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Why do we wet the bed and how to stop?

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The famous bed-wetting: we all went through this at a very young age, and our children too, if they’re not still in this phase. Its scientific name is “enuresis”, and is characterized by involuntary urination while sleeping. Enuresis can thus in particular occur at night. Primarily associated with children, it is also present in adults in some cases. However, as soon as you’re no longer in the bedwetting period that is typical of children, it’s often seen as shameful: if you or someone close to you is affected, you’ll rarely talk about it to those around you. You’ll also be somewhat embarrassed with your family doctor. For all that, there’s nothing demeaning given the causes responsible for it. This is why Polysleep has decided to treat this issue objectively from top to bottom, by going into the details of this affection and its origins, and by proposing solutions. So read on without further delay to solve the problem!

Nocturnal enuresis: a complex phenomenon that can be subdivided into several cases.

Young child lying on a bed

Enuresis in children

According to the Association Française d’Urologie, around 10% of children between 5 and 10 years old can be affected by enuresis, and boys are more regularly affected than girls. It’s defined as a complete and active urination of which the sleeper is not conscious, and which isn’t triggered voluntarily. Enuresis occurs, as mentioned previously, while sleeping, and takes place mainly at night. An important precision, enuresis in children can only be called so from the age of five: it’s only after this age that humans can physiologically control their bladder sphincter.

Moreover, two types of enuresis are to be distinguished, starting with the enuresis qualified as primary. This first case is very simple: it happens when a child has never fully mastered toilet training. It can affect 10–15% of children aged 5 years, and 6–8% of those aged 8 years. The second type is secondary enuresis: it occurs after at least six months of the child being toilet trained. In this second case, it will be wise for the attending physician to look for signs of urinary tract infection or parasitosis in the intestines. Although the majority of bedwetting is occasional nocturnal enuresis, others may occur during the day. Finally, some enuresis occurs both at night and during the day.

Different types of bedwetting can also be identified according to their frequency in children.

  • Total enuresis: the child wets the bed every night.

  • Sparse enuresis after 8 years old: this type of bedwetting is specific since it’s directly related to what the child may have experienced the previous day.

  • Intermittent enuresis: this type of enuresis occurs at specific times.

  • Episodic enuresis: these bedwetting episodes are very rare and accidental. They may occur during major events in the child's life (e.g. illness, divorce).

Enuresis in adults

Already taboo in children, it’s even more so among adults, of which between 2 and 3% could suffer from it. The definition previously stated for children concerning enuresis is also applicable to adults. It always occurs also at night, as for our dear little ones. It’s however necessary to consider enuresis as a symptom and not as a disease.

In spite of this, it remains very stigmatized socially: those suffering from it find this condition shameful, to the point that sometimes they refuse to see a doctor. We speak of adult enuresis in any person aged 15 years and older, for both genders. Depending on the case, it can either have persisted or reappeared after puberty and have, as you will see below, many causes.

The origins and symptoms of nocturnal enuresis are diverse and vary in children and adults.

3D rendering of an adult lying in bed on the side

Causes and symptoms of bedwetting in children

The first origin of enuresis in children will be heredity. Indeed, a child who has a parent that suffers from enuresis is almost 30% more likely to be enuretic his/herself. This percentage can even go up to 70% if both parents were concerned by this condition.

In many cases of primary enuresis, an immature bladder is involved, via a neuro-muscular delay of the reflexes used to control it. Another origin: a disorder in the antidiuretic hormone, which is responsible for producing urine. Finally, among the other possible causes, we note a bladder with lower than normal capacities, or a very high level of alertness. In the latter case, the child continues to sleep even though their bladder alerts them to go to the bathroom. Incomplete toilet training or drinking too much fluid before going to sleep may also be a cause. In the case of secondary enuresis, potential sources could include a urinary tract infection or type 1 diabetes.

Causes of enuresis in adults

In adults, several types of enuresis can be distinguished, and each of them is associated with specific causes.

Person suffering from bedwetting during sleep

Accidental enuresis, which is occasional.

The main origins can be excess alcohol, tobacco, but also a dream.

    • In the first case, alcohol increases the secretion of urine, and can disturb alertness if the adult is intoxicated when it is time to go to the toilet, causing him or her to urinate in the mattress without noticing.

    • In the case of tobacco, a coughing smoker can urinate without meaning to.

