Bed-wetting (also known as sleep enuresis and urinary incontinence) is a fairly common condition in young children and is seen as a sign of an immature, developing bladder. It is estimated that 15% of children over three, and 10% over five wet the bed occasionally. In fact, most doctors don’t consider bed-wetting in children to be a sign of a problem unless the child is older than seven years old, or the child has begun wetting the bed again after six months of maintaining overnight bladder control.

However, when adults wet the bed it is often an indication of an underlying illness, disease, or a symptom of other untreated medical conditions.

For adults, wetting the bed can not only be a devastatingly embarrassing condition, but it is often a sign of other medical troubles. If you’re an adult who frequently wets the bed, it’s a good idea to discuss your symptoms with your primary care provider to find the root cause of your problem. Here is a list of common causes of sleep enuresis.

Causes of adult bed-wetting

• Genetics. One of the first places to look for causes of urinary incontinence is whether there is a family history of bed-wetting.
• Urinary tract infection (UTI)
• Small bladder
• Over-active bladder
• Diabetes
• Kidney disease
• Enlarged prostate gland
• Prostate cancer
• Bladder cancer
• Side effects of medications
• Neurological disorders
• Stress, anxiety, fear, and other psychological issues
• Sleep apnea
• An imbalance of the anti-diuretic hormone (ADH)

Determining the cause of bed-wetting

Discovering the cause of bed-wetting can be tricky as it is often an underlying cause of another medical condition. When seeking treatment for your nocturnal enuresis you can expect one or more of the following routine tests

• A physical examination
• A neurological examination
• Urine tests
• Urologic examination
• Ultrasound of kidneys and bladder

To help your doctor better determine the causes of your troubles, it’s recommended that you keep track of important bed-wetting information such as:

• When your accidents are most likely to occur (time of day or night)
• Amount of urine voided
• Daily intake patterns of fluids
• Types of fluids ingested and whether they contain caffeine or alcohol.
• The number of dry nights vs the number of wet nights
• Recurrent urinary tract infections
• How your urine stream looks when going to the bathroom (strong and steady or weak and dribbling)
• Stress and anxiety have undisputed impact on not only bed wetting, but also physical disability and mobility limitations.There is convincing evidence that depression and stress increase the risk for physical disability and, in turn, physical disability results in increased depressive symptoms, that’s why it’s important to know some tips to improve mobility for seniors.
  Stress affects also the earlier stages of the functional limitation in mobility and can accelerate the transitioning along the pathway to disability.

Treatments for sleep enuresis

Lifestyle treatments

• Set fluid intake limitations
• Reduce or cut out caffeine and alcohol from diet
• Make urinating a routine. Set a schedule to make sure to urinate every one to two hours during the day
• Void bladder before bedtime even when you don’t quite feel the need to go
• Set a night time bathroom alarm to urinate in the middle of the night
• Protect your bed with special mattress covers
• Wear absorbent briefs during the night

Medical Treatments

In many cases controlling nocturnal urinary incontinence comes down to treating underlying medical conditions. However, there are some prescribed medications that have been shown to help.

• Anticholinergic drugs to calm irritated bladder
• Antibiotics to treat urinary tract infections
• Desmopressin acetate increases levels of ADH to slow night time urine production
• DHT-blocking medications to reduce prostate swelling
• Bladder relaxants, like FDA-approved Myrbetriq (pricing)

Potential Skin Conditions

Unfortunately, bed-wetting can also cause other problems, like adverse skin conditions. These issues can be very uncomfortable, and if left treated, could continue to get worse.

The key to prevention is ensuring that the incontinence product being used is the right size and absorbency level. If it doesn’t fit well or can’t handle the leakage level, skin irritations can occur.

Another way to prevent incontinence-related skin conditions is to address the area quickly by keeping it clean and dry as much as possible.

Treating sleep apnea

Bed-wetting is often a symptom of sleep apnea in children, but bed-wetting in adults is much less common. However, there is a small number of adults (one study showed 7% of sleep apnea patients had secondary enuresis) that begin to experience sleep enuresis as their sleep apnea symptoms worsen. For these patients, symptoms of bed-wetting often resolves once continuous airway pressure therapy (CPAP) introduced to treat sleep apnea.

For those living in Alaska and experiencing urinary incontinence that may be associated with worsening sleep apnea symptoms, contact the Alaska Sleep Clinic for a free 10-minute phone consultation with one of our sleep specialists to see if a sleep study may be right for you.