BED WETTING CAUSES |
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The causes of bed-wetting are not
entirely known. It tends to run in families. Most children with
primary enuresis have a close relative--a parent, aunt, or uncle--who
also had the disorder. About 70% of children with two parents who
wet the bed will also wet the bed. Twin studies have shown that both
of a pair of identical twins experience enuresis more often than
both of a pair of fraternal twins.
Sometimes bed-wetting can be caused by a serious medical problem
like diabetes, sickle-cell anemia, or epilepsy. Snoring and episodes
of interrupted breathing during sleep (sleep apnea) occasionally
contribute to bed-wetting problems. Enlarged adenoids can cause
these conditions. Other physiological problems, such as urinary
tract infection, severe constipation, or spinal cord injury, can
cause bed-wetting.
Children who wet the bed frequently may have a smaller than normal
functional bladder capacity. Functional bladder capacity is the
amount of urine a person can hold in the bladder before feeling a
strong urge to urinate. When functional capacity is small, the
bladder will not hold all the urine produced during the night. Tests
have shown that bladder size in these children is normal.
Nevertheless, they experience frequent strong urges to urinate. Such
children urinate often during the daytime and may wet several times
at night. Although a small functional bladder capacity may be caused
by a developmental delay, it may also be that the child's habit of
voiding frequently slows bladder development.
Parents often report that their bed-wetting child is an extremely
sound sleeper and difficult to wake. However, several research
studies found that bed-wetting children have normal sleep patterns
and that bed-wetting can occur in any stage of sleep.
Recent medical research has found that many children who wet the bed
may have a deficiency of an important hormone known as antidiuretic
hormone (ADH). ADH helps to concentrate urine during sleep hours,
meaning that the urine contains less water and therefore takes up
less space. This decreased volume of water usually prevents the
child's bladder from overfilling during the night, unless the child
drank a lot just before going to bed. Testing of many bed-wetting
children has shown that these children do not have the usual
increase in ADH during sleep. Children who wet the bed, therefore,
often produce more urine during the hours of sleep than their
bladders can hold. If they do not wake up, the bladder releases the
excess urine and the child wets the bed.
Research demonstrates that in most cases bed-wetting does not
indicate that the child has a physical or psychological problem.
Children who wet the bed usually have normal-sized bladders and have
sleep patterns that are no different from those of non-bed-wetting
children. Sometimes emotional stress, such as the birth of a
sibling, a death in the family, or separation from the family, may
be associated with the onset of bed-wetting in a previously
toilet-trained child. Daytime wetting, however, may indicate that
the problem has a physical cause.
While most children have no long-term problems as a result of
bed-wetting, some children may develop psychological problems. Low
self-esteem may occur when these children, who already feel
embarrassed, are further humiliated by angry or frustrated parents
who punish them or who are overly aggressive about toilet training.
The problem can by aggravated when playmates tease or when social
activities such as sleep-away camp are avoided for fear of teasing. |
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| BED WETTING RELATED ITEMS |
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