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Sleep Disorders

Bed wetting, dementia patient

12/04/2008

Question:

My wife has dementia and has begun to wet the bed. Is there a treatment or medication that would help her stop?

Answer:

Thank you for visiting NetWellness. Bed wetting during sleep, also known as sleep enuresis, often has different 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 population).

Bed wetting, or enuresis, has many causes and a careful history and examination are needed to help determine a cause. Enuresis can be the result of a local bladder problem (such as a urinary tract infection, bladder overactivity or bladder underactivity) or a symptom of a disease that affects the rest of the body (such as diabetes, heart failure, high blood pressure, or sleep apnea). It can also be due to a medication side effect (such as from water medications / diuretics like lasix) or due to excessive fluid intake (including water, caffeinated beverages and alcohol). There is certainly an association between enuresis and neurologic diseases such as dementia, though further evaluation would be needed before labeling this as the main cause of her problems.

In order to recommend how best to treat your wife, the cause for her bed wetting needs to be determined. For example, if she were suspected of having a primary sleep disorder such as sleep apnea (symptoms usually include snoring, gasping during sleep, temporary periods of not breathing during sleep and daytime sleepiness), then she may require a polysomnogram (sleep study). If sleep apnea were found, then treatment of this problem may resolve the enuresis. On the other hand, if she were found to have a bladder problem, or if the bed wetting was determined to be the result of her dementia, then medications might be recommended.

I recommend you discuss this issue with her Primary Care Physician. Specific factors in her history will be useful in determining how best to further evaluate and treat this problem. Her Primary Care Physician will need to review her entire medical history, medication use and pattern of enuresis so as to establish the correct diagnosis. Referral to a Urologist or a Sleep Specialist in your area may be needed.

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Response by:

Steven  Kadiev, MBBCh Steven Kadiev, MBBCh
Formerly:
Assistant Professor
College of Medicine
The Ohio State University