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Thursday, November 27, 2014
I am 39 yrs. old and have wet the bed most of my life. Have had a year or so gaps with little or no bedwetting. Now seems to happen each month around my menstural cycle, and if I have done a lot of physical activity all day, such as surfing. Just wonder if there is any advice for me. It pretty much sucks. Thanks a lot.
Bed wetting during sleep, also known as sleep enuresis, often has a variety of underlying causes. 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 becomes even less frequent in adulthood until urinary incontinence becomes a problem with aging (mostly in the elderly, over 65 year old, population).
Most 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, though urinary tract disorders can also lead to enuresis. These conditions include obstructive sleep apnea (repetitive airway closing in sleep), congestive heart failure, diabetes, urinary tract infections, nighttime seizures, depression, severe psychological stress, and dementia. Of course, excessive intake of fluids or substances that promote urination (i.e. diuretic medications, caffeine, and alcohol) can also lead nighttime bedwetting.
In your case, if you have had problems since childhood, then this may suggest some anatomic problem with your urinary tract system. The fact that physical activity worsens the problem lends support to this. However, the long gaps of time without symptoms may suggest another cause. There have been some studies linking urinary incontinence to the menstrual cycle, though the incontinence occurs mid cycle and not near menstruation. If you delivered children via natural childbirth or had any type of gynecologic surgery, your risk for developing enuresis would be increased.
In order to clarify the situation and get help, I recommend you discuss this issue with his Primary Care Physician or Gynecologist. Specific factors in your history will be useful in determining how best to further evaluate and treat this problem. Referral to a Urologist may be needed. Evaluation by a Sleep Specialist in your area might also be considered if there is concern for an underlying sleep disorder.
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, if needed. The website Sleep Education.com also can provide consumer-friendly information about sleep disorders. Good Luck!
Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University