Why Do I wet My bed?

Wetting your bed at Night is called Nocturnal Enuresis.  Bed wetting affects around half a million children and teenagers in the UK, so you are not alone.  It's an issue families can find very isolating and difficult to talk about openly and can take a huge toll on family life and affect your confidence and your mood day to day. It can take some time for you to learn to stay dry throughout the night, but there is practical advice, support and treatments that can help you.  

Causes of bed wetting 

There are three main reasons why you might wet the bed:  

  • Your bladder does not stretch enough to hold all the wee you make at night.
  • You produce too much wee at night.
  • You do not wake up when your bladder sends a signal that it is full.

Practical advice and steps to take for a healthy bladder 

  • It is especially important you drink well in the daytime.   Plenty of drink, evenly spread out throughout the day is essential for your bladder to get used to holding larger amounts.  Ensure you stop drinks an hour before bedtime.  
  • Practise a good bedtime toileting routine: schedule a relaxed toilet sit as part of preparing for bed, and pop back to the toilet just before sleep if it is more than ½ an hour later.
  • Have a trial without nappies. Even if nappies are always wet, try removing them for at least a week, otherwise you will never feel wet when you wee. It may be just the trigger you need to wake up.
  • Practicing going to the toilet, you may need a small light/torch if its dark. Think about if you are in a bunk bed and where your toilet is located. 
  • We do not encourage parents or carers to wake you in the night to go toilet as this does not help overall and although it may stop wet sheets, this can also encourage you to wet in your sleep as you do not fully wake. 
  • Constipation can cause bedwetting. The full bowel occupies the space in the tummy where the bladder wants to expand and fill.

There is not enough space in the bladder to accommodate all the night-time wee, so it leaks out. If you do not open your bowels regularly or it hurts when pushing out, please let a healthcare professional know whether it is your GP, School Nurse or Enuresis Nurse. 

Further Support required? 

If you have tried all the practical advice and completed the steps to a healthy bladder and are still bed wetting it’s time to see one of our Specialist Nurses in Enuresis.  This involves getting a referral and attending a local clinic.  This may sound scary, but it isn’t, carry on reading for more information.  

To gain a referral there are two ways this can be done, firstly arranging an appointment with your GP who will do an assessment which includes a urine sample which will be sent off to make sure there is not an infection which could be causing your wetting. If everything seems ok, they will make a referral to the Enuresis clinic. 

You can also arrange to see your School Nurse via school. Speak to your teacher or your parent can ring your local clinic and speak to a School Nurse. They will also do an assessment with you and ask some questions and then refer to the Enuresis clinic. 

From a referral being sent the aim is to see you in clinic within 4-8 weeks.   

You will attend clinic with your parent or guardian, so you will not be alone. The Enuresis Nurse will ask you some questions and give some advice and then discuss the treatments available and recommend either medication or a bed alarm. You will leave the clinic with either of them. 

The Enuresis Nurse will then keep in touch via phone with your parent or guardian. You can also contact your Enuresis Nurse at any point during your bed wetting journey if advice and support is needed. 

Treatments available

This treatment is for children that produce too much wee.  We all make Vasopressin, a special hormone, at night.  It tells our kidneys to make less wee while we sleep.  Some children do not yet make enough Vasopressin, so their kidneys produce lots of dilute wee – too much to fit inside their bladder.  Key indications you may lack this hormone is 

  • If you wet in the first 2 – 3 hours after going to sleep
  • Large patches of wee. 
  • Wet more than once.  

If this is considered the most appropriate treatment, then your GP will prescribe Desmomelts which is a melt you put under your tongue.   You must have not had a drink an hour before taking and then 8 hours after, but you will be asleep.   If this works you will have a week break off the medication every three months to see if you can remain dry without it.

Some children find it hard to wake up when they need a wee. 

It’s not because you are too fast asleep – your brain just doesn’t recognise the signal of a full bladder during sleep. It is often called 'poor arousability'.   A bed alarm would be provided for this.

In order for the bed alarm to be successful it is important to understand the expectations, it  can take 2-3 months on average for you to be dry consistently at night and can at times take longer.  Waking to the sound of the alarm is the treatment that helps you become dry.  Sometime your parent or guardian may need to help you with this at first.  

When the bed alarm goes off you need a plan of action, which will include getting out of bed, going to the bathroom if you need to finish your wee, change your pants and pjs and strip the bottom sheet.  

At the start of the treatment process, you may find you fully empty your bladder before you respond to the alarm. Over time, you will learn to stop the flow of urine when the alarm sounds.

Once you have achieved 14 nights of consecutive dry nights you can stop using the bed alarm, sometimes you may have the occasional accident, if that happens, re-use the alarm again until you achieve 14 consecutive dry nights.