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Sleep Disorders

One time adult bed wetting, need for concern?

08/14/2007

Question:

My husband wet the bed last night, should we be concerned that there may be an underlying health issue? He just turned 50, is diabetic (he watches his diet and excersices regulary) and had a kidney stone aprox. 8 years ago. Also he is greiving the loss of his father who passed away just a few weeks ago. Could any of this be a contributing factor? He has wet the bed once before; it was shortly after we were married and we`ve been married 30 years so it has not been an on going problem. I don`t think I could convince him to go to the doctor unless I can present an argument based on medical facts. He is very embarrased. If you suggest he see his physician what facts can you suggest that would help me to persuade him? Thank you.

Answer:

Bed wetting (enuresis) is very frequent in childhood, and it is much more common in teenagers and adults than generally appreciated (1-2% of 18 year-olds, 0.5% of adults, and 2% in older adults aged 65-80). However, only half of adults with enuresis seek medical advice.

In people with involuntary loss of urine, it is important to distinguish between enuresis and incontinence because the causes and treatments are different. Enuresis occurs only during sleep, while incontinence may occur during wakefulness, too.

Causes of incontinence are variable and can be broken down into those that cause temporary or short-term incontinence and those that cause persistent incontinence. Common causes of short-term incontinence include:

Common causes of chronic incontinence include:

On the other hand, causes of enuresis often remain unknown, though enuresis has been associated with some of the above mentioned problems, and also with:

In your husband's case, since the bed wetting has only occurred twice and in situations that may be associated with some of the temporary causes of loss of bladder control (the kidney stone and possible grieving-associated depression), it is certainly possible that it may be related to one of these issues.  Urinary tract infections, which are more common in diabetics, should also be considered, as well as the ingestion of substances (excessive water, alcohol or caffeine) on the night of the episodes.  While you did not provide any history to suggest a primary sleep disorder, this would also have to be considered though would seem less likely given the rare occurrences.  

In cases of persistent enuresis, only clinical evaluation can rule out important diseases. In most cases, bed wetting should resolve if an underlying problem is detected and if it proves to be treatable.

While his episodes are relatively infrequent, I recommend he discuss these issues with his doctor, particularly if they recur. Evaluation by a Sleep Medicine specialist may be necessary if a primary sleep disorder is suspected.

If you would like additional information regarding sleep and sleep disorders, you can obtain it on the American Academy of Sleep Medicine website . This website also contains a list of Sleep Centers across the country so you can locate one near you if need it. I wish you the best of luck.

For more information:

Go to the Sleep Disorders health topic, where you can:

Response by:

Ziad  Shaman, MD Ziad Shaman, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University