A factor that could play a role in childhood enuresis is sleep apnoea or sleep disordered breathing. The most common cause of sleep apnoea in children is large adenoids, which are located behind the nasal passages. Most children with large adenoids snore, but do not have sleep apnoea. The few children who do develop sleep apnoea actually stop breathing for short periods of time during sleep.
Children who struggle with bedwetting are more likely to experience anxiety, panic attacks, school phobia, social anxiety and separation anxiety. Research has also shown that children who experience bedwetting are significantly more likely to have stress or anxiety issues than children who do not wet the bed. So you can see it can be a bit of a vicious cycle.
A major diuretic is caffeine. Now this doesn’t mean just coffee. Caffeine is also found in tea, cola, energy drinks and chocolate drinks like drinking chocolate and milo. Sugary or carbonated drinks may also irritate sensitive bladders. Even fruit juices increase urine output.
Constipation is a major factor that can cause bedwetting. Constipation is so common. In fact, 25% of children with bedwetting are caused by constipation. You’re probably thinking, ‘but bedwetting is to do with weeing’, right? What’s poo got to do with it? .
Another factor that can cause bedwetting in children is to do with the kidneys. And that is when the kidneys make too much urine while asleep. To help you understand this better, I’ll first explain what normal kidney function is at night. The brain produces a hormone called antidiuretic hormone (ADH). This hormone’s role is to slow the kidney’s urine production during sleep, so it helps make less urine at night. So, for a child that wets the bed, their brain may not be making enough ADH while they’re sleeping, or the kidneys stop responding to the hormone. This then causes the kidneys to produce more urine.
Some children with bedwetting have bladders that can only hold a small amount of urine. So this prevents the child from sleeping through the night without wetting the bed. Children with small functional bladder capacity have normal-sized bladders, but what’s happening is, their body is sensing a full bladder even when their bladder could still hold more urine.
There is a debate surrounding whether sleep problems are caused by being a deep sleeper or whether the frequent brain stimulation without waking contributes to disordered sleep. One theory is that being a deep sleeper can affect the way the body communicates with the brain when it comes to doing wee. They have a harder time developing an effective signaling system that wakes them up when they need to wee during the night. So instead, the child’s pelvic floor relaxes during sleep, and bedwetting occurs.
Well, the first thing you should do if your child has daytime wetting as well as bedwetting, is set aside a period of time over the course of a few days to observe your child’s bladder and bowel behaviour. And take notes.
So to make it easier for you, below this article I’ve included a quick Daytime Wetting Checklist. It’s best to do this when your child is home so you can observe their toileting behaviour the whole day. This is super easy!
Void postponement is also more commonly known as ‘leakage’. It’s basically when a child keeps delaying or holding off on going to the toilet. The child may be too busy, so when the bladder is choc a block full, the urine leaks out and, well, along comes an accident!
Dysfunctional Voiding. A simpler term for this is ‘not emptying the bladder completely’.
This is a common condition amongst children which can contribute to daytime wetting accidents. In fact, according to some studies, as many as 20% of school aged children have at least one symptom of dysfunctional voiding.
An underactive bladder is when the child doesn’t urinate enough. For example less than 3 times a day. They may not even have the urge to wee and some children are able to go for more than 6 to 8 hours without doing a wee.
These children sometimes have to strain to wee because the bladder muscle itself can become “weak” from being overstretched and may not respond to the brain’s signal that it is time to go.
An overactive bladder can be defined as a sudden and uncontrollable urge to urinate. One common symptom of an overactive bladder in children is the urge to wee more often than normal, and sometimes, urgently!