    • A dream, such as dreaming that you are in the bathroom, can trigger an unwanted urination.

More frequent enuresis

The origin may be:

    • Genetics: As with children, heredity can play an important role in bedwetting. Thus, if one or both parents have suffered from enuresis, the chances that the child will suffer from enuresis as an adult are increased.

    • A disorder or trauma: Adults who have suffered from laterality disorders or head injuries often suffer from enuresis. Their condition leads them to make their contraction movements slowly. When they have to go to the bathroom for a #1, they no longer have the control they want over their bladder.

    • An anatomical particularity (too small bladder).

    • A temporary illness (urinary tract infection) or a longer one (hormonal problem).

    • Aging (e.g. enlarged prostate).

    • Linked to a psychological/neurological factor:

      • Emotional trauma.

      • Depression.

      • Fear.

      • Alzheimer’s disease.

Elderly woman, alone, looking thoughtfully by a window

How do I stop involuntary urination during sleep?

There are solutions for enuresis in both children and adults.

The treatment of enuresis in children.

Several types of measures can be taken to make enuresis disappear in children, starting with those related to education and hygiene. Above all, parents will have to positively encourage the child to boost their self-confidence. Here are some potential ways to solve the problem if the child is not completely toilet trained:

  • First of all, avoid making remarks about the child's enuresis.

  • Encourage your child to urinate regularly throughout the day.

  • Help your child to recognize and listen to the biological signals telling him to urinate.

  • Tell them that if they feel like it, they shouldn't hold it in; they need to go to the bathroom.

  • Have them reduce the amount of water they drink before going to sleep.

  • Set a night light so that they can easily urinate by themselves at night.

  • Reduce your child’s guilt by talking to them.

Little girl sleeping in bed with her teddy bear and bedside night on.

 

Sometimes, however, this may not be enough depending on the circumstances, and medication may be necessary. A consultation with your family doctor or your child's pediatrician is absolutely necessary to see which molecules are possible. One such molecule is desmopressin, which reduces the amount of urine secreted, and is administered to children over 5 years of age. However, the doctor will first explain what is happening anatomically to the child in a simple way and make him/her understand that a cure is possible. In some cases, a follow-up with a psychologist to involve the child as much as possible in the treatment process will be required.

Finally, an electronic solution exists: a nocturnal enuresis detection system. This usually consists of a detector underwear, a transmitter, and an alarm. The principle is simple: the alarm will be triggered as soon as the first drops of pee are detected by the sensor of the underwear. The child, then woken up by the alarm, will be able to go to the toilet to finish urinating like a grown-up!

Solutions against adult enuresis

Here again, as with children, good habits can make a difference, especially when it comes to urination :

    • Going to the bathroom at regular intervals to pee during the day.

    • Drink less in the evening, starting at 6 p.m.

    • Avoid drinking coffee or soft drinks, which can irritate the bladder.

    • Get up during the night to urinate, and more generally as soon as you feel the need to pee.

    • Eventually, keep a diary of the nights without and with enuresis.

Young woman sleeps comfortably in bed

If this isn't enough, your doctor may recommend an alert system like for younger children (e.g., EnuReflex) that will wake you up as soon as the first drops are taken. A follow-up by a psychologist in terms of behaviour can also be useful. For example, speech therapy, or even hypnosis, can solve sleep problems that are psychological in nature and can disrupt your urinary cycle. The best thing to do is to start by talking to your family doctor, and discuss possible treatment options with him or her if the above tips have not worked.

Learn more: Nocturnal cramps and muscle pain at night

Conclusion: Bedwetting is not pleasant, but it is not inevitable!

In short, uncontrolled peeing when you sleep, scientifically called enuresis, is not a fatality, both in children and adults. Temporary or prolonged, daytime, night-time or both, it’s first of all a symptom the origin of which must be sought. The causes can be physical, psychological or behavioral. However, in all cases, the first solution will be to consider a change in hygiene habits. If this is not enough, medication such as desmopressin can help. Other systems exist, such as the alarm device, which will allow us to finish urinating in the toilet, waking us up as soon as the first drops are detected. However, the child, adolescent or adult that suffers from enuresis may require psychological follow-up, as the inability to be clean is highly stigmatized socially. The goal will be, at the same time as the nocturnal peeing settles, to make the affected person regain confidence. If on the other hand it is the discomfort of your mattress that causes your bad nights, think of replacing it!


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