Bedwetting in teenagers can impact their self-esteem and cause worries in parents. Also known as nighttime incontinence or nocturnal enuresis, this condition causes the person to pass urine involuntarily while asleep. Nearly 1–2% of teens are affected by this condition (1). In addition, some teens may have daytime bladder problems such as diurnal enuresis. However, bedwetting is not always caused by disorders or diseases. Nevertheless, seeking medical care is recommended if your teen has frequent bedwetting. Read on to know the causes, complications, and treatment for bedwetting in teenagers.
Types Of Nocturnal Enuresis
There are two types of nocturnal enuresis — primary and secondary enuresis. In primary enuresis, a teen has always had bladder control problems at night and has always wet the bed. A teen with secondary enuresis wets the bed after not doing so for at least six months (2). Primary enuresis is usually more common and is associated with developmental delays. Both primary and secondary enuresis in teens warrants pediatric evaluation since it could indicate an underlying health issue.
Possible Causes Of Bedwetting In Teenagers
Below are some of the possible causes of bedwetting in teens (3) (4). No child or teen bed wets on purpose. Mostly, the interplay of two or more factors triggers nocturnal enuresis.
Risk Factors For Bedwetting
A child or teen is at greater risk of developing nocturnal enuresis in the following scenarios.
Family history: Studies show that bedwetting can be inherited. Scientists have identified specific “bedwetting genes” that could cause enuresis in children and teens with a family history of the condition. Research shows that a child has a 75 percent chance to develop enuresis if both parents were bedwetters (3). The risk drops to 15 percent if the child does not have a family history.
Stress: Experts believe that stressful events, such as family crisis, bullying at school, and accidents or trauma, could cause secondary enuresis in children and teens (2). Children and teens may also eat more salty foods or drink too much caffeine to alleviate stress. However, these habits further exacerbate bedwetting.
Medical conditions: Certain health conditions, such as constipation and urinary tract infections (UTIs), may cause nocturnal enuresis in children and teens. Chronic constipation could create tension on the bladder, causing a child to lose bladder control (2). In rare cases, sleep disorders, such as obstructive sleep apnea, may trigger bedwetting by triggering chemical changes in the brain due to problematic or interrupted breathing.
Neurological or urinary system abnormalities, diabetes, and ADHD may also enhance the chances of developing nocturnal enuresis. Boys are twice as much at risk than girls of developing the condition (4).
Diagnosis Of Bedwetting In Teens
Determining the exact cause or causes of bedwetting requires pediatric evaluation, especially when a teen has suddenly started bedwetting. The bedwetting diagnosis is likely to involve the following (3) (6) (8). All these tests can help find the underlying cause of bedwetting in teens. Timely diagnosis can help plan a treatment and management regimen to resolve the condition effectively.
Treatment For Bedwetting In Teens
In most cases, bedwetting resolves on its own. However, if it doesn’t, the treatment can involve the following (3) (9).
1. Lifestyle changes
Encourage teens to stay well hydrated but limit the intake of too much water or caffeinated beverages late in the evening. Work on the bladder training by developing a toilet routine. You can also try pelvic floor exercises and other behavioral interventions to overcome bladder issues. Address underlying causes, such as constipation and sleep apnea, to resolve the condition without additional interventions.
2. Moisture alarms
Moisture alarms are small, battery-operated devices that one can purchase from pharmacies without a prescription. A teen can connect them to a moisture-sensitive pad on the teen’s trousers or bedding before sleep. When the pad is wet, the alarm goes off. It will help a teen wake up and be void. In case a teen does not wake up, another person may wake them. The daily use of moisture alarms may take six weeks to three months to develop a toilet routine and reach completely dry nights. Motivate a teen to be patient and persistent.
3. Medications
If the above treatment modalities don’t prove useful, a teen may be prescribed medications to stop bedwetting for a short duration. However, no medicine cures bedwetting (10).
Desmopressin (DDAVP): It helps reduce the amount of urine produced at night. A teen should take the drug before bed and not consume fluids or liquids later to prevent electrolyte imbalance. The drug has minimal side effects. It is available in both nasal spray and pill forms.
Oxybutynin: If DDAVP did not work alone, oxybutynin (Ditropan XL) could be prescribed as an accompaniment. Oxybutynin is an anticholinergic drug that may reduce bladder contraction and allow the bladder to hold the urine longer. Its use is usually prevalent in patients with small bladders.
Imipramine: It is used in children older than six years. It is available in capsule or tablet form. It may cause side effects such as anxiety, irritability, moodiness, insomnia, and appetite loss. Imipramine is usually prescribed only to patients who do not respond to other treatments (2). Teens with cardiovascular issues should avoid this medicine.
Medication use should be considered only after thorough pediatric evaluation.
Possible Complications Of Bedwetting In Teens
Unless caused by a health issue, bedwetting is a benign condition. However, it may lead to some other problems in older children and teens.
Low self-esteem: A teen with a bedwetting issue feels embarrassed and always worried about someone finding out. This constant stress and feeling of shame hampers the teen’s self-esteem and lowers their confidence.
Social isolation: With low self-esteem and confidence, a teen may struggle to keep up with friends and family. They may voluntarily begin to isolate themselves by avoiding plans where they have to be alone with others. Night outs and sleepover plans with friends are some joyful events that they wish to attend but avoid compulsively.
Urinary tract infections: UTIs are one of the physical complications of bedwetting due to prolonged exposure to moisture. Constant wetness can also cause a genital rash, which is more common in children than teens as they tend to sleep in wet undergarments.
If bedwetting progresses into adulthood, it could affect an individual’s relationships and bring negative behavioral changes, such as anxiety and depression.
Tips For Coping With Bedwetting In Teens
Constant parental support and guidance can help a teen cope with bedwetting blues effectively. Here are some tips that you can try.
