Nighttime Wetting (Nocturnal Enuresis)

Wetting the bed at night after an age when most children are dry is called nocturnal enuresis (ehn-yoor-EE-sis). It is not cause for serious alarm. Nighttime wetting is common up to the age of 5.

There is no single cause for nighttime wetting, but many things can cause it:

• Some children take longer to develop bladder control than others. All children develop at their own pace. Some children learn to walk or talk later. Some children get control of their bladders later.
• Not being able to poop (constipation).
• If your child has a family member (mother, father or sibling) who wet the bed, this increases the chance your child will wet the bed.
• Some children are deep sleepers and do not wake when their bladder is full.
• Some children’s kidneys make more pee (urine) overnight than others.

Nighttime wetting is a problem for a lot of children, but it usually goes away as they get older. How often it happens also decreases with age. This table can help you understand how common nighttime wetting is:

After the age of 7 or 8, most children with nighttime wetting are old enough to take part in a night training program. It helps children learn how to control their bladders at night. For any program to work, your child must want to be dry and be willing to work with you.

Usually, children stop wetting at night as they grow older without any treatment. There is no way to know when your child will be dry every night. Treatment usually means helping your child to form habits that will allow them to control their need to pee. Do not punish or shame your child for nighttime wetting.

• Have your child pee every 2 to 3 hours during the day.
• Your child should drink most of their water earlier in the day. The goal is for the urine to be almost clear like water.
• Avoid liquids 2 hours before bed.
• Pee twice (double void) before bed every night.
• Avoid constipation. Your child should have a soft, mashed potato consistency stool (poop) every day. You can learn tips in our handout “Constipation: Treatment of Chronic Constipation and Soiling.”
  seattlechildrens.org/pdf/PE648.pdf

• The bedwetting alarm helps teach the brain and bladder to communicate more effectively, helping the brain to recognize when the bladder is full.
• Most alarms have a sensor that buzzes or vibrates when your child wets. In the beginning, you may need to wake your child when the alarm goes off. Most children wake up on their own over time.
• It is likely your child will still wet the bed in the beginning of the alarm program. Over time they will learn to respond to the bladder being full before wetting the bed. Practicing the alarm routine before going to bed can help with the program.
• If your child uses an alarm, they will use it every night until they are dry each night for 2 weeks. The alarm program is a commitment and can take 4 months to see improvement.
• The alarm works for about 60% of children.

• Sometimes we prescribe medicine to help your child be dry at night. Desmopressin acetate (DDAVP) is medicine that helps your child make less urine. Your child can take it every day or just once in a while. For example, if your child is going to a sleepover or camp, they may want to take medicine to help them not wet the bed at night.
• Medicine does not cure bedwetting, and it does not work for everyone. DDAVP is 30 to 40% effective while taking the medicine. After stopping the medicine, the bedwetting usually returns.

If you have any questions about nighttime wetting or these treatments, please call the Urology Clinic at 206-987-2509.