Nocturnal enuresis, or bedwetting, affects millions of children, teens and young adults.
It can lead to embarrassment, shame, and fear of participating in overnight activities such as sleepovers.
Bedwetting is usually defined by health care providers as accidental urination while asleep.
Because so many children under 6 have not achieved nighttime dryness, the condition usually refers to those 6 and older.
There are two types of nocturnal enuresis: primary and secondary.
Children with primary nocturnal enuresis have never been dry at night.
The condition is linked to genetics, inherited from a parent.
These children often have a small bladder for their body size. They do not wake up when their bladders feel full.
And they do not secrete antidiuretic hormone (ADH) when they go to sleep, meaning they do not decrease their urine output while asleep like most people.
Secondary nocturnal enuresis happens when a child wets the bed after having been dry at night for at least six consecutive months.
Causes of this are stress, sleep apnea, urinary tract infections, diabetes and chronic constipation.
Anatomical urinary tract or nervous system problems are rare causes of bedwetting.
About 13% of 6-year-olds and 5% of 10-year-olds wet the bed.
It is twice as common in boys as in girls, and more common in children with ADHD.
Although bedwetting is always outgrown at some point in childhood or early adulthood, certain measures may decrease it.
Drinking more liquids during the day and less at night may help.
Avoiding caffeine-containing drinks, urinating before going to bed and then again before falling asleep can be helpful.
Waking the child up in the middle of the night also helps.
Bedwetting alarms can be used to condition a child to sense when he starts to urinate in his sleep.
Moisture-sensing pads that fit on or under the child are available. When he urinates, an alarm goes off.
Sometimes the child sleeps so soundly that somebody else has to get him up and take him to the toilet.
These alarms can take a few months to fully condition the child.
Medication to replace the ADH that the sleeping child does not naturally secrete can be used to concentrate the urine.
Pullups can also be used, which are especially handy for sleepovers.