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Sleep Disorders

Bedwetting During Sleep

07/09/2009

Question:

I occasionally (once every three month or so) dream of being urinating when I would wake up dry and be able to urinate in the bathroom. However, I once a year or so do bedwet half way ususally before I wake up. This has been happening for the last five years only. to be exact, I had 4 half way episodes of bedwetting in the last five years. Today, I bedwet completely and without seenibg the typical dream of urination. I am 39 years old male. overweight, not drinker. I did bedwet when I was young and did not cured completely till I was 15.

I don`t see nightmares and don`t snore and I sleep well. I have noticed that I frequently urinate many times during the day if my feet for some reason gets very cold and noticed that my bedwetting (actual & dreams) happen when I get cold during sleep especially when the AC is on as I don`t have the issue in the winter when the heat is on. I usually don`t cover myself when sleeping. I must have my feet uncovered to be a sleep.

Is it possible I am getting cold while a sleep through my feet and then the urgency to urinate same way it happens sometime during the day.

Please help.

Answer:

Thank you for using NetWellness. I will attempt to provide some guidance to you with regards to your current problem. However, with the limited information from your question, I cannot make a diagnosis and you will need a full evaluation.

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.

Primary nocturnal enuresis (PNE), or primary bed-wetting, that is not associated with any of the above mentioned conditions, is a very common clinical and a significant social problem in most western countries. It is known that 20% of 4 year old children and 10% of 7 year old children have this problem. Persistent symptoms of PNE may occur in adult life and could certainly be associated with underlying bladder dysfunction. A recent study noted that 2% of adults have persistent PNE. It also appeared that the disorder was more likely to persist compared to children where in most situations it resolves.

The treatment really depends on the cause. For example, if the problem is related to excessive fluid intake, then restricting fluid intake would be the primary treatment. On the other hand, if an overactive bladder or enlarged prostate is the problem, then a number of different medications can be useful and seeing a Urologist may be indicated.

You mention your problem may be worse with cold exposure. It is also well known that exposure to cold temperatures results in increased urination so you should attempt to regulate your bedroom temperature as best as you can.

Aside from the cold, many medical conditions can result in excessive urination and a comprehensive screen by your primary care physician is therefore required. 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.

Once again thank you for using NetWellness.

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Response by:

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