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Sleep Disorders

Urinating during dreams

04/25/2007

Question:

For many years now I occasionally have a dream that I am urinating (in the dream) but also in reality I pass urine in bed. The wet sensation is not a akward one as in the dream water is spashing or urine is flowing in a oddly profuse way. Recently it has happened 3 times in one week. I don`t know how to differenciate this reality or keep myself from dreaming the need to pee.

Answer:

This question has been forwarded by Urinary Disorders:

You are describing nocturnal enuresis or urinary incontinence during sleep. This is a condition mostly described in children ages 3 to 6 years, and is often benign and limited. In adults, however, it is very uncommon and requires particular attention. The possible explanations are numerous and it is imperative that a physician performs a thorough evaluation in this case.

Seizures are probably the most pressing concern. Commonly associated with urinary incontinence, seizures can also, cause tongue biting and muscle pain. The possibility of abnormal sleep architecture resulting in difficulty arousing to the urge to urinate and the bladder reflexes needs to be considered. Such disruption in sleep architecture may occur when one takes any of a variety of medications or herbal supplements.

Sleep Apnea is a serious sleep disorder that may cause disruption in sleep architecture and result in difficulty arousing. In adults, Sleep Apnea more commonly causes frequent arousals from sleep. Medications that may result in abnormal bladder reflexes may include over the counter sleeping aids, and a variety of depression medications. Certainly, diuretics or water pills would contribute to this problem.

You are describing association of a dream context; that is the urge to urinate but the inability to arouse to do so. This does not rule out any of the possibilities mentioned above, but may make it more likely to be related to be a problem in the sleep architecture with preponderance of deeper sleep. There are several treatment strategies; some are behavioral, others may be pharmacological. It is imperative, however, to undergo an evaluation by your doctor first to determine the likelihood of seizures, anatomical abnormality, or bladder reflex abnormality, and to review your medications.

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Response by:

Rami N Khayat, MD Rami N Khayat, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University