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Sleep Disorders

Nocturnal Enuresis

12/03/2010

Question:

I had problem of bedwetting in childhood that became normal as I grew. Now I`m 30 years old. Yesterday night before sleeping I drank water & at 3.30am. I was having dream then I felt a little wet & I was surprised to see that I had passed urine but still I had to go to toilet to void fully. Is this a reason to worry? I have no local symptoms otherwise.

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.

In your case, I suspect, based on the information you provided, that you may have taken in too much water before bedtime, leading to this episode of bedwetting. The fact that you had to fully void after this, suggests your bladder was quite full. I would watch to see if this happens again, particularly in the setting of not drinking prior to bedtime. If it does recur, then other aspects of your history and physical exam will be important in determining why you this is happening. The treatment of this problem depends heavily on the underlying cause, so trying to pin this down is key to solving you problem. Again, I suspect it may be related to excessive water intake before bedtime.

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 sleepeducation.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