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Monday, December 9, 2013
12 Year Old Wets Bed Occasionally
I have a 12 year old daughter who had a bed wetting problem. It has drastically improved in the past year. We were not having any occurences for many months. This winter she seems to have started wetting again. This seems to occur when she is comming down with a cold and while she has the cold. Do you have any ideas on what I can do as this is very upsetting to her. Her father was a bedwetter into his late teens and her brother until he was 8.
I can only imagine how frustrating and embarrassing the problem is as a young teen! Having dealt with the problem now with your son and knowing your husband struggled with the same problem until his late teens, I know that you understand that it is largely likely to be a problem that has been inherited. Research does show that children with normal growth and development will outgrow the problem given time - but we never know how long that will take. As your husband found, the problem can linger until the late teens for 1-3% of all bedwetters.
Bedwetters are believed to have alterations in bladder volume, bladder function, amount of antidiuretic hormone produced at night, as well as impaired arousal from sleep. Since your daughter had marked improvement and now the problem returns with upper respiratory infections, it may be that cold medications she is taking for symptom relief are helping her sleep so soundly that she is unaware of the need to urinate until it is too late or morning has come. Some cold medications, especially decongestants cause vasoconstriction and tachycardia. These could increase urine production and urine volume in the bladder. Her bladder may not be able to accommodate the increased volume of urine. Decongestants also impair sleep quality. Enlargement of the tonsils and adenoids, whether through normal tissue growth or swelling due to a virus can cause sleep apnea. One-third of children with sleep apnea have problems with bedwetting. The problem resolves once their tonsils and adenoids are removed or the virus clears.
So my suggestion would be to avoid the use of cold and flu medications altogether. If her nasal congestion makes it impossible to sleep, try Ocean salt water nasal drops first. Use them generously both to cleanse out the virus as well as remove secretions and calm the irritated nasal lining. If that does not help, use a decongestant nasal spray for only 3 days max. The amount of decongestant she will absorb will be far less than if she takes a cold or allergy medication containing a decongestant. Make sure she drinks lots of fluids when ill during the day and use a vaporizer or humidifier at night to moisten the air.
If your daughter snores and mouth breathes at night even when not having a bad cold or flu, consider a referral to an ear, nose and throat specialist (ENT) to evaluate the need for tonsils and adenoids to be removed. This likely will resolve any sleep apnea and improve enuresis as well.
You may well know this already, but I will include this as well. If your daughter experiences any burning, or pain with urination, an increase in the need and urgency to urinate, bladder cramping, or foul smelling urine, make an appointment with her doctor to check her for a bladder infection.
I hope this is helpful information.
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University