Some people might think that bedwetting only happens to children, but, it is problem that you can have at any age. Bedwetting, or nocturnal enuresis, meaning involuntary release of urine during sleep, is a medical condition like any other, and it should be treated accordingly. We do not know how common it is because of people’s reluctance to report it, but some data suggest that approximately 1-2% of adults experience the disorder. So, you are not alone, and, there is no reason to be ashamed. Nocturnal enuresis is not a personal failure of any sort, and it’s not a sign of laziness or weakness. It is a physical condition with physiological roots, and it absolutely can be managed, treated, and in many cases, cured. The first step towards that treatment is to seek out help. In Australia you can get help from incontinence nurses. As a first step you can call the Continence Helpline, 1 800 33 00 66. The National Continence Helpline is a free telephone advisory service staffed by a team of continence nurse advisors who provide information, education and advice to callers with bladder and or bowel problems.
The US National Association For Continence, NAFC, and HDIS provides a guide to good nights and great mornings. Pjama Down Under has been given the permission to share their useful information with you.
A REAL IMPACT
The NAFC guide states that the anxiety and embarrassment associated with nocturnal enuresis can be remarkably powerful – so powerful, in fact, that people would rather suffer silently with the condition than talk about it with others.
Please be aware that untreated bedwetting can result in some serious consequences:
Health Issues – Don’t assume that bedwetting is the problem itself – it may be a symptom of an even more significant underlying health issue..
Skin Care – The skin is a sensitive organ, and prolonged exposure to the acid and moisture of urine can be very damaging. Ongoing bedwetting can be responsible for the creation of sores, infection and worse.
Emotional well-being – The psychological stress that comes with bedwetting can be hard for many people to handle. There is often a loss of self-esteem associated with enuresis – and that’s especially true in the elderly population, who already have a higher rates of depression than the general population.
Lifestyle Limitations – The fear of wetting the bed keeps many sufferers from ever traveling beyond their home – no vacations, no family visits, no business trips.
Strained Relationships – Bedwetting can put enormous pressure between spouses, family members and caregivers. Those with the condition are often deeply ashamed of their inability to control themselves, while those around them can find themselves feeling frustrated, angry and resentful. These feelings may not be rational and they’re nothing that anybody is proud of, but we’re all human and we have human reactions.
Added effort and expense – The amount of additional effort and expense that go into housekeeping can be considerable when dealing with wet beds. Sheets and clothing need to be laundered more often than they otherwise might be – and mattress replacement can be a major expense.
WHAT CAUSES ENURESIS?
Bedwetting is not always a chronic, ongoing problem. One-time accidents can and do occur,
most frequently following extreme events – for example, after a night of high alcohol consumption or during a period of severe stress. These temporary conditions cause a failure in the body’s restraint mechanism, and the result is an involuntary discharge of urine. While unpleasant, this isn’t something that usually sends people to the doctor.
Where the condition becomes a real problem is when the episodes become more frequent. Here are some of the most common causes of ongoing enuresis, whether it’s nightly, every few nights or less-often, but still regular:
Hormonal – While you sleep, your body produces a hormone called ADH, which is responsible for slowing down the kidney’s production of urine. If you don’t produce enough of this, it can result in episodes of bedwetting. This is especially true for people with diabetes, since lower ADH production is a symptom of the disease.
Neurological – When your bladder is full, it sends a signal to the brain that it’s time to go to the bathroom. In some people with smaller bladder capacity, there may be a disconnect between how much urine their bladder holds and how the brain is signaled. People with overactive bladder mat be particularly susceptible, as can those with multiple sclerosis, spinal cord injury and other nerve disorders.
Anatomical & Physiological – There are a number of medical conditions that can result in enuresis, and many of these can be serious health matters in their own right. They include urinary tract infections, urinary tract stones, enlarged prostate, bladder cancer and prostate cancer, among others.
Medication-related – Certain drugs can result in bedwetting as a side effect, including psychiatric medications such as Thioridazine, Clozapine and Risperidone. Diuretics like Hydrochlorothiazide (HCTZ) can also contribute to bedwetting because they help rid the body of fluid. And today’s strong sleeping pills can make it harder for people to wake up when they’re ready to go to the bathroom.
