Bedwetting (nocturnal enuresis)

Bedwetting (nocturnal enuresis) is the involuntary passing of urine during sleep. In children it is very common and, up to a point, developmentally normal — bladder control at night matures later than in the day, and many children simply need time. It often runs in families. This kind of longstanding childhood bedwetting usually reflects a combination of a bladder that holds less at night, producing more urine overnight, and deep sleep that does not rouse the child to the signal of a full bladder; it typically improves with age and simple measures. What changes the picture is when bedwetting is new after a child has been reliably dry, or persists into older childhood or adulthood, or comes with other symptoms — because then it can signal an underlying cause. New bedwetting with excessive thirst and daytime urination can be a sign of diabetes. A urinary tract infection can cause it, often with daytime frequency, urgency or burning. Constipation is a surprisingly common contributor. Other causes include an overactive or small-capacity bladder, obstructive sleep apnoea, certain medicines, and, less commonly, kidney or nerve conditions. So while most childhood bedwetting is benign and self-limiting, new or adult-onset bedwetting, or bedwetting with other symptoms, deserves a look for a treatable cause.

• Normal developmental bedwetting in young children — common, often familial, usually resolves with time.
• Urinary tract infection — often with daytime frequency, urgency or burning.
• Diabetes — new bedwetting with thirst and excessive daytime urination.
• Constipation — a common and treatable contributor.
• Overactive or small-capacity bladder.
• Obstructive sleep apnoea.
• Certain medicines, and, less commonly, kidney or nerve conditions.

Longstanding bedwetting in a young child with no other symptoms usually needs no tests beyond a simple check. When bedwetting is new, persistent in an older child or adult, or comes with other symptoms, a few tests help find a cause: a urinalysis (and urine culture if needed) for infection, and a check of glucose — a urine dipstick or fasting glucose — especially if there is thirst and daytime urination, to look for diabetes. Constipation is assessed clinically. A bladder diary recording drinks, daytime urination and wet nights is very useful. Mediora.AI can surface signs of infection or a raised glucose from your results that may explain new bedwetting; the assessment belongs with your doctor.