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Thursday, April 17, 2014
Incontinence - Adult Bed Wetting
I have started wetting the bed every 1 and a half months or so over the last 5 months. I have now done it in back to back nights and now am getting a little worried. I have been reading up and have read that it is pretty common, however, the difference is I have no idea this is happening when I am sleeping. I will just wake up cold and realize it is because I am wet. I am a 45 year old male. Is it common to not even realize this is happening? I have had numerous back surgeries over the years but this has only started in the last few months. Thank you and I will be looking for any input you may have for this problem.
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 over 65 year old population).
Most cases of sleep enuresis in adulthood are due to other underlying medical problems and usually do not represent a problem with the urinary system per se, although urinary tract disorders can also lead to enuresis. Medical conditions associated with enuresis include obstructive sleep apnea (repetitive airway closing in sleep), congestive heart failure, diabetes, urinary tract infections, prostate problems, 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.
You mention that you have had several back surgeries. Depending on the nature of the surgery, it’s possible that this could be a contributing factor. Sleep apnea and problems with an enlarged prostate would also need to be considered, among the other conditions listed, in a male your age. However, based on the limited information in your question, it’s hard to pinpoint an exact cause for your enuresis.
If there are lifestyle changes you can make (such as avoiding alcohol or caffeine near bedtime), then I would try these first. If these fail to resolve the problem, then further evaluation should be considered. You should not accept that this is normal.
If your problems persist, then I recommend you address this issue with your primary care physician. Additional 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