Understanding Sleep Enuresis (Bedwetting): Causes and Solutions

Understanding Sleep Enuresis (Bedwetting): Causes and Solutions

Bedwetting is a common problem that can be embarrassing and frustrating for children and parents alike. It can even be dangerous for the child if it continues to occur over a long period. Unfortunately, many children suffer from this problem at some point in their lives. Some of these children will continue to wet the bed until adulthood. For others, the problem will resolve itself on its own after a few years. If your child has been having trouble with bedwetting, there are several factors that could be causing the issue. In this article, we’ll discuss the causes and effective solutions for this problem.

What is bedwetting (nocturnal enuresis)?

Bedwetting, or nocturnal enuresis, is a condition that affects children and even some adults. It is defined as the involuntary discharge of urine during sleep, often without any awareness on the part of the person affected. The causes of bedwetting can be complex and multifactorial, but they are usually related to delays in developmental milestones such as bladder control or psychological factors such as anxiety.

Bedwetting is more common in boys than girls and tends to run in families. Children who wet the bed may feel embarrassed or ashamed, leading to social isolation and poor self-esteem. Parents should know that bedwetting is not caused by laziness or disobedience but rather a medical problem that needs attention.

Fortunately, treatment options for bedwetting are available and can help reduce symptoms over time.

When Is Bedwetting a Problem?

Bedwetting is a common problem among young children, with up to 20% of five-year-olds wetting the bed at least once a month. This can be alarming for parents, but it’s important to know that it is a normal part of development. As children grow and their bodies mature, they become more able to control their bladder during the night.

Around age five, the rate of bedwetting in children starts to drop significantly. While some children may still wet the bed occasionally after this age, most will have fewer incidents as they get older. By adulthood, less than one percent of people regularly wet the bed every month.

It’s worth noting that there are many factors that can contribute to bedwetting beyond simple physical development. Stress and anxiety can play a role, as can certain medical conditions or medications.

Children develop at different rates and reach different developmental milestones at their own pace, so bedwetting may last until the ages of nine or ten years old or later. It’s usually thought that occasional bedwetting in childhood is benign and nothing to worry about.

In most cases, bedwetting is not a cause for concern and resolves on its own over time. However, there are rare instances where bedwetting indicates an underlying medical problem that requires attention.

If your child experiences sudden onset episodes of bedwetting after being dry for an extended period, you may want to consider medical testing. This could indicate a urinary tract infection or other underlying condition that needs treatment. Painful urination, cloudy or discolored urine, daytime incontinence, and bowel movement issues are also red flags that warrant further investigation by a healthcare provider. It’s important to note that while rare, these underlying conditions do exist and should not be ignored if they present themselves.


What Happens in Enuresis?

Enuresis is a condition that affects many people, but there are two types of enuresis: primary nocturnal enuresis and secondary enuresis. Primary nocturnal enuresis is the most common type of enuresis, and it occurs when a person has been wet since they were a baby. This means that they have never learned to control their bladder, even while sleeping at night. This type of enuresis can be caused by genetic factors or developmental delays.

It takes at least 6 months after a person learns to control their bladder for secondary enuresis to develop. This means that someone who hasn’t had any problems with bedwetting suddenly starts experiencing it again. The causes for this type of enuresis can vary greatly and may include physical or emotional trauma, urinary tract infections, or underlying medical conditions such as diabetes or sleep apnea.

In people with normal bladder control, the nerves in the bladder wall send a message to the brain when the bladder is full. When the person is ready to go to the bathroom, the brain sends a message back to the bladder to keep it from emptying. However, people with nocturnal enuresis have a problem with this system which causes them to pee involuntarily at night. This issue could be due to an overactive bladder or an underdeveloped nervous system that controls urination during sleep.

How common is bedwetting?

Nocturnal enuresis, also known as bedwetting, is a common condition among children and adolescents in the United States. According to recent studies, about 1 in 10 children suffer from nocturnal enuresis at some point during their childhood. It typically happens more frequently among younger children than older ones, with about 30% of children ages 7 and under experiencing this condition. 

As children grow older, the incidence of bedwetting decreases gradually. For example, about five out of ten-year-old children may still experience bedwetting issues while an estimated one to two U.S. teenagers aged fifteen years suffer from nocturnal enuresis. However, it’s important to note that even adults are not entirely immune to this condition; roughly two to three percent of individuals over eighteen years have primary nocturnal enuresis.

Symptoms of nocturnal enuresis?

