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Treatments and drugs
By Mayo Clinic staffMost children outgrow bed-wetting on their own. If there's a family history of bed-wetting, your child will probably stop bed-wetting around the age the parent stopped bed-wetting.
Generally, your child will be your doctor's guide to the level of necessary treatment. If your child isn't especially bothered or embarrassed by an occasional wet night, home remedies may be the ideal treatment. However, if your grade schooler is terrified about wetting the bed during a sleepover, he or she may be more motivated to try additional treatments.
Moisture alarms
These small, battery-operated devices — available without a prescription at most pharmacies — connect to a moisture-sensitive pad on your child's pajamas or bedding. When the pad senses wetness, the alarm goes off. Ideally, the moisture alarm sounds just as your child begins to urinate — in time to help your child wake, stop the urine stream and get to the toilet. If your child is a heavy sleeper, another person may need to listen for the alarm.
If you try a moisture alarm, give it plenty of time. It often takes at least two weeks to see any type of response and up to 12 weeks to enjoy dry nights. Moisture alarms are highly effective, carry a low risk of relapse or side effects, and may provide a better long-term solution than medication does.
Medication
As a last resort, your child's doctor may prescribe medication to stop bed-wetting. Various types of medication can:
- Slow nighttime urine production. The drug desmopressin acetate (DDAVP) boosts levels of a natural hormone (anti-diuretic hormone, or ADH) that forces the body to make less urine at night. Although DDAVP has few side effects, the most serious is the potential for seizures. This can happen if your child drinks too much when taking the medication. For this reason, don't use this medication on nights when your child drinks a lot of fluids. Additionally, don't give your child this medication if he or she has a headache, has vomited or feels nauseous.
- Calm the bladder. If your child has a small bladder, an anticholinergic drug such as oxybutynin (Ditropan) or hyoscyamine (Levsin) may help reduce bladder contractions and increase bladder capacity. Side effects may include dry mouth and facial flushing.
- Change a child's sleeping and waking pattern. The antidepressant imipramine (Tofranil) may provide bed-wetting relief by changing a child's sleeping and waking pattern. The medication may also increase the amount of time a child can hold urine or reduce the amount of urine produced. Imipramine has been associated with mood changes and sleep problems. Caution is essential when using this medication, because an overdose could be fatal. Because of the serious nature of these side effects, this medication is generally recommended only when other treatments have failed.
Sometimes a combination of medications is most effective. There are no guarantees, however, and medication doesn't cure the problem. Bed-wetting typically resumes when the medication is stopped.
- 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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