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Sleep Disorders

Adult Bedwetting at Night

02/05/2010

Question:

For the past two months I have experienced waking to a wet bed. This is highly unusual for me. I am 62 and going through menopause. My family are mostly diabetics and my family doctor has said I am one step away from being diabetic. Could this be a symptom of either of those? Or perhaps stress related? I am a high school teacher. I have noticed that these two nights I was sleeping so soundly. I was dreaming and waking rested. I am just wondering if I should call my physician or if this will pass on its own?

Answer:

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 underlying medical problems and do not represent a problem with the urinary system per se, though urinary tract disorders can also lead to enuresis. These conditions include obstructive sleep apnea (repetitive airway closing in sleep), congestive heart failure, diabetes, urinary tract infections, nighttime 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.

There does not appear to be a clear link between menopause and urinary incontinence during sleep. However, as you mentioned, you are at risk for diabetes, and thus this may be a significant factor to consider. Other aspects of your history and physical exam may be important in determining why you are experiencing sleep enuresis. The treatment of this problem depends heavily on the underlying cause, so trying to pin this down is key to solving you problem.

I recommend you discuss this issue with your primary care physician. Referral to a Urologist may be needed. Evaluation by a Sleep Specialist in your area may also be considered if there is concern for an underlying sleep disorder.

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 Seep 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