A Guide to Adult Nocturnal Enuresis

24 April 2018

Nocturnal Enuresis is really just a fancy word for nighttime bedwetting. More specifically, it's a term used for bedwetting by people at bladder control age. Needless to say, most adults with nocturnal enuresis don't talk about the problem. They’re embarrassed. They feel their problem is unique. They feel alone.

ADULT NOCTURNAL ENURESIS

It may help to know that the problem is not that uncommon. According to the Bladder and Bowel Community, about 1 in every 100 people may be affected in their adult life. That's a considerable amount. Nobody should feel isolated in this situation.

There is a lot of help and support available from a variety of communities and organisations. Your doctor or community nurse should be able to provide you with details of where you can get more help.

Bedwetting can be completely cured. Most of the time it is the result of a manageable underlying problem.

It’s important to actively seek out help, even if you feel you’ve tried everything.

Causes

Like any kind of incontinence, there are a number of reasons that could lead to bedwetting;

Your Kidneys may be producing more urine than normal

This could be because you’re not producing enough of a hormone called Antidiuretic Hormone (ADH). At night, this hormone normally tells your kidneys to decrease urine production while you sleep. Not enough ADH could result in bedwetting or regular trips to the toilet through the night.

Also, your kidneys may not be responding properly to ADH, which will cause similar problems.

Diabetes can also affect ADH levels which can lead to bedwetting.

You may have an overactive bladder

Under normal circumstances, your bladder muscles contract when your bladder is full. This contraction is what leads to the urge to urinate.

If you have an overactive bladder, your bladder muscles will contract randomly - even when your bladder is empty. This causes a sudden and urgent need to urinate that can be difficult to control and lead to leakage. It can also happen at night, and result in bedwetting.

Other causes may include;

  • Medication - some sleeping medication and antidepressant medicines can irritate the bladder
  • Enlarged prostate gland (in men)
  • Urinary Tract Infection
  • Constipation
  • Structural problems with the bladder and/or urethra - this may be something you were born with

Treatment and Management

When managing bedwetting at night, one of the main approaches is to change your evening routine prior to going to bed;

  • Don't drink anything at least a couple of hours before bed
  • Avoid caffeine and alcohol - especially after 2 pm as these are natural diuretics which make more urine and increase the chances of bedwetting at night
  • Try bladder retraining- this means going to the toilet at set times throughout the day and night. Training your bladder will allow you to hold more urine for longer, which will decrease your chances of leaks.
  • Bed-wetting alarm systems may be helpful in keeping leaks under control
  • Medication may help in reducing the amount of urine your kidneys produce. Talk to your doctor if you feel medicine might help you.
  • Incontinence sheets can be an effective way of protecting your mattress against leaks.
  • Pads and pull up pants can be comfortably worn at night to help absorb leaks and keep you dry
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