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Sleep Disorders

Causes of bedwetting

09/05/2008

Question:

I am a 20 yr old young lady. About 3 months ago I had a seizure a morning during my sleep. Before that I had wet the bed about 3 times. I wasn`t paying any attention to it. A nuerologist placed me on a pill topamax. I came off it on my own. Now about 2 months after stop takin the pill last week I wet the bed again. Can you advise me please on what next step to do? Should I take the ECG or EEG the doctor recommended?

Answer:

I apologize for the delay in getting a response to you, but hope this is helpful.

Bed wetting during sleep, also known as sleep enuresis, often has a variety of underlying causes. Sleep enuresis 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 becomes even less frequent in adulthood until urinary incontinence becomes a problem with aging (mostly in the over 65 year old population).

Most cases of sleep enuresis in adulthood are due to other underlying medical problems and usually do not represent a problem with the urinary system per se, although urinary tract disorders can also lead to enuresis. Medical conditions associated with enuresis include obstructive sleep apnea (repetitive airway closing in sleep), congestive heart failure, diabetes, urinary tract infections, night-time seizures, depression, severe psychological stress, and dementia. Of course, excessive intake of fluids or substances that promote urination (i.e. diuretic medications, caffeine, and alcohol) can also lead nighttime bedwetting.

In your question, you mention you experienced enuresis prior to being diagnosed with possible night-time seizures. If I understand you correctly, it sounds like you the bed wetting resolved while on the topamax (an antiseizure medication), but you have experienced recurrent enuresis since coming off the medication. It’s very possible that your bed wetting episodes are a symptom of night-time seizures. Loss of bladder control is a typical feature of many types of seizures and the timing you describe in your question sounds like this could be the case.

If your enuresis is related to night-time seizures, then the treatment would be to control the seizures. However, attempting to eliminate bed wetting should not be your only motivation for taking the seizure medication. Having uncontrolled seizures can be very dangerous and hazardous to your health.

I recommend you definitely follow the advice of the neurologist and get this problem fully evaluated and appropriately treated. If your problems persists despite control of your seizure disorder, then further evaluation may be needed.

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, if needed. The website Sleep Education.com also can provide consumer-friendly information about sleep disorders. 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