For most individuals who experience enuresis, urinating while sleeping is the only symptom that they experience. However, this can be a frustrating and embarrassing issue for many children and adults alike. Many kids who wet the bed are very deep sleepers, which means that they may not even realize what has happened until they wake up in the morning.

If you or someone you know experiences enuresis, it’s important to speak with your doctor to determine if there is an underlying medical issue causing this condition.

Causes of Bedwetting

There are several factors that may contribute to bedwetting, including physical and psychological causes. Understanding these causes can help individuals take the necessary steps toward managing or overcoming this condition. They include:


Research has shown that children who struggle with bedwetting are more likely to have anxiety issues than those who don’t. A chronic, ongoing state of distress can be the cause of anxiety. Children who suffer from bedwetting may experience fear and anxiety about going to sleep or staying overnight at a friend’s house. They may also worry about being teased or ridiculed by others if their secret gets out. This constant stress can lead to generalized anxiety and panic attacks, making it difficult for them to cope with everyday life situations.

Eating and drinking habits

Foods and drinks that are diuretics, such as coffee, tea, and alcohol, can cause the body to excrete more urine. This means that consuming these beverages can increase the frequency of urination in both adults and children. Unfortunately, some children are more sensitive than others to diuretics and may experience bedwetting or other urinary issues as a result.

Caffeine is one of the most common diuretics found in coffee and tea. Even though caffeine is a stimulant that can help people stay awake during the day, it can also cause unwanted side effects such as increased urination at night. When a child consumes drinks containing caffeine before bedtime, they are more likely to wet the bed due to their body’s need to frequently empty their bladder. Many parents restrict their children’s fluid intake in the evening as they get ready for sleep.

Urinary Tract Infections (UTIs)

Urinary tract infections (UTIs) are a common cause of bedwetting in children. UTIs occur when bacteria enter the urethra, bladder, or kidneys and multiply, leading to inflammation and infection. In children, UTIs often go undiagnosed because they may not be able to express their symptoms clearly or may not be aware of what is happening to them.

The most common symptom of a UTI is frequent and unexpected urination. Children with a UTI may also experience pain or burning during urination, abdominal pain, fever, and cloudy or strong-smelling urine. The inflammation caused by the infection can irritate the bladder and increase the need to urinate more frequently than usual. This can result in bedwetting for some children who have never previously experienced this issue.

Sleep apnea

Sleep apnea is a condition that causes the body to repeatedly stop breathing during sleep. There is a potential effect of sleep apnea on the production of a hormone called ANP. If ANP causes the kidneys to produce extra urine during sleep, it could lead to bedwetting. Children who experience bedwetting may feel embarrassed or ashamed, but it is important for parents and caregivers to understand that it can be a symptom of an underlying medical condition like sleep apnea. Fortunately, there are treatment options available for sleep apnea in both adults and children.


Constipation is a common condition that affects people of all ages. It occurs when bowel movements become difficult or infrequent, resulting in the accumulation of excess waste in the rectum. The rectum is located behind the bladder, and when it becomes full, it can bulge outwards. This bulging can cause pressure on surrounding organs, including the bladder.

In some cases, constipation can lead to bedwetting in children. When the bulging rectum pushes against the bladder, it can result in involuntary urine leakage during sleep. Although bedwetting is a common problem among children, regular occurrence beyond age five should be evaluated by a healthcare provider as it might be caused by other underlying conditions such as constipation.

If your child experiences both constipation and bedwetting simultaneously, addressing constipation first may help alleviate bedwetting symptoms.


Kidney Issues

The kidneys are an essential part of the urinary system, responsible for filtering waste products from the blood and producing urine. Any dysfunction in this process can result in a range of complications, including bedwetting. Enlarged kidneys or chronic kidney disease are some of the underlying causes that lead to bedwetting in children.

Kidney disease is a relatively common condition among children, with one in every 650 children being diagnosed with it each year. Some of the signs and symptoms associated with kidney disease include weight loss, increased thirst, and increased urination frequency. Bedwetting is often a secondary symptom of these issues; however, it’s important to note that not all children who wet their beds have kidney problems.

To diagnose whether or not enlarged kidneys or chronic kidney disease is causing bedwetting in your child, you should seek medical advice as soon as possible.

ADH Insufficiency

Antidiuretic hormone, or ADH, is a crucial hormone produced by the brain in healthy individuals. This hormone plays an essential role in regulating the body’s water balance and blood pressure. One of its functions is to slow down the rate at which kidneys produce urine during the night. This slowing effect allows a person to sleep through the night without waking up to use the bathroom.

