Nighttime Bedwetting (Nocturnal Enuresis): Causes and Solutions. Dr. Narmin Azizova

Articles in English
07 May 2025

Nighttime bedwetting is one of the most common issues seen in children. If a child over the age of 5 is unable to control urination during sleep and wets the bed, this condition is medically referred to as nocturnal enuresis. In most cases, it is associated with the incomplete development of the nervous system.

  • About 15% of 5-year-old children experience this problem.
  • By the age of 15, this rate decreases to around 1%.

Types of Nocturnal Enuresis

Nocturnal enuresis is categorized into two main groups:

  1. Monosymptomatic Nocturnal Enuresis (MNE):
    • Characterized solely by bedwetting at night, with no issues during the day.
  2. Non-Monosymptomatic Nocturnal Enuresis (NMNE):
    • Along with nighttime bedwetting, there are difficulties in controlling urination during the day, sudden urges, accidental leaks, and chronic constipation.

Understanding these distinctions is crucial, as each type requires different treatment approaches.

Causes of Nocturnal Enuresis

The primary causes of nighttime bedwetting include:

  1. Arousal Difficulty:
    • The child does not feel the fullness of the bladder or, even if they do, they do not wake up. Typically, children only realize it after the bed is already wet.
  2. Functional Bladder Issues:
    • Reduced bladder capacity or increased bladder activity during nighttime.
  3. Increased Nighttime Urine Production:
    • Excessive fluid intake before bedtime or decreased secretion of the antidiuretic hormone (ADH) at night.

What Should Parents Do?

If you notice bedwetting in your child, consider the following recommendations:

  • Reduce fluid intake two hours before bedtime.
  • Take your child to the bathroom before going to bed and two hours after falling asleep.
  • Avoid salty foods in the evening.
  • Address any constipation issues:
    • Include fiber-rich foods in the diet.
    • Establish regular toilet habits after meals.
  • Reward successful dry nights. This helps to boost the child’s motivation.

Treatment Options

If the problem persists for a long time and becomes challenging for the family, it is important to consult a specialist. Treatment options include:

  1. Medication Therapy:
    • Certain medications can help reduce urine production or increase bladder capacity.
  2. Alarm Method (Enuresis Alarm):
    • A device that signals when the child starts to urinate.
    • Approximately 80% effective, and the risk of recurrence is lower compared to medication therapy.

Important Reminders

Nocturnal enuresis can affect both the psychological well-being of the child and family life. It is crucial for parents to be patient and understanding. Scolding or shaming the child will not help solve the problem. Offering support, approaching the situation with empathy, and applying appropriate treatment methods are the keys to resolving this issue.

The founder of Pediatriya.az