The Bedwetting Blues
There are three main causes of bedwetting: motivational, physical, and “deep sleep.” It can be hard to tell whether bedwetting stems from the I-don't-feel-like-getting-out-of-bed-to-use-the-potty-at-night syndrome as most parents tend to think at first.
Physical problems ranging from small bladder size to a bladder infection can cause incontinence. Many can be easily corrected. Sleep apnea can prevent children from awakening so they can use the potty; the brain never receives the bladder's signal that it is full. Eventually the sphincter gives way, causing an accident. If apnea is due to problems with the adenoids and tonsils, it can be easily treated. Apnea is sometimes difficult to diagnose because obvious symptoms may only be present at night, so children can appear healthy when examined by a doctor. Bedwetting also can infrequently be the result of bladder infection, a hormone deficiency, petit mal seizures, diabetes, a small bladder, a physical abnormality or malformation, or a central nervous system disorder.
Physical problems are thought to affect less than three percent of children. The usual problem which causes millions of youngsters to wet the bed is that they sleep so deeply, they simply don't awaken so they can use the potty. They may have some dry nights, but if they can't manage to go a full month without wetting the bed, the diagnosis may turn out to be “primary enuresis.” What keeps them from awakening isn't understood.
Only 45 percent of girls and 35 percent of boys stay dry at night before age three, according to an article in
Boys, who are known to mature more slowly than girls, are more likely to be bedwetters, and since 15 percent of bedwetters spontaneously outgrow the problem every year, physical maturity is thought to be a factor. Most bedwetters have relatives who had the same problem as children, so heredity is thought to play a role.
Children who stay dry every night for a month and then start wetting the bed again probably have “secondary enuresis.” The usual causes are fatigue, stress, and depression, all of which cause children to sleep more soundly than usual. Like youngsters suffering from primary enuresis, they are unable to wake up. The problem can be expected to disappear as soon as the child is back on an even keel.