However, when there is insufficient ADH production or when our bodies do not process or respond adequately to this hormone, it can lead to conditions such as bedwetting. Bedwetting occurs when urine production does not slow down sufficiently at night, leading to involuntary urination during sleep. This condition can be distressing for children and adults alike and can impact their self-esteem negatively.


Millions of people worldwide suffer from diabetes, a chronic disease that has frequent urination as one of its most common symptoms. When left untreated, diabetes forces the body to eliminate sugar through the urine, resulting in hyper-frequent urination. This symptom is especially pronounced in children who have recently been diagnosed with diabetes.

Parents may notice a marked uptick in urination and bedwetting in their children, which should prompt them to seek medical attention immediately. If left untreated, diabetes can lead to serious complications such as blindness, kidney failure, nerve damage, and even limb amputation.

Family History

Millions of children worldwide are affected by bedwetting, which recent evidence suggests may have a hereditary component. Studies indicate that a child with no family history of bedwetting has a 15% chance of experiencing this problem. However, if one parent had bedwetting during childhood, the child’s risk factor increases to 50%, while having two parents with bedwetting issues results in a higher risk factor of 75%. Thus, genetics play a significant role in determining whether or not a child will struggle with bedwetting.

While genetics is an essential factor in determining the likelihood of bedwetting, other factors can also contribute. For example, certain medical conditions such as diabetes or urinary tract infections can increase the risk of bedwetting.


Studies have shown that kids with ADHD are more likely to struggle with this issue than their neurotypical peers. While the exact link between bedwetting and ADHD is still unclear, researchers believe that there may be a connection between the two conditions due to shared underlying neurological factors. In particular, some studies suggest that bedwetting could be related to difficulties in regulating bladder control and sleep patterns – both of which can also affect people with ADHD.

It’s important for parents and caregivers to understand that bedwetting is not something children can control or should feel ashamed about. Instead, it’s essential to offer support and seek treatment options if necessary.

Being a “deep sleeper”

A child who wets the bed is often described as a deep sleeper. This is because it can be hard for a child to wake up when they need to urinate. The child’s Pelvic floor muscles relax during sleep, which makes it difficult for them to control their bladder. This can lead to bedwetting and cause anxiety and embarrassment for both the child and their parents.

It is essential to understand that brain-bladder control develops naturally and will improve with age. However, children who are deep sleepers often take longer to become fully continent at night. It is not uncommon for children up until the age of five or six years old, even those who are not deep sleepers, to wet the bed occasionally as their bodies learn how to control their bladder while sleeping.

How is nocturnal enuresis diagnosed?

Nocturnal enuresis, commonly known as bedwetting, is a condition that affects many children and adults. While it is often considered a normal part of childhood development, in some cases it can indicate an underlying medical or psychological condition. If you or your child experiences bedwetting regularly, it’s important to speak with a healthcare provider.

During the diagnosis process, your healthcare provider will take a complete medical history to determine if there are any underlying conditions that may be contributing to the bedwetting. They may also perform tests such as urine analysis, blood tests, or X-rays to identify any potential abnormalities. In some cases, further imaging studies like ultrasound may also be recommended.

It’s important to note that in some instances mental health factors can contribute to bedwetting. If this is suspected by your healthcare provider they may recommend speaking with a mental health professional for additional support and guidance.

However, if bedwetting persists beyond a certain age or becomes an ongoing problem, then it may be a good idea to speak with your healthcare provider.

On the other hand, daytime wetting (enuresis) is less common and generally not considered normal. This can occur when children are too busy playing or engaged in other activities to take a break and go to the bathroom. If your child is experiencing daytime wetting regularly, it’s important to have them evaluated by a healthcare professional. It could potentially be due to an underlying medical condition that requires treatment or intervention.


Treatment for Bedwetting

There are a variety of factors that can contribute to bedwetting, including medical conditions, emotional stressors, and developmental delays. By taking a proactive approach and trying out different strategies, you can help your child reduce their bedwetting frequency and regain confidence in themselves. In this article, we’ve compiled a list of actionable steps you can take to help address your child’s bedwetting problem and get them on the path toward dry nights once again.

Communication with the child

Numerous children experience bedwetting, which can cause frustration and embarrassment for both the child and their parents. However, effective communication is a valuable approach to addressing this issue. Children who wet their beds often feel ashamed and helpless, but talking openly about the issue can help them feel more comfortable and confident.

If your child has been experiencing bedwetting, it’s important to approach the subject in a compassionate way. Try to understand how they are feeling and what might be causing their bedwetting. It could be due to stress or anxiety, or simply because they are not yet fully developed physically. By asking your child questions about their emotions and body, you can create an environment where they feel safe sharing their thoughts and concerns with you.