Diet-related – The two biggest culprits when it comes to diet are alcohol and caffeine. Caffeine is a diuretic, so it can increase the production of urine. Alcohol is also a powerful diuretic as well as a depressant, so you don’t only produce more fluid, you can also sleep so deeply that you don’t recognize when you have to go.
Stress-related – Less commonly, significant emotional trauma can produce episodes of bedwetting. For example, some emotionally traumatized combat veterans report that a symptom of PTSD includes enuresis.
The good news is that there is a wonderful range of treatment options available for people who suffer with enuresis – enough, in fact, that virtually everyone can wake up dry. In many cases, that simply means finding products that are effective in wicking away moisture and locking it in, so it stays away from the body and the bedding. In other cases, medications may be helpful, along with certain lifestyle and dietary changes. Rest assured, there is almost certainly something that’s right for you.
The first step that people often take to address their enuresis is to use an absorbent product. It’s a great approach for many, but it’s important that you choose the right product or your results could be very disappointing. Make sure to select an item that’s appropriate for your size, your shape and the amount of urine you typically release at night. Because there are so many types of products available, and each of them may vary by size, liquid capacity and more, it may take several tries to find something that works for you. Don’t get discouraged. It’s not unheard of to try 5 to 6 different products before finding the right one.
No matter what you decide on – reusable underwear, pads with light, moderate or heavy protection, Pjama’s pyjama shorts or pants (SIZE GUIDE) – make sure that you choose a product with a reliably absorbent core. That way, moisture is drawn from your skin and kept off the bedsheets, so there’s less irritation and no mess in the morning to worry about.
Also note that maxi-pads are not recommended for nighttime urine absorption - day or night. They typically contain plastic backing or barriers that actually push out moisture, and that may keep you or the bed wet.
Some people feel more confident when using a mattress pad or underpad. These can be excellent additional products to consider, but use them in coordination with absorbent underwear or pads – you’ll generally be far more comfortable, and you’ll be doing a better job protecting your skin from irritation or worse.
There are medications available that may help some people control their enuresis.
These include DDAVP, also known as Desmopressin, which is a manufactured form of a naturally occurring hormone that works as an anti-diuretic. It actually decreases urine volume and helps control frequent urination and thirst.
There are a few simple strategies that may make a big difference for you. Begin by setting a routine, making sure that you urinate every one to two hours during the day. You’ll also want to make sure you empty your bladder as completely as possible before bedtime, even if you don’t quite feel the need to go. Then try setting a nighttime alarm that wakes you in the middle of the night to go to the bathroom.
Eliminating Contributing Factors
You’ll want to make sure that you’re controlling as many potential contributing factors as you can. That includes:
Medications – Review your current medications with your physician to see if any of them may play a role in your condition. There may be alternative medications available that have fewer side effects, and you may be able to change your schedule so you take medications when they’re less likely to cause nighttime problems.
Fluid Management – This is not simply a matter of ‘drinking less.’ You will want to remain properly hydrated but not consume so much that it will contribute to bedwetting. That means understanding how much you ought to be drinking and being aware of when you’re drinking. You’ll also want to limit your caffeine and alcohol intake, especially in the evenings.
Keeping a Diary – Speaking of scheduling, many people find that keeping track of bedwetting episodes, fluid intake and other factors can be very helpful in the treatment process, since you can see trends as they develop over time.
FEEDBACK FROM A BEDWETTER
The Continence Foundation of Australia publishes a quarterly magazine called the Bridge. In their most recent issue the cover story is about Matt, a young man telling his story of living with bedwetting since he was a teenager. Being an adult bed wetter can certainly complicate how you live your life. You can read the full story here
Matt contacted Pjama Down Under a few months ago and said he was tired of washing sheets every morning. We talked about Pjama and how they could possibly help him. Matt decided to buy a pair and recently he contacted us to say that the Pjama shorts have been an absolute life saver for him. He is thrilled with them as they make life so much easier.”
If you want to share your feedback to tell others they are not alone, please send us an email to firstname.lastname@example.org. Any comments will be shared anonymously.