Statistics show that only 34 percent of Australian families with a child who wets the bed seek professional help. Instead, they wait for what’s called spontaneous remission, where the child grows out of it naturally. Quite often, this is something that does eventually occur naturally in many children, but not all of them. It is a worrying statistic when you consider the impact that bed wetting can have on a child. It can affect everything from self-esteem to the child’s relationships with friends and parents,even when bed wetting occurs as little as once a month). Many people do understand that the majority of techniques that families try themselves to solve the problem don’t work. In comparison, proper treatment for bed wetting can be effective in more than 90 percent of cases.
The initial treatment for a child with a bed wetting problem is an alarm, waking a child at the exact moment when wetting begins. The idea is that after a period of time, alarm therapy improves arousal from sleep, helping to alert and sensitise a child to respond to a full bladder when they’re asleep.
In Australia, there are two types of enuresis alarms available to parents and children – the pad-and-bell alarm consists of a soft rubber mat which is connected to an alarm unit. The mat is placed on the bed and covered with sheets. The alarm rings as the child begins to wet. The personal or body-worn alarm consists of an alarm unit and sensor. The alarm unit is clipped onto the child’s pyjamas and the sensor is placed inside the pants. Once the sensor becomes wet, the alarm sounds. Studies show that around two-thirds of children treated with alarm therapy become ‘dry’ during the period of time that they use the alarm, and about half of those remain dry, without the need for further treatment.
It’s generally recommended that alarm treatment be continued for at least two to three months, with the recommendation being that a child uses the alarm until they achieve 14 consecutive nights of remaining dry.
Medications are also available to treat bed wetting. One of them has an active ingredient called desmopressin. It works like vasopressin, which is a naturally occurring substance produced by the brain. For children who wet the bed as a result of low levels of vasopressin during the night, desmopressin supplements the body’s natural vasopressin, thus reducing the amount of urine produced during the night.
Oxybutynin is an anticholinergic medication and may be used if a child has an overactive bladder during sleep. Tricyclic antidepressants such as imipramine, are also approved for the treatment of bedwetting, however they are less commonly recommended because of their potential side-effects.
You may also hear about other treatments that are less commonly used such as hypnosis, acupuncture, psychotherapy, reward systems and fluid restriction. It has not been established whether these treatments are effective in managing bedwetting. The primary goal however is to use the most effective treatment that will keep your child dry at night.