers or sleepovers with friends. A drop in self-esteem has long reaching psychological implications too, impacting on their school work and even sports activities.
Nocturnal enuresis in adolescence and adulthood has a strong hereditary link. The National Association for Continence links family history to the likelihood of persistent primary nocturnal enuresis. This is when someone has never been more than six months without wetting the bed in their life. Secondary nocturnal enuresis is where a child or adult is dry for a long period of time, before beginning to wet the bed again. If this happens it usually indicates a urinary-tract infection, it could be a symptom of a more serious illness like diabetes, or it might be due to stress.
The NAFC says that where both parents had primary nocturnal enuresis, there is a 77% chance that their offspring will do the same. If it is just one parent, then their child has a 40% chance of also having nocturnal enuresis. These percentages carry forward as they go into adulthood. So if both parents were still wetting the bed when they were teens, it is highly likely their children will too.
One cause is a medical condition where the body doesn’t have enough of a hormone called vasopressin. The pituitary gland produces this and it controls the urine production by the kidneys. We start producing this hormone at night around the age of five years. Where not enough vasopressin is made by the body, bedwetting results. It’s possible that this lack of hormone production is down to a defective gene.
An overactive bladder is another cause. This is where it spasms when it is only a tiny bit full. Or it may simply only hold a small amount of urine before signaling to the brain that it needs to empty. Many bedwetters are also particularly deep sleepers. Combine a deep sleep with a brain that hasn’t yet fully developed its messaging system and bedwetting happens.
Medical reasons need to be ruled out first, and your physician may ask for a diary to be kept noting when accidents happen, the quantity of urine, types of liquid consumed and when, and what the urine looks like (dark or light, cloudy, etc). Note other symptoms that come with the bedwetting.
According to the NAFC, the types of tests involved include:
• Neurological evaluation
• Post-void residual urine measurements
It is possible to outgrow bedwetting. If your parent stopped wetting the bed when they were 15 it is likely their children will stop around the same age for example.
The Enuresis Treatment Centre suggests these two bladder exercises to help strengthen bladder control.
1. Wait to pee. During the day, when there is an urge to urinate, hold on for a little while longer than normal.
2. Hold the stream. When urinating try stopping and holding mid-stream.
The Mayo Clinic offers some lifestyle changes to help reduce bedwetting:
1. Limit liquid intake in the evenings. Focus on offering drinks in the morning and early afternoon.
2. Avoid caffeine, and also foods with caffeine as this can stimulate their bladder.
3. Go to the bathroom twice before bed. Once at the start of their night time routine. And then again just as they are about to fall asleep.
4. Constipation can cause bedwetting, so make sure this is checked and treated.