Thursday, May 12, 2011

Relieve Adult Bedwetting and Sleep Easy

Do you lose control and wet the bed during the night? Studies show that at least 2% of adults suffer from nocturnal enuresis (NE). There are different types of nocturnal enuresis and nocturnal enuresis is not the same as waking two or more time during the night to go to the bathroom which is known as nocturia enuresis. Persistent Primary Nocturnal Enuresis is a condition that begins during childhood when nighttime dryness is not achieved for longer than six month. 2-3% of adults over the age of 18 continue to have this type of NE. Adult Onset Secondary Enuresis is when bedwetting begins at an older age. It is important to understand that adult bedwetting, like bedwetting for children, is unintentional and is not voluntarily controlled.

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While bedwetting is generally associated with the very young or very old, it can affect people of any age. Some cases of bedwetting are caused by a person sleeping too deeply so they don’t wake up if they need to urinate. If you have trouble falling asleep easy and take a sleep aid this may be the reason you sleep too deep. To relieve adult bedwetting and sleep easy may be a simple as a change in your medication or reducing the dose. Discuss with your doctor other alternative sleep aid methods or natural sleep aid products that can help you sleep.

Another factor that NE occurs in adults is that it could be hereditary. Research has indicated if someone with two bedwetting parents has a 77% chance of becoming a bed wetter and with one parent the probability is a 40% chance. Bedwetting has been linked to the hormone, antidiuretic or ADH which tells the kidneys to decrease the amount of urine produced. Usually the body produces more ADH at night to reduce urine, but some people don’t produce enough ADH therefore, they have too much urine that causes NE in adults. People with type II diabetes produce less ADH with diabetics the condition is known as nocturnal polyuria.

Primary Nocturnal Enuresis with some is a result of a smaller bladder which means that the amount of urine the bladder will hold until a signal is sent to the brain indicating it is time to urinate is a smaller capacity and not that the bladder itself is actually a smaller size. The muscle that controls the need to go never fully relaxes; therefore, the bladders capacity is not very large. This muscle can also be overactive or instable causing NE and alcohol and/or caffeine can contribute to the problem by increase urine production.

Additional causes of secondary enuresis may also include diabetes, urinary tract infection, urinary tract stones, neurological disorders, anatomical abnormalities, urinary tract calculi, prostate cancer, prostate enlargement, bladder cancer, and obstructive sleep apnea. In very rare cases, acute anxiety or emotional disorder may cause adult bedwetting.

One way you can help your doctor diagnosis your condition is to keep a journal of your symptoms and daily habits. These details will determine the cause and severity of your NE. Describe your liquid intake and what you drink, when accidents occur, how long without an accident, if there are any problems urinating and other medical conditions that may contribute to NE like an UTI or night sweats. Also write down any prescription drugs, over-the-counter medications or herbal supplements you are taking. During your consultation you will be asked about family medical history as well as your own. You may also be required to give a urine sample and have a physical exam. NE tests include the Uroflowemetry that involves urinating into a funnel that measures flow rate, amount of urine and time required to urinate and the Post-void residual urine measurements that uses an ultrasound to determine the amount of urine left in the bladder after urinating.

Treating NE may be a minimal as making a few lifestyle changes. Limiting fluids in the afternoon and evening, especially right before bedtime, will decrease the amount of urine produced at night. Decreasing or eliminated caffeine and alcohol may also be suggested. If you have been diagnosed with a small bladder capacity or your bladder muscle is overactive you will be given a bladder volume training exercise that involves drinking large amounts of fluid during the daytime and refraining from urinating as long as possible, up to 2-3 hours. Through training, the functional bladder capacity is increased, making fewer trips to the bathroom.

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There are a number of bedwetting alarm systems that wake an individual from sleep as soon as an accident begins. These wet detection devices are attached to the underwear or bed pad. Making a habit of waking to the bathroom takes a few weeks to work and require determination, commitment and the ability to stop the flow of urine upon awakening and finishing in the bathroom. Sometimes this is a little harder for men to control. When you wrote in your journal the night you had an accident you should have also stated the time. If the accidents seem to occur around the same time you could set an alarm and wake up to urinate. Remember to adjust the time so your bladder doesn’t get used to a set schedule.

There are many prescription medications available to treat NE. Some may be taken alone or with lifestyle changes to become more effective. Medication is good as long as it is taken and if stopped the NE returns. It is important to treat the underlying condition or factors caused NE. If you are diagnosed with a reduction in ADH there is a drug that mimics this hormone and makes the kidney produce less urine. Desmopressin or DDAVP taken before bedtime make help a person get through the night without incident as long as they are taking this medication. It comes in the form of nasal spray or pill. This is an option that works well will other treatments such as the alarm when traveling. Side effects include but not limited to; mood changes, dry mouth, sleep disturbances and elevation in blood pressure for older people. Other NE drugs on the market are; anticholinergic medications: Darifenacin, Oxybutynin, Tolterodine, Trispium Chloride and Solifenacin.

Surgery is an option but limited to those with severe cases and only considered it all invasive treatments have been exhausted. Sacral Nerve Stimulation is when the sacral nerve root is stimulated by neuromodulation, a process where neurotransmitters control various neuron groups. This is recommended for people with moderate to severe urge incontinence because it decreases the activity level of the muscle causing less frequent urination episodes. Clam Cystoplasty is when the bladder is cut open and a patch of intestine is placed in between the two halves to control bladder instability and increase capacity. Detrusor Myectomy a surgery that removes a portion of the exterior muscle surrounding the bladder to strengthen contractions and reduce the number of them. Other treatments undergoing trials are the Botulinun Toxin A an injectable bulking agent and Laser Acupuncture which is being used to target specific areas of the body for a variety of medical problems.

If you or someone you know has NE there are ways to manage the accidents. Make sure you use a waterproof mattress cover, wear absorbent briefs and protect the skin from irritation with various skincare products. Remember NE could be a symptom of another medical condition, a side effect of medication or just diminishing bladder muscles due to age. There are exercises specifically for muscle tone of the bladder to recover some of its strength. Some herbal supplements have shown to help reduce or prevent bed wetting depending on the exact cause. Saw palmetto, for example, is an effective way for males with an enlarged prostate to control their symptoms which can include excessive urination and bed wetting. Another herb that is helpful in treating bed wetting is fennel.

If you suffer from persistent primary nocturnal enuresis, you may first see a primary care professional, such as a family practice physician or nurse practitioner. However, individuals with adult onset nocturnal enuresis usually need to be referred to a specialist, such as an urologist or sleep disorder specialist. While you may be embarrassed to address the issue with others, a medical professional is able to give you options to help treat bedwetting. In many cases, bedwetting can be cured. Please contact NAFC by going to or call 1-800-BLADDER. The content provided in Relieve Adult Bedwetting and Sleep Easy is for information purposes only, intended to raise the awareness of different solutions for you or your families sleep problems and should not be considered medical advice. For medical diagnosis and treatment, please see your qualified health-care professional.

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