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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, less aggressive treatments may be all that's needed. However, if your grade schooler is terrified about wetting the bed on 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
If all else fails, 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. The medication is available as a pill or nasal spray. However, the nasal spray isn't recommended for the treatment of bed-wetting because this form of the medication stays active for much longer, which can increase the risk of serious side effects. Although DDAVP has few side effects, the most serious is a seizure. This can happen if the medication is accompanied by too many fluids. For this reason, don't use this medication on nights when your child has had 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 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.
