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Enuresis Research FAQ

What Research Says About the Causes of Bed-Wetting—A Summary.

My child is a bed-wetter, is that unusual?
20% of 5-year-olds and 10% of 7-year-olds wet the bed at night. By the age of 10, that figure is closer to 5%, and even at the age of 18 it is still 1-2%. In short, bed-wetting is quite common.

Does it mean that there is something wrong with my child's bladder?
bed-wetting is hardly ever caused by abnormalities in the bladder. But if your child is previously "dry" and then starts to wet the bed at night or during the day, then it is important to see a doctor to check out if there is any medical reason for that. A few children may have a rather small bladder, but that usually shows up by a child needing to go to the bathroom frequently during the day, and passing only a small amount of urine. Again, if you suspect that this is the case, have you child checked out by your doctor, and bladder stretching exercises may be necessary before starting any treatment for night-time bed-wetting.

Does this mean my child sleeps too deeply?
All children who wet the bed sleep very deeply, but research indicates that all young children sleep more heavily than adults, because they spend more time in the deep sleep phases. Therefore there is no consistent evidence that children who wet the bed actually sleep more heavily than children who do not. Nonetheless parents will usually agree that their bed-wetter sleeps more heavily that their other children.
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I used to wet the bed myself when I was young, could I have passed this on to my child?
Yes, that is very likely, because it has been found that if both mother and father were bed-wetters that there is around a 70% chance that the pattern will be repeated in one of their children. If only one parent was a bed-wetter there is a 50% chance of a child being a bed-wetter. But remember that it can sometimes miss generations and you may find that it was a cousin or grandparent who was a bed-wetter rather than a parent.

Are there different kinds of bed-wetting?
Yes there are. If a child has never been dry at night since coming out of diapers, then this is what is called "primary" bed-wetting, and that's the most common problem, and is the one which is passed on in the genes.

When a child has been dry and starts to wet the bed, perhaps in the daytime too, that is called "secondary" bed-wetting, because it is secondary to some other problem. It is most likely to be caused by a medical condition or perhaps an upset of some kind. This secondary type is the one that needs to be checked out by a doctor. However, it is fairly uncommon, perhaps around 1-2% of cases.

What actually causes bed-wetting?
There is no single answer but I will sum up what is known so far.
  • Primary bed-wetting runs in families and is a genetic condition. It is a pattern of heavy sleeping, and producing high amounts of urine while asleep. The high amounts of urine are produced because a hormone which is produced at night in adults and most children to cut down the production of urine when asleep, is not produced in large enough amounts in bed-wetters, and so their production of urine is too high.
  • Secondary bed-wetting might be due to a physical or emotional problem, but as I said, it is quite uncommon.
  • Recent research suggests that some children who wet the bed may suffer obstructed breathing while they sleep. These children may have problems with their tonsils, and some of them have been found to have a rather narrow “V” shaped palate. These children are inclined to snore. If your child snores at night, and in particular you notice that breathing stops for a period, or your child suffers from infected tonsils, then it is important to have this checked out by your doctor.
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What should I do now?
First of all decide whether your child's bed-wetting is the primary kind, the primary kind is when your child has mostly not been dry at night since coming out of diapers (a rule of thumb is that your child is at least five years old, and bed-wetting is happening at least two times a week). This type of bed-wetting is the case with 98% of bed-wetting.

If your child has been dry at night for two or three years, and then begins to start bed-wetting, then this is likely to be the secondary kind and needs to be investigated by your doctor.

If your child suffers throat infections, or snores at night and in particular appears to stop breathing at times, then this also needs to be investigated by your doctor.

My child has never been dry at night and so it's the primary kind of bed-wetting. What's the best way of curing this problem?
Prof pijamas, a world expert from Finland, has said that the bed-wetting alarm “...is the only method proven to have cured the problem”.

My child wets the bed more than once in the night. Does that means that even after learning to wake he will have to get up to go to the bathroom several times a night?
As I explained earlier, for adults and most children over the age of 5 years, their brain produces a hormone (called an antidiuretic hormone) which cuts down the amount of urine produced at night. This is why most people can sleep through the night and not get up to go to the bathroom, or maybe go just once. In the case of bed-wetters, they do not produce enough of this hormone (and that’s probably part of the genetic pattern) and so their brain tells their kidneys to keep producing daytime amounts of urine. This is why cutting out drinks before bed makes no difference to bed-wetting.

Now, what happens when using the DRI Excel® is that very soon after learning to wake consistently at night, your child will be able to sleep through the night, perhaps sometimes waking to go to the bathroom during the night.  It appears that the brain has been kick-started into producing the right amount of the hormone to cut down the production of urine at night. While there is no research yet that proves that the correct amount of hormone is now being produced at night, there is a consistent observation that children who used to be bed-wetters and who have been successfully treated with a bed-wetting alarm can now sleep through the night without wetting, and mostly do not need to get up to go to the bathroom.

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