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Sleep Disorders

Adult Bedwetting

06/05/2008

Question:

I am a 22 year old African American female. I have only had one episode of wetting the bed in my entire life thus far. For the past few days I have felt an itching during urination and it somewhat feels like something is sitting in my urinary tract that was not there before. I had recently had unprotected sex with my monagamus boyfriend and I figured I had a UTI. Upon looking up the symptoms of a UTI I relaized none of them fit me. I have been under an unusual amount of stress lately. Tonight I lay in bed dreaming that I was at work and that I had to urinate, when I made it to the bathroom and started to urinate I awoke realizing that I really was urinating in bed, I stopped and went to the bathroom. I am concerned as to why this would happen at random. The first and only episode I had was when I was about 7 or 8. I just wondering what could be the cause of this.

Answer:

Before going into the issue of bed wetting, it’s very likely that, based on the information you provided, you do have a urinary tract infection (UTI) and that this is the cause of your symptoms. UTIs may present with a variety of symptoms that are not always “classic.” The recent sexual intercourse and symptom of itching during urination make it very likely that you do have a UTI and I recommend seeking evaluation and treatment for this.

Despite the above, it might be help for you to here some additional information on bed wetting in sleep. This is also known as sleep enuresis and is quite common in children but begins to decrease in frequency once above the age of 5. Only about 1-2% of 18 year olds will have this problem and it was previously thought to become less frequent in adulthood, though recent studies suggest 0.5-2% of adults report enuresis. It then becomes more common in the elderly population, when other factors, such as urinary incontinence may develop.

Many cases of sleep enuresis in adulthood are due to other underlying medical problems and do not represent a problem with the urinary system per se. These conditions may include obstructive sleep apnea (repetitive airway closing in sleep), congestive heart failure, diabetes, nighttime seizures, depression, severe psychological stress, and dementia. Problems or disorders of the urinary tract system that can result in enuresis include urinary tract infections, an overactive bladder muscle or loss of control of the bladder sphincter. Of course, the excessive intake of fluids or substances that promote urination (i.e. diuretic medications, caffeine, and alcohol) can lead nighttime bedwetting.

In your case, a single episode in the face of a probable UTI suggests that if you get appropriately treated, you will be unlikely to have recurrent problems.

If you would like further information about sleep disorders or sleep itself, I recommend the American Academy of Sleep Medicine website. In addition to information about sleep medicine, the website also contains a list of accredited Sleep Centers and may help you to locate one nearest you. Good Luck!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University