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Sleep Disorders

Adult bed wetting

08/21/2007

Question:

Im 19 years old and recently i started to wet the bed. I go to school 3 days a week and work 40 hrs, i have a bf and dont really get to see him so i do have some stress in my life but after a year and a half i started to wet the bed, i doesnt happen offten just about once a month, im usually having a dream that im using the bathroom. when i wake up it`s already too late. once i get up i still have to pee. when this all started i had about two days with some pain when i peed but then it went away, now my pee smells really bad and i started to wet the bed. ive been looking at alot of the web sites that ffer help and the one thing that jeeps coming up is uti but i dont have to pee alot and it doesnt hurt, and the other thing was diabetes. i really dont know what to do and it`s getting increasing more embrassing.

Answer:

Bed wetting in sleep, also known as sleep enuresis, is quite common in children but begins to decrease in frequency once above the age of 5. Only about 1-2% of 18 year olds will have this problem and it was previously thought to become less frequent in adulthood, though recent studies suggest 0.5-2% of adults report enuresis. It then becomes more common in the elderly population, when other factors, such as urinary incontinence may develop.

Many cases of sleep enuresis in adulthood are due to other underlying medical problems and do not represent a problem with the urinary system per se. These conditions may include obstructive sleep apnea (repetitive airway closing in sleep), congestive heart failure, diabetes, nighttime seizures, depression, severe psychological stress, and dementia. Problems or disorders of the urinary tract system that can result in enuresis include urinary tract infections, an overactive bladder muscle or loss of control of the bladder sphincter. Of course, the excessive intake of fluids or substances that promote urination (i.e. diuretic medications, caffeine, and alcohol) can lead nighttime bedwetting.

Based on the information you provided in your question (and without knowing additional information), it is possible that you may have a problem with your urinary tract. This might include intermittent urinary infections (particularly if you are sexually active), problems with the bladder muscle or problems with the sphincter that controls urine flow. A primary sleep disorder and lifestyle issues also should be considered.

If there is not something obvious you can identify and change (such as avoiding caffeine 4-6 hours before bedtime, avoiding alcohol near bedtime, etc.), then it would be worthwhile discussing this problem with your primary care physician. Specific factors in your history will be useful in determining how best to further evaluate and treat your problem. Referral to a Urologist or Sleep Specialist in your area may also be needed. You should not be embarrassed by this problem as it is quite common and almost all of the underlying causes can be treated successfully.

If you would like further information about sleep disorders or sleep itself, I recommend the American Academy of Sleep Medicine website. In addition to information about sleep medicine, the website also contains a list of accredited Sleep Centers and may help you to locate one nearest you. Good Luck!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University