When to Worry About Bedwetting

Bedwetting during sleep is common in young kids and considered normal up to age 6. Still troubled? Here’s what you need to know.

Bedwetting, also called nocturnal enuresis, is a common condition affecting some five million children in the United States — it’s more common in boys than girls. “Doctors don’t consider children to be ‘bedwetters’ unless they wet the bed at night after age 6,” explains Howard J. Bennett, MD, a pediatrician in Washington, D.C., and author of several health-related books for kids, including Waking Up Dry: A Guide to Help Children Overcome Bedwetting.

If your child is under the age of 6 and is still wetting the bed, don’t be overly concerned. He probably will outgrow the condition, says Dr. Bennett. “Although bedwetting goes away, kids should not have to wait if they want to be dry now,” he continues.

Understanding Bedwetting

Doctors characterize bedwetting as either primary bedwetting or secondary bedwetting.

  • Primary bedwetting is being unable to stay dry for six consecutive months.
  • Secondary bedwetting is wetting again after having been dry for six consecutive months.

Adult bedwetting is also an issue. Studies show that at least 2 percent of adults experience bedwetting.

What Causes Bedwetting?

Bedwetting runs in families. “About 75 percent of children who wet the bed at night have a parent or first-degree relative who had the same problem as a child,” says Bennett.

In most cases, primary bedwetting is not caused by an underlying medical problem. However, secondary bedwetting in kids and adults may be the result of a urinary tract infection, a prostate problem in men, diabetes, sleep apnea, sleep disorders, sickle cell disease, or certain neurological problems. Emotional stress, such as the death of a loved one or a change in one’s environment, may also cause secondary bedwetting.

Constipation can also cause bedwetting, says Bennett. “This occurs because the rectum is anatomically right behind the bladder. If a child has an overly full rectum, it can interfere with bladder size and it can cause irregular bladder contractions that may result in nighttime wetting,” he explains.

How Is Bedwetting Treated?

Most children will outgrow bedwetting on their own; treatment is usually not necessary unless the child is bothered by bedwetting. However, here are several techniques you can try before going to sleep to prevent bedwetting:

  • Limit how much your child drinks before bed. Drinking too much after dinner is not considered to be a cause of bedwetting, although it can cause occasional wet nights, says Bennett.
  • Go to the bathroom before bed, and then again. Have your child go to the bathroom — or at least try — before going to sleep. Also wake up your child before you go to sleep and take him to the bathroom.
  • Try a bedwetting alarm. If the above tips don’t seem to help, try a bedwetting alarm. A bedwetting alarm works by sounding off as soon as it senses urine. The alarm will wake your child so that he can get up to use the bathroom. Bedwetting alarms are highly effective, but also require a lot of patience and dedication on the part of the child and parents. “When used properly, the alarm works 75 to 80 percent of the time,” says Bennett. Be sure to remind your child to reset the alarm before going back to sleep.
  • Medications. Certain medications may help prevent bedwetting. However, medication is typically used as a last resort or for short-term use only, such as for a sleepover or overnight camp, and is not recommended for children younger than age 5. Medications used for bedwetting include desmopressin (DDAVP), imipramine (Tofranil), and oxybutynin (Ditropan).

These approaches may also help adult bedwetting problems.

Bedwetting can be traumatic for a child. “Because a child’s self-esteem can be affected by bedwetting, parents should never punish, criticize, or humiliate a child for a wet night,” says Bennett. Instead, reward your child for dry nights.

If your child feels anxious or embarrassed about bedwetting, let him know how common bedwetting is and reassure him that it is not his fault. Share stories about how other family members wet the bed, as this will help to reduce some anxiety.

Bedwetting: When to Talk to the Doctor

“Parents often do not bring up bedwetting with their [child’s] doctor. This can be because they are embarrassed about it or don’t see it as a medical problem,” says Bennett. However, you should talk to your child’s doctor about bedwetting if your child is still wet at age 6 or if it bothers your child at a younger age, he says. If your child was previously dry for at least six months and then starts wetting the bed, call the doctor promptly, as there may be a medical reason for the behavior.

Bedwetting is very common. Most kids will outgrow the behavior on their own, but if you are concerned about your child’s bedwetting, talk to your pediatrician.

By Hedy Marks, MPHMedically reviewed by Pat F. Bass III, MD, MPH