FREQUENTLY ASKED QUESTIONS
Day-wetting is a distressing symptom with a significant impact on self-esteem. It affects about 5% of children between 5-12 years of age, girls more often than boys.
Day-wetting often indicates a medical problem and a doctor’s advice should be sought. Daytime wetting problems can be due to:
- a current urinary tract infection (UTI)
- previous UTI leaving irritation or scarring
- spasmodic bladder muscle contractions (overactive bladder)
- other physiological/anatomical problems.
Other symptoms suggestive of medical problems include:
- pain or discomfort while urinating
- cloudy or smelly urine
- inability to hold on (urgency)
- needing to go to the toilet very often (frequency)
Generally, side effects are mild. A small number of people experience headache, nausea, stomach aches, nasal congestion or nose bleeds. Because the drug works by preventing urine production, it is very important to keep fluid intake low each night once the drug has been taken. If excess fluid is drunk, hyponatremia (fluid overload) can occur, which may cause convulsions. This is a rare side effect.
Desmopressin will have an effect on about 60% of bedwetters. This effect varies from complete dryness each night it is taken, to patchy wet and dry nights. The response depends to a certain extent on how long it works in the body. For some people it will not work at all,for others it may work for 4 hours, and others may get a full 8 hours of action. The drug must be taken each night at bedtime.
Because desmopressin is a synthetic anti-diuretic hormone (ADH), it is more effective in wetters who do not produce ADH while sleeping and therefore do not concentrate their urine.
If desmopressin taken at full dose does not work within a few nights of use, discontinue, as it is not effective for your child.
Sometimes children (and parents) can become tired with sleep disruption from the alarm. In the first two weeks, the alarm may go several times a night. However frequency is the first thing to reduce and it usually settles down to 1-2 times a night, which is more the average. An advantage of frequent alarms in the early stages is that there is rapid alarm reinforcement, and progress through to dry nights can be faster because of this.
Approximately 15% of bedwetters become dry spontaneously each year. Your dilemma is that there is no way of knowing when this will happen for your child.
Approximately 1-2% of adults still suffer from childhood based bedwetting. It can be treated in the same way as childhood bedwetting.
Pullups or training pants have made life a lot easier for the parents of children who continue to wet the bed. Unfortunately there are some costs – apparent and hidden.
Cost: The accumulated cost of these products over the years is huge. Many families will easily spend $1,000 annually, just on pull-ups.
Environmental effect: As we are all becoming aware of the fragility of our environment, the accumulation of disposable diapers and pull-ups in our waste is of real concern.
Extension of bedwetting: It is estimated that one to two percent of the adult population continues childhood bedwetting into adulthood. We are yet to see if there is an increased risk of boys and girls failing to develop night time bladder control when insulated from the consequences of wetting by training pants.
Future infertility?: Temperature increases inside disposable nappies, pull-ups and diapers. We do know that the male testes need a reduced temperature to develop and function correctly (that is why they hang outside the body). This raises the question of future sperm production and fertility. We expect it will take some years before the impact of these products on male fertility can be assessed.
No – unless you want to blame your genes! Most bedwetters have inherited this condition, just like they inherited the colour of their eyes. Sometimes you cannot trace a family history, but it is probably there, hidden away in the past. If one parent was a bedwetter, there is a 40% chance their child will be. If both parents were bedwetters, this increases to an 80% chance that their child will wet the bed.
It is a reverse learning process for the other children. Just as the bedwetter learns to hear the alarm and respond, the non-bedwetting children learn to screen out the noise and keep sleeping.
As bedwetting is primarily an arousal disorder, it is very common for these children to sleep through extremely loud noises.
In our clinical experience, the majority of bedwetters do learn to hear the alarm.
The key is good preparation, so they know why the alarm is being used, and motivation from the child, so they will want to take charge of their wetting and become dry.
Some children will hear the alarm from the first night, others will need help at first to wake. Parents should not leave the alarm ringing for a long period, as there is no learning occuring.
If after 3 weeks of regular alarm use, you find your child is still completely unaware of the alarm sounding, and the volume of wetting is not reducing, discontinue training for a while. When your child has matured more, and become more frustrated with their wetting, they will be more receptive to an alarm.
Expect an average of 3 months to reach 21 consecutive dry nights. Each child is unique, so the range can be from 4 weeks to 7 months. Use the alarm every night, encourage self-responsibility, and keep positive.
Yes. Alarms come with instruction pamphlets which provide step-by-step instruction on set-up. Minimal set-up is required. When the alarm is triggered by wetting, the child is encouraged to turn the alarm off themselves before going to the toilet. The alarm is then set-up again before the child goes back to sleep. If you have any problems, our phone and e-mail helplines will provide assistance.