I am a Radologist in Rockhampton,QLD. My daughter aged 11 years has been having nocturnal eneuresis and we have tried using a bed wetting alarm-but as expected in such children she is in very deep sleep and is not easily woken up. She has no problem with continence in the morning. I have had her MRI for spine and Urine examination etc--all of which was normal. We have been reading a lot on this topic and some are of the opinion that the abnormal sleep and the relatively small or immature bladder, abnormal ADH secretion patterns are all incriminated and need to be addressed.
Firstly, please accept my apologies for the delay in getting back to you I have had a large volume of questions to answer over the past two weeks. There are numerous reasons why children experience primary nocturnal enuresis. Generally we find that nocturnal enuresis is caused by a mismatch between nocturnal bladder capacity and the amount of urine produced overnight as well as impaired arousal, that is children are unable to wake up in response to a full bladder. We also find a strong family history when it comes to bedwetting with about 8 in 10 children experiencing nighttime incontinence if both parents wet the bed as children, reducing to 4 in10 if only one parent wet the bed. If genetically determined – most children will show a spontaneous resolution around the same age that their parent achieved continence. More recently researchers have examined the link with food allergies with some children experiencing a reduction in wetting in response to a change in diet. Unfortunately the conditioning alarm does not work with all children although I find its success depends to a certain extent on the amount of support received (from a continence specialist) as well as how motivated children are to be dry. Given her age I’m sure motivation is not an issue. It is quite common for children not to wake on their own to the alarm – it is usually necessary for parents to wake their children initially – you should do this even if she is already wet as this is how she will eventually learn to wake on her own. It is not unusual for children to experience a relapse after treatment – if this is the case you will need to reintroduce the program. Some parents have reported better outcomes when combining this with other forms of treatment such as hypnotherapy. In the meantime it is important that you do not allow her bedwetting to interfere with social opportunities as this can have a negative impact on her self-esteem and self-confidence. Most girls her age will be interested in attending sleepovers – talk with her about how to best manage this – there are some tips on the DryNites website you may find helpful.
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