Sleepwetting in the Child Care Setting

What is it?

Sleepwetting is unintentional urination during sleep which continues beyond age 4 years for daytime and beyond age 6 years for nighttime.

Sleepwetting is a term used to emphasize the fact that the child is wetting while sleeping. This gives the parent and the child care provider a different view of the situation than the commonly used term “bedwetting.”

Who is most affected?

Sleepwetting affects between 5 and 7 million children in the United States. Both sexes are affected, but it is more common in boys. The occurrence of sleepwetting in all children is 10 percent by age 4 years in the daytime and 25 percent at nighttime. By the time children are 8 years old, only 10 percent experience nighttime sleepwetting, and by age 13, only 2 percent.

Although sleepwetting is a common problem, it is unfortunately a problem with a stigma attached to it. First, you need to confront your own feelings. The negativity you may feel is normal: sleepwetting creates more work for you. You may also have some personal concerns about your own effectiveness as a parent or a child care provider. Both you and the child may be feeling sensitive and alert to criticism. You may feel the child is lazy, just doesn’t care, or is too immature to be able to control him or her self. These are normal feelings; however, they also increase the anxiety both you and the child experience.

Sleepwetting incidents put everything behind schedule. Neither you nor the child’s day is off to a happy start, and the stress stays with both of you. In child care, this usually happens midday, at naptime.

What causes sleepwetting?

In most cases the cause of sleepwetting is unknown, although the most common known causes are:

• Underlying illness such as diabetes
• Infections (including urinary tract)
• Small or weak bladder
• Genetic factors
• Psychological problems caused by stress or separation from parents
• Sleep disorders
• Irritation of the genital area from bubble bath/shampoos, pinworms, trauma, etc.
• Sexual abuse
• The child not being aware of bodily messages

In some cases where one or both of the biological parents have experienced sleepwetting as a child, their offspring often experience the same difficulty.

How do I manage it?

Things that will not help

Historically, management of sleepwetting has emphasized punishment, humiliation and other disciplinary techniques. Today it is understood that sleepwetting is best dealt with through love, understanding and positive support. Criticizing, shaming, comparing, punishing, threatening, name-calling or spanking will only increase the stress between you and the child.

Things that you can do to help

Protect the bed. Reduce some of the stress by eliminating the problem of wet, soggy mattresses and/or sheets. Disposable underpads are convenient – some will cover most of the bed. Try waterproof mattress protectors or double sheeting with a rubber sheet between layers to ease changes of bedding.

Arrange for a physical check-up to rule out any physical problem.