Bedwetting, also called nighttime incontinence or nocturnal enuresis, is not uncommon in toddlers. According to AACAP, twenty percent of children wet the bed at the age of five. However, continued bedwetting past the toddler stage may be caused by an underlying issue rather than the occasional accident. There are several reasons your child wets the bed, some of which are completely normal.
Possible Causes of Bedwetting
Bedwetting usually subsides by puberty, and most children who wet the bed do not suffer emotional problems. However, Wake Forest Pediatricians know it’s essential to be conscious of the possible side effects, whether physical or emotional. Below are some underlying reasons your child may be wetting the bed.
Brain and Bladder Communication
Per Healthychildren.org, the bladder signals the brain that it’s filling up with urine. However, bedwetting will happen if the brain doesn’t send a message back to the bladder to hold the urine until awake or where it is appropriate to urinate. In this case, it is recommended to reduce liquid intake before bed and encourage your child to use the restroom before settling in for the night. Brain to bladder incontinence is not a huge cause for concern, as some children may need extra time to develop control of their bladder, especially during the nighttime.
Urinary Tract Infection
Urinary tract infections often referred to as UTIs, are infections of the urinary system. The urinary system is made up of four organs, including your kidneys, ureters, bladder, and urethra. Some signs and symptoms of a UTI in children, according to KidsHealth, include:
- Pain, burning, or a stinging sensation while peeing
- An increased urge to pee, but decreased amount of passed pee
- Wetting the bed even though the child is potty trained
- Foul-smelling pee that contains blood or is cloudy
UTIs are more common in girls and women due to their urethra being closer to their anus, yet uncircumcised boys under the age of one also pose a higher risk. A medical professional can treat UTIs with antibiotics and possibly urine tests. Symptoms, including bedwetting, should improve within 2-3 days of starting the antibiotics.
Sleep apnea, a form of sleep disordered breathing (SDB), is when breathing repeatedly stops and starts throughout the span of your slumber. A study conducted by the National Library of Medicine found that a total of 15.3% of the studied children had primary nocturnal enuresis, and 47 children with enuresis (30.7%) had SDB. Possible correlations between bed-wetting and sleep apnea include bladder pressure, arousal response, or urinary hormone secretion.
Although a risk factor, sleep apnea is much more common in adults, men, and those who are obese. Sleep apnea can be managed with a breathing assistance device, such as a continuous positive airway pressure machine called a CPAP machine.
It is not uncommon for a hormonal imbalance to cause bedwetting. Antidiuretic hormones (ADH) are hormones produced by the brain that slow urine production. According to the Urology Care Foundation, more urine is produced when the brain doesn’t produce enough ADH, or the kidneys stop responding to the hormone. This excess of urine is what causes nighttime incontinence. Generally, when ADH is produced at a normal level, and the body responds to it, less urine is produced, which helps a normal bladder hold urine throughout the night.
It is important to note that bedwetting can be hereditary and is more common if the child has a parent, aunt, uncle, or other family members who struggled with bedwetting. And remember, it’s not your child’s fault, so try not to punish them but instead offer support. If your child is having persistent bedwetting accidents, it may be time to reach out to their pediatrician. If you have more questions, you can find resources on our website or call us at (919) 556-4779 to discuss your concerns with a medical professional.