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Causes
By Mayo Clinic staffNo one knows for sure what causes bed-wetting, but various factors may play a role.
- A small bladder. Your child's bladder may not be developed enough to hold urine produced during the night.
- Inability to recognize a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child — especially if your child is a deep sleeper.
- A hormone imbalance. During childhood, some kids don't produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.
- Stress. Stressful events — such as becoming a big brother or sister, starting a new school, or sleeping away from home — may trigger bed-wetting.
- Urinary tract infection. A urinary tract infection can make it difficult for your child to control urination. Signs and symptoms may include bed-wetting, daytime accidents, frequent urination, bloody urine and pain during urination.
- Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep — often because of inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring, frequent ear and sinus infections, sore throat, and daytime drowsiness.
- Diabetes. For a child who's usually dry at night, bed-wetting may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.
- Chronic constipation. A lack of regular bowel movements may make it so your child's bladder can't hold much urine, which can cause bed-wetting at night.
- A structural problem in the urinary tract or nervous system. Rarely, bed-wetting is related to a defect in the child's neurological system or urinary system.
References
- Urinary incontinence in children. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/uichildren. Accessed June 28, 2011.
- Gonzales Jr. ET, et al. Management of nocturnal enuresis in children. http://www.uptodate.com/home/index.html. Accessed June 28, 2011.
- Bedwetting: Information for parents - Questions kids ask. National Kidney Foundation. http://www.kidney.org/patients/bw/BW_faq.cfm?id=par. Accessed June 28, 2011.
- Brown ML, et al. Treatment of primary nocturnal enuresis in children: A review. Child: Care, Health and Development. 2011;37:153.
- Robson WL. Evaluation and management of enuresis. New England Journal of Medicine. 2009;360:1429.
- Tu NW, et al. Management of nocturnal enuresis in children. http://www.uptodate.com/home/index.html. Accessed June 28, 2011.
- Shreeram S, et al. Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S. children: Results from a nationally representative study. Journal of the American Academy of Child and Adolescent Psychiatry. 2009;48:35.
- Bower WF, et al. Acupuncture as a treatment for nocturnal enuresis. Autonomic Neuroscience. 2010;157:63.
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