Bedwetting in older children and adults

Bed-wetting or nocturnal enuresis is the unintentional passing of urine at a time when the bladder should already have control. Standard treatment through the NHS is through GP surgeries which use specialist nurses. These usually are there for really young children and are limited use to older ones who know they have a problem but just don't know how to control it.

The condition as solution focused therapists see it lies not with the bladder control, but the sleep pattern. The person is sleeping too deeply, which means the signal being sent from the bladder to brain to wake up and empty is not being detected.

This sleep behaviour appears to fall into two categories from my experience:

Late sleep cycle wetting

When the person may wake after 2 or 3 cycles and goes back to sleep deeply again and has ignored the full bladder message. This condition can be related to symptoms of depression. Just the continuous cycle of bedwetting can spark this depression, so focusing on what helps, relaxation and working through how they feel about things can often help. Along with body alarms that you can set to a clear sleep pattern, can alert the person to getting up and emptying the bladder before going back down into the deep sleep.

Early sleep cycle wetting

This is when the person is bed wetting in the first 90 minutes. This is often linked with sleep walking condition in the slow wave sleep cycle, calle NREM parasomnia disorder. American research has found that activity during this cycle is linked to lack of self esteem, and cases I have seen have been mostly in young men on the verge of pubity that find fitting in with the "in crowd" to be difficult. Watches that vibrate the person awake can be still helpful here, but focusing on building self esteem appears to be more effective.

One key element here is blame. No one is to blame, it's just one of those things. Older children and adults who are bedwetting are not doing it for fun, or spite and all would happily wish it away. So the things you can try yourselves before going to bed are:

  • Make sure you're winding down for the day.
  • Don't watch TV as you go off to sleep, the blue light from the TV can have an effect on melatonin.
  • Read a book or a magazine to help you drift off
  • Listen to relaxing music or a relaxation CD
  • Wake yourself up properly when you come out of a sleep cycle and make sure you go to the toilet - the signal can take time so making the trip can help things along. You could use a vibrating watch to wake you if you're away on camp or sharing a room.
  • Have a bath an hour or so before bed time this can help the sleep.
  • Keep a journal to find times when it's better and times when it's worse. Quite often being very energetic and tiring oneself out can add to later bed wetting.
  • Start to feel better/good about yourself, this will help change the brain chemistry and help make the sleep patterns lighter.

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