‍I must be the only one?
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‍Wetting the bed at night is surprisingly common, although very few people talk about it. It affects about one person in 100 throughout adult life but you probably thought that you were the only one. Some people wet the bed all their lives. Others become dry during childhood, but later start wetting the bed again.

Bedwetting is also known as "nocturnal enuresis". It affects different people in different ways. The practical problems of coping, with wet bedding, even at home, can be considerable, especially if you do not have good washing and drying facilities. You may find that you worry about staying away for the night, going on holiday or business trips, going to college or moving away from home. You may find that you don't want to get into a relationship in case your new partner finds out. It may cost you a lot of money to wash and dry bedding or buy disposable products.

However, in most cases, with the right advice and support, something can be done to improve the situation, sometimes even cure bedwetting.

Even if you tried everything when you were a child, it is always worth trying again. New methods and treatments are becoming available all the time.

By picking up this leaflet, you have made a start - now don't delay - get some help today!


What causes bedwetting?
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‍Most people produce most of their urine during the day and very little at night. Some people who wet the bed produce urine at a constant rate throughout the day and night, and this may explain why the bladder needs emptying at night (although not why you don't wake). However, it is not true that most people who wet the bed sleep more deeply than other people.

Some people have an overactive, or "unstable" bladder, and this can cause daytime problems as well as at night, such as passing urine very often (frequency), having to rush to the toilet (urgency) and accidentally leaking urine on the way (urge incontinence). The cause of this unstable bladder is often unknown.

Occasionally, an infection in the urine or other bladder problems may cause bedwetting. Stress or anxiety may sometimes start the problem, with the wet nights continuing long after the stress is over.


What help is available?
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‍The first step is to talk to your family doctor or local nurse continence advisor. Some people feel too embarrassed to talk about bedwetting. Take this leaflet with you if you think it may help to start the conversation.

Your Doctor or Continence Advisor will want to know about your bladder habits. You may find it useful to keep a diary for about a week before your appointment showing how often you pass urine, how much you drink and when you are wet. A sample of your urine may be tested for infection. Sometimes a doctor will recommend that you attend the hospital outpatient department for a bladder test ("urodynamic" studies).

‍Medicine

‍Your Doctor will assess your symptoms and may prescribe an appropriate medicine to control your bedwetting. It is important that your doctor knows whether you have daytime symptoms.

One type of medicine (e.g. desmopressin) works by reducing the quantity of urine produced overnight. The other type (e.g. oxybutinin, or Vesicare) works by relaxing the bladder, allowing it to hold more urine.

Medication can often control bedwetting and may provide a long-term solution to the problem.

‍Enuresis alarm

‍These are designed to wake you up when you start to wet, either by sounding a buzzer or by vibrating, which may be preferable if you are sharing a bedroom. Gradually your body learns to hold the urine, or to wake so that you can empty the bladder. Nobody knows why this works, but it often does. Modern alarms are small and discreet, and can be worn close to the body.

An alarm is most successful if used with professional supervision (e.g. from your continence advisor). PHONE 0800 650 659 FOR A LIST OF CONTACTS.

‍Complementary therapies
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‍While there is limited scientific research as yet, some people find that homeopathic medicines, hypnosis or acupuncture can be beneficial. It is important to obtain advice from a trained practitioner.
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‍How can I help myself?
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Drinks
‍You need to drink at least 6- 8 glasses of fluid (i.e. water, tea, coffee, milo, soup etc.) every 24 hours. If you don't drink enough, your body may not be able to get rid of its waste products efficiently. It doesn't matter when you drink, but you may find it sensible to drink mostly during the day, with less fluid in the evening. Some people find that drinks with caffeine (such as coffee, tea and cola and some other fizzy drinks) irritate the bladder. Try cutting down on these, especially in the evening. It is worth experimenting with different drinks to see if they all have the same effect.Alcoholic drinks make the bedwetting worse. This may be the effect of the alcohol itself, or the extra fluid, especially in beers and other long drinks. Low alcohol drinks may be better - but are not to everyone's taste!

‍Waking
‍You should ensure that you empty your bladder before you go to sleep. Some people find that waking to empty their bladder, by setting an alarm clock for a couple of hours after going to bed, can save a wet bed, although of course it does not "cure" the problem. If you do this, vary the time you set the clock for, otherwise your bladder may get into a habit of emptying at the same time, whether you are awake or not.

‍Bladder training
‍If you have a daytime problem of frequency and/or urgency, or pass urine very often at night, it may help to increase the amount of urine that your bladder can hold. A "normal" bladder should hold up to two cups (400 - 450mls) of urine. If yours doesn't hold this much, practice "holding on" and going to the toilet less frequently during the day. This takes a lot of willpower. It may help to keep a record or chart.

‍Practical management
‍It is often said that a problem shared is a problem halved, and this can be true of bedwetting. Talking about it can be a tremendous relief, especially when you realise that most people will be sympathetic and supportive. The "Further Help" section at the end of this leaflet gives details of the NZ Continence Association Help line and of other sources of support and information.

Bedwetting can seem like a real barrier if you want to start a new relationship. Talking openly and honestly, before the situation arises, can sometimes bring you closer to a partner - you have shown enough trust to share your problem.

Protecting your mattress and bedding does not mean you have to sleep wrapped in plastic. Newer 'breathable' waterproof fabrics are a lot more comfortable and less hot. Avoid nylon bedclothes and nightwear, which tend not to absorb sweat and smell. Washable absorbent under sheets come with cotton or 'stay-dry' facings and some are available in double-bed size. Disposable sheets and underpads may be useful away from home. Some hotels will provide bed protection if you ask in advance.

Fresh urine should not smell, and as long as you have a good wash each day and keep wet sheets in an airtight container until washed, odour should not cause a problem.

This document has been developed by, and remains the property of, the Continence Foundation of Australia © Continence Foundation of Australia 2015
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