When you’re tired and at your wits end it’s much easier to blame something, or someone, for a seemingly insoluble problem than to find and implement a solution. This is often the case with bedwetting. We frequently hear parents say: “I can’t understand why little Johnny wets the bed. I never had this problem as a child, nor did my siblings. It must have come from my wife/husband’s side of the family!”
It’s true that there can be a genetic link to bedwetting. A child has a 40% chance of being a bed wetter if one parent wet the bed as a child. This rises to 70% if both parents suffered from bedwetting. However, genetics are not always to blame and even if genetics do play a part, knowing this does not help the child or the parent understand the physiology of bedwetting and how to treat it.
Essentially, the reason 1 in 7 five-year-olds suffer from primary nocturnal enuresis is that the neurological development of their bladders is delayed. Variation in normal bladder neurological development is to be expected in the population at large, and generally 15% of bed wetting children will outgrow the problem each year. However, this means that many children will suffer the problem well into puberty and a minority will go right through adolescence with it.
The bladder relies on muscles to contract and release when the body is ready to urinate. The internal sphincter is the primary muscle for prohibiting the release of urine from the bladder. It is made of smooth muscle and is under involuntary or autonomic control, i.e., it can’t be consciously controlled. The external sphincter muscle is the secondary muscle controlling the flow of urine through the urethra. Unlike the internal sphincter muscle, the external sphincter is made of skeletal muscle therefore it can be consciously controlled.
In bed wetters the neurological developmental delay means that the signal to wake when the bladder is full is weak or inoperative and the internal sphincter allows automatic, involuntary voiding when the bladder fills above a certain level. Also, if the bed wetter does not wake up they are unable to consciously clamp the external sphincter muscle shut to stop the urine flow.
Another factor that is linked to bedwetting is the anti-diuretic hormone (ADH). Some bed wetters do not produce enough of this hormone at night to allow them to sleep right through without needing to go to the toilet. So, if you add the over-production of urine at night to the lack of a ‘wake-up’ call when the bladder is full, you end up with a child who cannot help but wet the bed!
The good news, however, is that bedwetting alarms can be used to treat nocturnal enuresis (night time bedwetting). In fact, if your child has never been dry at night then the only method which has been proven to cure the problem is a bedwetting alarm.
Bedwetting alarms work by placing a sensor in the child’s underwear that sounds an alarm when a small amount of urine is released, waking the child up. Over time the child gradually learns to associate the sensation of a full bladder with the need to awaken and eventually the bladder reflex will function correctly and let your child sleep through the night.
Clinical psychologist, Dr Kushnir, who uses our DRI Sleeper® bedwetting alarms in his enuresis clinics has developed the following video to help children understand what their bodies are doing when they wet the bed at night. It also shows how a bedwetting alarm can help them stop bedwetting. It is important to reassure your child that bedwetting is not unusual and that there is a way of treating it. Take some time out to watch the video with your child. Reassure him or her that their bedwetting can be cured and you and DRI Sleeper® are here to help and support them.