Bedwetting is common for children, affecting more boys than girls. The condition occurs in 30% of children at the age of 4, 10% at the age of 6, and drops to 1% by the age of 18. Although children develop bladder control at different rates, most boys can control their bladder during the day and night by the age of 6, and most girls by the age of 5. When a child who is old enough to have bladder control urinates accidentally while sleeping, it's called nocturnal enuresis.
There are two main types of nocturnal enuresis: primary and secondary. The primary type is a condition where a child still wets the bed after age 5 or 6. It's often hereditary. The secondary type occurs when a child who had stopped bedwetting for at least six months starts again, often due to emotional stress or a medical condition.
Possible causes of primary nocturnal enuresis include the following:
Rare possible causes include the following:
Although it is often said that emotional stress causes primary nocturnal enuresis, there is little scientific evidence to support this claim. However, bedwetting itself may lead to feelings of shame and lowered self-esteem.
Causes of secondary nocturnal enuresis include the following:
For sleeping children who are old enough to control their bladders, the symptoms of bedwetting are obvious. Regularly finding urine-soaked sheets is a clear sign of the problem. Also, a child may wake and cry during the night when the wetting occurs, or wake up caregivers to alert them.
The most common complication of bedwetting is the impact on self-esteem and the emotional distress it causes children. Assuring children that the occurrences are accidental (and not blaming the condition on them) is key to managing the psychological effects. Many children who wet the bed may fear staying overnight at a friend's house in case they wet the bed there.