Show acceptance and support

Bedwetting is a common issue that affects many children. It can be frightening and inconvenient for parents, but it is important to remember that the majority of children do not wet their beds intentionally. Bedwetting should not be treated with punishment or shame; instead, it should be addressed compassionately and without judgment. Parents should reassure their children that bedwetting is just a hiccup and that they will work together to find a solution.

It is important to understand that bedwetting can have both physical and emotional causes. Some children may simply have smaller bladders or produce more urine at night, while others may experience stress or anxiety. It is essential to approach the issue with sensitivity and understanding, as negative reactions from parents can exacerbate the problem. Parents should talk openly with their children about bedwetting, encouraging them to share any concerns they may have.

Focus on sleep hygiene

Sleep problems can have various negative effects on our daily lives. Fortunately, many of these issues can be improved with the adoption of healthy sleep hygiene practices. Sleep hygiene refers to a set of habits and behaviors that promote good quality sleep. These practices include developing routines before bed, creating a relaxing sleeping environment, and maintaining a regular sleep schedule.

One specific way in which improving sleep hygiene can make a difference in our lives is through the improvement of bladder control. Bedwetting is often associated with poor sleep hygiene, as lack of routine or disrupted sleep patterns can negatively affect bladder function during the night. By establishing consistent bedtime routines and practicing good sleep habits, such as going screen-free for an hour before bed and avoiding caffeine late in the day, individuals may find that their bladder control improves over time.

To improve overall sleep hygiene, it is important to prioritize good habits both during the day and at night.

Maintain balanced liquid consumption

It’s important to establish a healthy bedtime routine for your child, and this includes monitoring their fluid intake before bed. If possible, try to keep children from drinking for 1-2 hours before bedtime, so they will be less likely to need to urinate during the night. This can help prevent disrupted sleep patterns and ensure your child gets the restful sleep they need.

However, it’s also crucial to make sure your child stays hydrated throughout the day. Dehydration can lead to a range of problems, including headaches and fatigue. Encourage your child to drink regularly throughout the day so that they don’t become too thirsty in the evenings. This will help avoid a thirst overload near bedtime and reduce the risk of waking up because of dehydration during the night.

It’s worth noting that every child is different when it comes to their fluid intake needs, especially depending on age and activity level.

Create bathroom schedule

Making sure your child goes to the bathroom as close to bedtime as possible is an essential part of their nighttime routine. It’s crucial because it can prevent bedwetting accidents and ensure that your child gets a good night’s sleep without any disruptions. Encouraging your child to use the bathroom before going to bed should be one of the very last things they do in their nighttime routine, followed by brushing their teeth and getting into bed.

In addition to making sure your child uses the restroom before bedtime, it’s also important to schedule regular bathroom breaks throughout the day. This will help keep their kidneys and bladder healthy and teach them how to pay attention to their body’s needs. Make sure they understand that holding urine for too long can lead to urinary tract infections or even damage their kidneys over time.

Avoid bladder irritants

Bedwetting is a common condition among children, but some parents believe that certain foods and drinks can cause their child’s bladder to produce more urine or irritate the bladder and reduce their bladder control. While it is true that caffeine and alcohol intake may lead to frequent urination, there is limited scientific evidence to support dietary changes as a cure for bedwetting. In fact, some experts advise against changing a child’s diet to manage bedwetting.

If you suspect that your child’s diet might be causing excessive urination or bladder irritation, it is important to consult with your pediatrician before making any dietary changes. Your pediatrician can help identify any underlying medical conditions that may be contributing to bedwetting and provide advice on how best to manage it. They can also recommend alternative strategies such as behavioral therapies or medication if necessary.


Keep a calendar

Bedwetting is a common problem that many children face, and it can be frustrating for both the child and their parents. However, keeping track of dry days can help parents get a better sense of the issue. By recording when their child has a dry night, parents can start to see patterns and identify potential triggers for bedwetting.

One way to keep track of dry days is by creating a bedwetting calendar with the child. This allows them to visually see their progress and feel proud of each night they stay dry. Additionally, offering rewards for achieving one full dry night can be motivating for some children. This form of therapy not only helps with managing bedwetting but also boosts self-esteem and confidence in children.

It’s important to remember that bedwetting is not something that children have control over, and it’s crucial to approach the topic with empathy and support.


Bedwetting is a common problem among children that can cause significant stress and anxiety. Studies have shown that biofeedback could be a successful treatment for children who struggle with bedwetting. This non-invasive therapy helps children become more aware of their body’s responses, which in turn leads to improvements in bladder control.

