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Sleep Disorders

Bed Wetting

12/10/2008

Question:

I dont know if you have ever met anyone that has wet the bed since they were born? I`m a 28 year female, that has wet the bed my whole life. I have found out a lot of information. I don`t know my real dad so I don`t know if it is hereditary on his side. It`s not on my mom`s side. I have tried everything. When I was younger my parents took me to a doctor and I had the alarm, but that didn`t work. I think my parents and doctors gave up on trying to figure out what was going on. I have tried all the other ways to stop, but none of it has worked. My husbend is very supportive, but I still get embarassed. I did go to a doctor about 5 years ago and he said that it is common in some adults so he didn`t do any tests. I am going to make an appointment with my family doctor and see what he has to say. But, I saw your web site and thought I would also ask you what you thought. Thank you for your time.

Answer:

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). Enuresis should not be accepted as “common” or “normal” for someone in your age group.

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, 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. Urinary tract problems, such as problems with bladder sphincter control, bladder muscle control or spasm, or abnormal urinary tract anatomy, can be causes of enuresis in some individuals.

In your case, if you have had problems since childhood, then this may suggest some anatomic problem with your urinary tract system. Additional evaluation will be needed to help determine what the underlying problem is in your case.

In order to clarify the situation and get help, I recommend you discuss this issue with your Primary Care Physician. 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 (www.amassment.org/). 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 sleepeducation.com also can provide consumer-friendly information about sleep disorders. 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