Bedwetting or an issue called nocturnal enuresis is a problem experienced by many adults. It happens when a person fails to wake up from sleep during the urge to urinate leading to bedwetting. Typically, bedwetting is more common in children but can occur healthy adults as well. Many adults are ashamed to discuss these issues resulting in frustration and poor quality of life.
Common reasons for bedwetting in adults
- Overactive bladder: If you experience the frequent, urgent need to urinate and have trouble making it to the bathroom, you may have a problem called overactive bladder. This occurs when the nerves of the bladder send repeated signals to the brain that the bladder is full leading to frequent trips to the bathroom. The bladder may also contract prematurely resulting in leakage during sleep. Overactive bladder can be treated with behavioral changes, Kegel exercises and medications
- Consuming fluids prior to bed: Your kidneys are actively making urine while you sleep. If you’re in the habit of drinking right up until bedtime, then your kidneys will be working overtime producing lots of urine while you sleep. Cutting back on fluids two hours prior to bed, will reduce the amount of urine made by the kidneys while you sleep and will help you stay dry.
- Sleep medications: In the past 20 years, there has been an increase in the number of prescriptions for sleep aids to treat insomnia. The intended effect of sleep aids is to create drowsiness and muscle relaxation so that you sleep better. However, the unintended consequence is that drowsiness reduces your urge to urinate causing urinary leakage while sleeping. Cutting back on sleep aids will enable you to respond more effectively to the body’s signal to urinate helping you wake to void when your bladder is full.
- Alcohol consumption: Alcohol affects bladder control in two important ways. First it acts like a diuretic increasing the amount of urine made by the kidneys. Additional, alcohol causes relaxation of skeletal muscles. Inadvertent relaxation of the bladder muscles necessary to store urine during sleep will result in bedwetting. Therefore, limiting alcohol consumption prior to sleep is an important strategy to prevent bedwetting.
First steps in evaluating bedwetting
The initial steps in your evaluation for bedwetting includes keeping a diary of your fluid intake during the day and around bedtime. Make a list of your medical conditions and the medicines you’re currently taking. Don’t forget to review the common side effects of over-the-counter drugs or sleep medications that you use. If you suffer from the frequent urge to urinate when you are awake, then you may have an overactive bladder. If you’ve cut back on alcohol, sleep aids and fluids prior to bed then you should speak with your doctor regarding problems like diabetes mellitus, kidney disease, heart disease or sleep apnea as these conditions all impact urine production and may be the source of your bedwetting.
The important thing to know is that this problem can be treated so seeking care from your doctor is a great place to start.
I am board certified in Obsetrics and Gynecology (OBGYN) and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). I currently serve as the Medical Director of Female Pelvic Medicine for the Crozer Health Medical Group in the greater Philadelphia area. I obtained my residency training in OBGYN at the Los Angeles County+ University of Southern California Medical Center and fellowship training in FPMRS at Johns Hopkins. I am passionate about the field of Women’s Health and the treatment of pelvic floor disorders like urinary incontinence and pelvic organ prolapse.