Nocturnal enuresis, or bedwetting, is a form of urinary incontinence. While very common in young children, less than 3% of adults experience this involuntary night-time urination. Here’s a look at understanding the causes and treatments of adult bedwetting.
Primary vs. Secondary Bedwetting
There are two kinds of nocturnal enuresis: primary and secondary. While primary bedwetting refers to bedwetting that has continued without ever getting under control, secondary bedwetting refers to nocturnal enuresis that has stopped for at least six months before beginning again. Secondary bedwetting is generally more concerning, because it is more often indicative of an underlying medical issue.
Causes of Bedwetting in Adults
There are a whole variety of reasons adults wet the bed -- and none of them are reasons of personal fault. In children, it often has to do with the little one’s undeveloped nervous system and urinary tract or a small bladder -- it simply takes time for kids to get full control over their potty breaks. But in adults, it is often much more serious. Here are some common causes:
- Hormone Imbalance: The anti-diuretic hormone (ADH) is designed to help the body produce less urine in the evenings and at night. If the body produces insufficient amounts, you may be producing just as much urine during the day, while attempting to hold it for 8 hours. For some people, this means waking up several times a night; for others, it appears as enuresis.
- Structural Issues: Although rarely the cause of nocturnal enuresis in children, structural issues are a more likely culprit in adults -- particularly if they have stuck around since childhood. In men, prostate cancer or an enlarged prostate can cause nightly incontinence by putting pressure on the urethra, through which urine passes. Pelvic organ prolapse, a condition more common in women who have had pregnancies or who are dealing with menopause, may also put extra pressure on the urinary tract, causing nocturnal enuresis. Bladder cancer can result in incontinence in either gender. Other issues include overactive bladder, chronic urinary tract infections, bladder stones, and chronic constipation. These can all make it difficult to hold urine as long, as well as interfering with the integrity of the involved muscles.
- Underlying Disorders: Nocturnal enuresis can also be indicative of the development of type 1 diabetes. Additional signs to look for include excessive thirst, fatigue, and unintended weight loss. Night terrors, extreme psychological stress or anxiety, and disorders of the spinal cord (such as spina bifida) and nervous system may also contribute to nocturnal enuresis in adults. Furthermore, some medications can increase the risk of nighttime elimination.
Treatments for Bedwetting in Adults
Determining whatever is causing you to involuntarily urinate while sleeping is the key to finding an appropriate treatment program. Obviously, treating the underlying issue is going to be the first step. This might mean starting treatment for diabetes, taking antibiotics for infections, changing your diet to improve bowel movements, speaking with a counselor to learn how to manage your stress, taking an anticholinergic to reduce bladder spasms, or beginning desmopressin to improve ADH production. Talk to your doctor about what the underlying issue might be, and what the best treatment options are for you.
There are, however, a few easy at-home tricks that may help while finding the best medications or other medical management for your issue. In addition to limiting fluids in the evening, avoid caffeine and alcohol, particularly close to bedtime, as these chemicals can stimulate the bladder. Go to the bathroom twice, right in a row (called “double elimination”) before going to sleep to ensure your bladder is as empty as possible. Kegel exercises, for men or women, a few times a day can help strengthen the muscles. Go to the bathroom frequently during the day in order to get the bladder on a sort of schedule and keep it empty.
Finally, items like the moisture alarm are helpful for some people. A small, battery operated alarm is attached to a special pad that sounds as soon as it feels wetness, waking you up so you can get to the bathroom. If you don’t wake up, or use adult diapers, be sure to use moisturizing creams, like A&D ointment, to help prevent rashes.
