How to Stop Bedwetting

Developing the ability to control the bladder overnight does not follow a predetermined schedule, and some children require more time than their peers to overcome bedwetting. The key is to provide all the necessary factors to reduce the chances of bedwetting (also known as nocturnal enuresis or nighttime wetting). However, this issue is not exclusive to young children. Whether you are trying to help your child or yourself, controlling bedwetting can be achieved with patience and dedication.

Don't Panic. Almost 15% of children still experience bedwetting until they are 5 years old. Although this number decreases over time, generally, there is no need to be concerned about bedwetting until a child is 7 years old. Before this age, the bladder and its control mechanisms are still developing.

Limit the amount of fluids your child consumes at night. At bedtime, you should aim to reduce the amount of liquid your child drinks. This doesn't mean they shouldn't drink water throughout the day. On the contrary, encouraging your child to drink water in the morning and early afternoon will help minimize their thirst in the evening. If your child is thirsty at night, especially if they have been active or engaged in sports, you should allow them to drink water.

• If your child's school permits, you might consider letting them bring a water bottle to prevent excessive drinking in the afternoon and evening.

Avoid giving your child caffeine. Caffeine is a diuretic, which means it can trigger the need to urinate. While it's generally advisable to avoid caffeine for children, this is particularly important when you are trying to stop bedwetting.

Minimize bladder irritants. In addition to caffeine, you should try to reduce other bladder irritants in the evening that could contribute to bedwetting. These include citrus fruit juices, food coloring (especially red-colored fruit juices), sweeteners, and artificial flavors.

Encourage frequent bathroom visits. In the afternoon and evening, you should encourage your child to use the bathroom every two hours. This will help them avoid the urge to urinate during the night.

Use the 'double voiding' technique before bed. Many children tend to use the bathroom at the start of their bedtime routine, such as when they're changing into pajamas or brushing their teeth. 'Double voiding' means your child will use the bathroom once, and then go again right before they actually fall asleep.

Address constipation issues. The pressure on your child's rectum due to constipation can manifest as bedwetting. To complicate matters, young children often feel embarrassed discussing constipation, yet this simple issue accounts for about one-third of uncontrolled bedwetting cases in children.

• If you suspect your child is constipated, you can try feeding them a high-fiber diet for a few days. If this doesn't help, it's advisable to consult a pediatrician. There are several effective options available to help children with constipation.

Never punish your child. While this process can be frustrating, it's crucial not to punish your child for bedwetting. They are likely feeling embarrassed about the situation and want to stop just as much as you do. Instead of punishment, reward your child on the nights they stay dry.

• You can reward them with things like extra playtime, stickers, or their favorite food at dinner. Use rewards that you know they will appreciate.

Consider using a bedwetting alarm if necessary. Waking your child up before you go to bed to have them use the bathroom might frustrate them and prevent proper rest. You also don't want to wake them up unnecessarily. These alarms attach to their underwear or a mattress pad and sound an alert as soon as they detect moisture, helping your child wake up and use the bathroom before bedwetting occurs.

See a pediatrician. Bedwetting in young children can, in some cases, indicate a more serious underlying issue. For safety, you should visit a pediatrician to rule out potential conditions such as:

• Sleep apnea
• Urinary tract infections
• Diabetes
• Abnormalities in the urinary tract or nervous system

Consult your pediatrician about medication options. Since bedwetting often resolves as children grow older, doctors rarely recommend medication. However, in some cases, medications may be considered as a last resort. These include:

• Desmopressin (DDAVP), an antidiuretic hormone that reduces nighttime urination. However, it can have side effects and affect sodium levels, so you should monitor your child's fluid intake while using this medication.
• Oxybutynin (Ditropan XL), which reduces bladder contractions and increases bladder capacity.

Limit fluid intake in the evening. By reducing the amount of fluids you consume a few hours before bedtime, your body will produce less urine during the night, helping to prevent bedwetting.

• This doesn't mean you should reduce your overall water intake. Aim to drink about 8 glasses of water daily. Try to drink more in the morning and afternoon. Staying hydrated is crucial, as dehydration can also lead to bedwetting in adults.

Avoid excessive caffeine or alcohol. Both caffeine and alcohol are diuretics, meaning they cause your body to produce more urine. Alcohol also makes it harder to wake up during the night to urinate when needed, contributing to bedwetting. It's best to avoid caffeinated beverages and excessive alcohol consumption in the evening.

Treat constipation. Constipation can create pressure on the bladder and reduce its control during the night. If bedwetting occurs alongside constipation, you should increase fiber in your diet, including leafy greens, beans, and other plant-based fiber sources.

• You can find more information on treating constipation through other articles on our website.

Use a bedwetting alarm. This device is designed to help teenagers and adults who need to train their bodies to respond when they need to urinate. The bedwetting alarm attaches to underwear or a mattress pad and emits a beep or buzz when it detects moisture, allowing you to wake up and go to the bathroom before bedwetting occurs.

Check for medication side effects. Some medications may have side effects that contribute to bedwetting. It's important to check if any medication you're taking might be causing this issue, but always consult with a doctor before making any changes to your prescribed medications. Some medications that can cause bedwetting include:

• Clozapine
• Risperidone
• Olanzapine
• Quetiapine

Watch for signs of sleep apnea. If you snore loudly and wake up in the morning with chest pain, headaches, or a sore throat, you may have sleep apnea. For adults who haven't had issues controlling their bladder previously, bedwetting can be a symptom of this condition.

• If you believe you may have sleep apnea, it's advisable to visit a doctor for a proper diagnosis and treatment options.

Visit a doctor. If your bedwetting isn't caused by excessive water intake or constipation, you should consult a doctor. Secondary bedwetting (in someone who has previously had bladder control) is often a symptom of another underlying issue. Your doctor will perform tests to rule out other conditions, including:

• Diabetes
• Neurological disorders
• Urinary tract infections
• Urinary stones
• Prostate enlargement/cancer
• Bladder cancer
• Anxiety or emotional disorders

Consider medication options. You may want to explore certain medications that can help manage bedwetting in adults. It's essential to consult your doctor to determine which medication is most suitable for your situation during your consultation. Options include:

• Desmopressin, which reduces the amount of urine the kidneys produce.
• Imipramine, which has been shown to be effective for about 40% of cases.
• Anticholinergic drugs, which treat overactive smooth muscle, including darifenacin, oxybutynin, and trospium chloride.

Explore surgical options. Surgery is typically considered for severe cases where there is overactive smooth muscle, and is usually reserved for individuals also dealing with daytime incontinence or bedwetting. Surgery is a last resort. Your doctor may discuss the following procedures:

• Bladder augmentation – A surgical procedure that increases the bladder's capacity by placing a piece of intestine into an incision to expand the bladder.
• Smooth muscle incision – This procedure removes part of the smooth muscle to help strengthen the bladder and reduce its spasms.
• Sacral nerve stimulation – This surgery reduces the activity of the smooth muscle by altering the nerve activity that controls it.