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Medical Edge Newspaper Column from Mayo Clinic
WHEN AN OLDER CHILD STARTS WETTING THE BED
DEAR MAYO CLINIC: My son is 11 years old and has been wetting the
bed for about 10 months now. It happens every night. We have tried to
wake him up to go, but this does not consistently work. My son has tried
medicine — he was on the highest dose my doctor would give and he still
wet every night. I’ve considered getting a bed alarm, but he is a very
deep sleeper (an alarm could go off for an hour without his budging).
I am feeling frustrated and sad for him. He is too old for this, and he
feels really bad each morning.
ANSWER: I would first have your son get re-evaluated by his physician,
as it is unusual for an 11-year-old to begin wetting the bed. Eighty percent
of children who wet the bed (a condition called nocturnal enuresis) will
have been doing so since infancy.
Those who begin wetting after more than six months of dryness have secondary
enuresis. This condition can be associated with medical problems that
cause the child to overproduce urine, reduce bladder capacity or compromise
the child’s ability to detect a full bladder during sleep. These problems
can include urinary-tract infections, constipation, diabetes or sleep
apnea.
If none of these medical problems is present in his case, a likely treatment
is the enuresis conditioning alarm. This is a moisture-sensitive, battery-operated
device that is activated when the child wets. They come in different versions,
such as bed pads that are attached to an alarm box or body-worn devices
that are much smaller. This treatment has been widely used in practice
and shown to be effective, with a conservatively estimated success rate
of 65 to 75 percent. However, it often requires professional supervision
to complete an average treatment course of 16 weeks.
You note that your son is a very deep sleeper, and in fact some children
who wet the bed do have a higher threshold for arousal from sleep. Louder
alarms are available, and you can get them from various sources through
the Internet. I would look at www.bedwettingstore.com for such devices.
Remember, your son may need more direct professional supervision to successfully
treat his condition. You could ask your doctor for a referral to a specialty
enuresis clinic or to a pediatric psychologist. Or you could find a pediatric
psychologist yourself by contacting the Society of Pediatric Psychology
at www.apa.org/divisions/div54/.
— Michael W. Mellon, Ph.D., Pediatric Psychologist,
Director of the Enuresis Conditioning Program, Mayo Clinic, Rochester,
Minn.
Additional Resources:
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of Bedwetting
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READERS: Alzheimer’s and other forms of dementia are not inevitable
with aging. In recent years, researchers have identified many factors
that may delay or prevent the development or slow the course of such conditions.
The Mayo Clinic Health Letter outlines some:
— Control diabetes, high blood pressure, high cholesterol levels and obesity.
There’s increasing evidence that these major risk factors for heart disease
and stroke may also predispose people to dementia.
— Vascular dementia, a common form of the illness, results from damage
caused by small and large blood-vessel disease. By controlling cardiovascular
risk factors, you may prevent the blockages and damage to your brain that
can lead to this condition.
— Manage depression. Like dementia, depression can cause difficulty in
remembering, thinking clearly and concentrating. Sometimes, depression
occurs with dementia. Treating depression won’t stop dementia from progressing,
but it could help minimize its impact.
— Keep your mind sharp. Some researchers believe that lifelong learning
may promote the growth of additional synapses in your brain and, therefore,
reduce the risk of dementia. Try reading, writing stories or playing cards
or checkers. Or start a new hobby. Studies have found an association between
frequent participation in intellectually stimulating activities and reduced
risk of Alzheimer’s.
— Stay connected with friends. Spending time with family and friends,
volunteering or joining a group helps stimulate your memory, concentration
and mental processing.
Additional Resources:
Neurology
Appointment
Information
More
Information on Dementia
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Medical Edge from Mayo Clinic is an educational resource and doesn’t
replace regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite
114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2004 TRIBUNE MEDIA SERVICES, INC.
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