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What Causes Nighttime Incontinence? (page 3)

— National Institute of Mental Health
Updated on Mar 6, 2013

What treats or cures incontinence?

Growth and Development

Most urinary incontinence fades away naturally. Here are examples of what can happen over time:

  • Bladder capacity increases.

  • Natural body alarms become activated.

  • An overactive bladder settles down.

  • Production of ADH becomes normal.

  • The child learns to respond to the body’s signal that it is time to void.

  • Stressful events or periods pass.

Many children overcome incontinence naturally—without treatment—as they grow older. The number of cases of incontinence goes down by 15 percent for each year after the age of 5.

Medications

Nighttime incontinence may be treated by increasing ADH levels. The hormone can be boosted by a synthetic version known as desmopressin, or DDAVP, which is available in pill form, nasal spray, or nose drops. Desmopressin is approved for use in children.

Another medication, called imipramine, is also used to treat sleepwetting. It acts on both the brain and the urinary bladder. Researchers estimate that these medications may help as many as 70 percent of patients achieve short-term success. Many patients, however, relapse once the medication is withdrawn.

If a young person experiences incontinence resulting from an overactive bladder, a doctor might prescribe a medicine that helps to calm the bladder muscle. This medicine controls muscle spasms and belongs to a class of medications called anticholinergics.

Bladder Training and Related Strategies

Bladder training consists of exercises for strengthening and coordinating muscles of the bladder and urethra, and may help the control of urination. These techniques teach the child to anticipate the need to urinate and prevent urination when away from a toilet. Techniques that may help nighttime incontinence include

  • determining bladder capacity

  • drinking less fluid before sleeping

  • developing routines for waking up

Unfortunately, none of these techniques guarantees success.

Techniques that may help daytime incontinence include

  • urinating on a schedule—timed voiding—such as every 2 hours

  • avoiding caffeine or other foods or drinks that you suspect may contribute to your child’s incontinence

  • following suggestions for healthy urination, such as relaxing muscles and taking your time

Moisture Alarms

At night, moisture alarms can awaken a person when he or she begins to urinate. These devices include a water-sensitive pad worn in pajamas, a wire connecting to a battery-driven control, and an alarm that sounds when moisture is first detected. For the alarm to be effective, the child must awaken as soon as the alarm goes off, go to the bathroom, and change the bedding. Using alarms may require having another person sleep in the same room to awaken the bedwetter.

Incontinence is also called enuresis

  • Primary enuresis is wetting in a person who has never been dry for at least 6 months.

  • Secondary enuresis is wetting that begins after at least 6 months of dryness.

  • Nocturnal enuresis is wetting that usually occurs during sleep, also called nighttime incontinence.

  • Diurnal enuresis is wetting when awake, also called daytime incontinence.

Points to Remember

  • Urinary incontinence in children is common.

  • Nighttime wetting occurs more commonly in boys.

  • Daytime wetting is more common in girls.

  • After age 5, incontinence disappears naturally at a rate of 15 percent of cases per year.

  • Treatments include waiting, dietary modification, moisture alarms, medications, and bladder training.

For More Information

American Academy of Pediatrics 141 Northwest Point Boulevard Elk Grove Village, IL 60007–1098 Phone: 847–434–4000 Email: kidsdocs@aap.org Internet: www.aap.org

Urology Care Foundation 1000 Corporate Boulevard Linthicum, MD 21090 Phone: 1–866–RING–AUA (746–4282) or 410–689–3700 Email: patienteducation@urologycarefoundation.org Internet: www.UrologyHealth.org

National Association for Continence P.O. Box 1019 Charleston, SC 29402–1019 Phone: 1–800–BLADDER (252–3337) or 843–377–0900 Email: memberservices@nafc.org Internet: www.nafc.org

National Kidney Foundation 30 East 33rd Street New York, NY 10016 Phone: 1–800–622–9010 or 212–889–2210 Email: info@kidney.org Internet: www.kidney.org

The Simon Foundation for Continence P.O. Box 835 Wilmette, IL 60091 Phone: 1–800–23–SIMON (237–4666) or 847–864–3913 Email: simoninfo@simonfoundation.org Internet: www.simonfoundation.org

Society of Urologic Nurses and Associates P.O. Box 56 East Holly Avenue Pitman, NJ 08071–0056 Phone: 1–888–TAP–SUNA (827–7862) or 856–256–2335 Email: suna@ajj.com Internet: www.suna.org

You may also find additional information on this topic using the following databases:

The NIDDK Reference Collection is a collection of thousands of materials produced for patients and health care professionals, including fact sheets, brochures, and audiovisuals materials. Visit www.catalog.niddk.nih.gov/resources.

MedlinePlus is the consumer version of MEDLINE with easy access to medical journal articles, medical dictionaries, directories, drug and supplement lists, interactive patient tutorials, publications, and the latest health news. Visit www.medlineplus.org.


National Kidney and Urologic Diseases Information Clearinghouse

3 Information Way Bethesda, MD 20892–3580 Email: nkudic@info.niddk.nih.gov

The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1987, the Clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. The NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases.

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This publication was also reviewed by Stuart B. Bauer, M.D., Harvard Medical School and Children’s Hospital, Boston.

This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.

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