During biofeedback sessions, a child is connected to electromechanical equipment that monitors changes in their bodily processes such as temperature, muscle tension, breathing, brain activity, and more. The information gathered by the equipment is then relayed back to the child through visual or auditory cues. By learning to recognize these cues and make conscious adjustments to their bodily functions, children can gain greater control over their bladder function.

One of the advantages of using biofeedback as a treatment for bedwetting is its effectiveness without medication or surgery.

Practice exercises to strengthen the pelvic floor

According to recent studies, performing regular pelvic floor exercises can help improve bladder control and ultimately eliminate bedwetting in many children. Although more research is needed to confirm the effectiveness of this method, it is certainly worth considering as a potential solution when other treatments have failed.

Pelvic floor exercises involve contracting and relaxing the muscles of the pelvis repeatedly over time. By doing so, these muscles become stronger and more able to support bladder control. This type of exercise has been shown to be effective in treating urinary incontinence in adults, and now researchers are testing its efficacy in treating bedwetting in children.

Introduce a wetness alarm

sensor placed in a child’s pajamas or sheets can help prevent bedwetting accidents. When the child starts to pee, the alarm goes off and provides an opportunity for the child to get up and use the bathroom. This method is known as a bedwetting alarm and has been proven to be an effective treatment option for children who struggle with bedwetting.

Bedwetting alarms come in different shapes and sizes, but most are designed to detect moisture. The sensors are usually placed in absorbent underwear or on a pad that is placed under the sheet. When moisture is detected, an alarm sounds, alerting the child that it’s time to use the bathroom. Some alarms even vibrate or have flashing lights instead of sound to avoid waking up other family members.

Consult with the pediatrician

If your child continues to wet the bed past the age of 6, talking to your pediatrician may help identify potential causes and treatment options.

Your pediatrician can perform tests to rule out any medical conditions such as diabetes or urinary tract infections that may be contributing to bedwetting. They can also assess if there are any psychological factors such as stress or anxiety that may be causing your child’s bedwetting. By identifying potential underlying factors, you and your pediatrician can work together to develop a management plan that fits your child’s needs.

It is important for parents not to shame or punish their children for wetting the bed as it is often out of their control.


Bedwetting is a common problem among young children, and it’s normal for kids to wet the bed occasionally until they’re around five years old. However, if your child is at least seven years old and still regularly wets the bed, it may be time to consider seeking medical advice. There are several reasons why an older child may continue to wet the bed, including underlying medical conditions or psychological issues.

One potential cause of bedwetting in older children is sleep apnea. This condition can disrupt a child’s breathing during sleep, leading to interruptions in their sleep cycle that can prevent them from waking up when they need to use the bathroom. Other medical issues such as diabetes or urinary tract infections can also lead to bedwetting. Additionally, emotional stressors like anxiety or trauma can cause nighttime accidents in some cases.

Secondary enuresis is a condition where an individual, who has been dry at night for six months or more, starts wetting the bed again. While primary enuresis (bedwetting that has never stopped) is common in children and teens, secondary enuresis can occur at any age. Medical conditions such as diabetes, urinary tract abnormalities, constipation, and urinary tract infections are some of the potential triggers for secondary enuresis.

Diabetes is a medical condition that can cause secondary enuresis. High blood sugar levels can lead to an increase in urine production which may result in bedwetting. Urinary tract abnormalities such as problems with bladder control due to weak muscles or nerve damage can also trigger this condition. Constipation can also lead to bedwetting because it puts pressure on the bladder and reduces its capacity to hold urine for long periods.

Enuresis, commonly known as bedwetting, is a condition that affects millions of children worldwide. It can be a frustrating and embarrassing problem for both parents and children alike. The main symptom of enuresis is repeated bed-wetting, which occurs when a child involuntarily passes urine in their sleep.

Children who suffer from enuresis may also experience wetting in their clothes during the day. This can be particularly challenging for children who are attending school or social events. In addition to these symptoms, enuresis is typically diagnosed when a child wets the bed at least twice a week for approximately three months. If your child is experiencing any of these symptoms, it’s important to seek medical attention to determine the underlying cause and appropriate treatment options.


Sleep enuresis is a common issue that affects millions of people around the world. Its causes are varied and complex, ranging from genetics to psychological factors. However, it is not an irreversible condition – there are several solutions available for both children and adults alike. From simple lifestyle changes to medical treatments and therapies, there is hope for those who struggle with bedwetting. By understanding its causes and seeking appropriate help, individuals can overcome this challenge and improve their quality of life. Don’t let bedwetting hold you back – take action today!

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