The Impact of Change on Bedwetting in Kids with ADHD & Autism, and What You Can Do About It

Aug 31, 2023 | 10 Minutes Read

Father and son laughing in the kitchen

Kids with ADHD and Autism are routine-oriented, and can be extremely sensitive to change. Periods of change like going back to school, traveling, the holidays, or even Daylight Savings Time can increase stress in all of us. For a child with ADHD or Autism, it can be even more stressful. And for a child who also wets the bed, these moments can lead to an increase in bedwetting. Symptoms that seemed to have passed may return, and wet sheets can become more common.

We spoke to a panel of experts including Dr. Kerry Magro Ed.D. member of the Autism Society of America’s Council of Autistic Advisors, and CEO & President of KFM Making a Difference and Dr. Sasha Hamdani MD, Psychiatrist and ADHD expert to provide you with a deeper understanding of how periods of change can affect the bedwetting journey for kids with ADHD and Autism, and share advice for navigating those times when it is unavoidable.

How Change Can Affect Kids with ADHD and Autism

Change can be difficult for kids with ADHD and Autism. Any moment or event that requires flexibility in adapting to an unfamiliar situation, increased social interaction or stimulation, or deviates from their expected routine can be triggering to some children. According to Dr. Sasha Hamdani, these moments “can be destabilizing. Any time there’s a loss of routine, causing them to have to think on their feet or adjust to the situation, it can open the door to emotional dysregulation.” This can lead to an increase in bedwetting.

How Change Impacts the Bedwetting Journey

While stress and anxiety may not cause a child to begin wetting the bed out of nowhere, it can make existing bedwetting symptoms worse. According to Dr. Kerry Magro, “heightened anxiety can lead to additional bedwetting. That overwhelming feeling can be challenging.”

In addition, if stress and overstimulation are leading to lost sleep, it can also cause a child to wet the bed. Bedwetting often occurs in kids who are deep sleepers, and sleep deprivation causes even deeper sleep, which can result in bedwetting.

How School Can Trigger Bedwetting in Kids with ADHD & Autism

School is a major period of change that can have a big impact on bedwetting for kids with ADHD and Autism. Whether it is starting school for the first time or getting back into the swing of things after a long summer, routines are being switched up, and kids may be experiencing more than back- to-school jitters. Many studies have shown that students are more stressed and anxious than ever before about going back to school. Not to mention that kids with ADHD often have difficulty sitting still, controlling impulses, and paying attention while Autism Spectrum Disorder can affect their communication skills and make social and emotional connection more difficult. This can all add to their anxiety and stress, and ultimately lead to more accidents.

After the transition back to school, kids will be faced with other situations that can add stress. Even simple everyday things like navigating friendships, homework and tests can be enough to induce anxiety. There are likely to be more school trips and sleepover invites as your child gets to middle school, yet according to Goodnites’ proprietary Landmark Study with parents of kids with ADHD and Autism who wet the bed, ⅔ of kids have had to miss out on sleepovers due to their bedwetting.

And unfortunately, with 1 in 6 kids being bullied on a weekly basis, bullying  is another factor that can lead to a regression or increase in bedwetting.

How Travel Can Trigger Increased Bedwetting in Kids with ADHD and Autism

According to our Landmark Study, 45% of parents of kids with ADHD and/or Autism say bedwetting has limited their family vacations because you can’t bring the systems and routines you have at home with you when you travel. This disruption in routine can be stressful for a child with ADHD and Autism, and can be further exacerbated by changes in diet, overstimulation, and sleep disruptions from changing time zones, jet lag, and/or excitement, which can all lead to more frequent bedwetting.

Common Periods of Change that Can Trigger Bedwetting

It’s important to note that children with Autism and ADHD are all unique, and triggers can vary widely. However, beyond school and travel, here are some of the most common periods of change that you and your child may experience on the bedwetting journey:

The holidays can be stressful for kids with ADHD and Autism. Traveling to visit relatives can disrupt their day-to-day routines. There’s less control over meals and snacks. And all of the excitement can be overstimulating. Sleep schedules may also go out the window. All of these disruptions can lead to an increase in bedwetting.

Daylight Savings Time
According to Dr. Kerry Magro, “the one that should be discussed more is Daylight Savings Time.” It’s not until having kids that caregivers realize how much Daylight Savings Time can throw you off of your routine. Because many children with ADHD and Autism face sleep challenges, it is so much more than simply turning the clocks backwards or forwards by an hour. To your child it can feel like an unexpected change in routine that can lead to sleep disruptions and ultimately bedwetting.

Family and Life Events
Big life moments like meeting a new sibling or furry family member, losing a loved one, moving to a new home or apartment, and going through a divorce can all impact your child’s routine and heighten anxiety and stress. However, the little day-to-day moments like fighting with a sibling, witnessing a conflict between parents or caregivers, or a change in diet can also have an unexpected effect on your child’s bedwetting.

How to Navigate Change in Kids with ADHD and Autism

Learn Your Child’s Triggers
The more you understand what triggers your child and why, the more you can help minimize or avoid stressors and help them cope when change is unavoidable. Knowing your child’s limits can also help them avoid getting to the point of overstimulation when possible.

Talk to Your Child
Kids with ADHD and Autism rely on predictability. According to Dr. Sasha Hamdani, “Kids get dysregulated because they’re unsure about what’s going on.” Explain every detail of what’s happening or prepare them with what to expect to avoid sudden changes that can create stress, meltdowns, and bedwetting episodes. For example, if you are visiting relatives or introducing someone new, show your child their photo and explain who they are to ease anxiety about new people, and help them feel more comfortable when the time comes. Your doctor can also help with having these conversations with your child.

Prepare for Everything
Understanding your child’s triggers can help you prepare them for anything. Start practicing your back-to-school routine a few weeks to a month ahead of time. Bring their favorite meal or snacks with you when you know meal time could be an issue. And ask your child how you can help or best accommodate them.

Talk to Others
Talk to your family or friends about your child’s triggers. Talk to their siblings, teachers, coaches, and friends’ parents, so everyone understands how to show support in the way your child needs it.

How To Manage a Bedwetting Regression or Increase

Be Patient
Dr. Magro’s rule of thumb is, “First, be patient, it’s a process.” Bedwetting won’t go away overnight, and it’s not your child’s fault. But there are things to help you manage it.

Try Goodnites® Nighttime Underwear
When your child is experiencing an increase in bedwetting or a regression, try incorporating Goodnites® absorbent nighttime underwear into your child’s bedtime routine. They can add an element of consistency to your routine, even amidst periods of change, and help your child wake up dry with up to 100% less leaks.

Try a Sleep Journal
Dr. Magro suggests starting a sleep journal that tracks bedwetting, and can help you discover any potential triggers. “You can start a sleep journal for your child to help you have open conversations with them when they feel wet. Over time this will help create an open line of communication, and help you track (and celebrate) progress.”

Find Support
“If things aren’t getting better, talk to your child’s pediatrician for a recommendation. You can also look for a support group with one of Autism Society’s affiliate chapters to get advice from other parents/self-advocates who may have had similar challenges.” Dr. Kerry Magro advised.