No one knows for sure what causes bed-wetting, but various factors may play a role:
Oct. 11, 2014
- 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. This infection can make it difficult for your child to control urination. Signs and symptoms may include bed-wetting, daytime accidents, frequent urination, red or pink 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 due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring, frequent ear and sinus infections, sore throat, or 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. The same muscles are used to control urine and stool elimination. When constipation is long term, these muscles can become dysfunctional and contribute to 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.
- Urinary incontinence in children. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/uichildren/. Accessed Aug. 24, 2014.
- Tu ND, et al. Nocturnal enuresis in children: Management. http://www.uptodate.com/home. Accessed Aug. 24, 2014.
- What I need to know about my child's bedwetting. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/bedwetting_ez/index.aspx. Accessed Aug. 24, 2014.
- Caldwell PHY, et al. Management of nocturnal enuresis. BMJ. 2013;347:f6259.
- Tu ND, et al. Nocturnal enuresis in children: Etiology and evaluation. http://www.uptodate.com/home. Accessed Aug. 24, 2014.
- Bayne AP, et al, Nocturnal enuresis: An approach to assessment and treatment. Pediatrics in Review. 2014;35:327.
- Huang T, et al. Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005230.pub2/abstract. Accessed Aug. 24, 2014.
- Enuresis. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Aug. 24, 2014.
- Complementary, alternative, or integrative health: What's in a name? National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/whatiscam. Accessed Aug. 29, 2014.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 1, 2014.
- Lynch BA (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 18, 2014.
- Desmopressin Acetate (marketed as DDAVP Nasal Spray, DDAVP Rhinal Tube, DDAVP, DDVP, Minirin, and Stimate Nasal Spray) December 2007. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm152113.htm. Accessed Sept. 19, 2014.