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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 rouse your child from sleep — 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 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 lead to reduced bladder capacity, which can cause bed-wetting at night.
- Anatomical defect. 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 Aug. 18, 2009.
- Gonzales Jr. ET, et al. Approach to the child with nocturnal enuresis. http://www.uptodate.com/home/index.html. Accessed Aug. 18, 2009.
- Robson WL. Evaluation and management of enuresis. New England Journal of Medicine. 2009;360:1429.
- 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.
- AAP Parenting Corner Q&A: Bedwetting. American Academy of Pediatrics. http://www.aap.org/publiced/BR_BedWetting.htm. Accessed Aug. 18, 2009.
- Cutting DA, et al. Nocturnal enuresis: Application of evidence-based medicine in community practice. Journal of Pediatrics and Child Health. 2007;43:167.
- Bedwetting: Information for parents: Questions kids ask. National Kidney Foundation. http://www.kidney.org/patients/bw/BW_faq.cfm?id=par. Accessed Aug. 18, 2009.
- Tu NW, et al. Management of nocturnal enuresis in children. http://www.uptodate.com/home/index.html. Accessed Aug. 18, 2009.
- Culbert TP, et al. Wetting the bed: Integrative approaches to nocturnal enuresis. Explore. 2008;4:215.
