Nocturnal / Secondary Enuresis

Nov 02, 2022 | 6 minutes Read

Nocturnal Secondary Enuresis

Knowledge Can Help Lead To Dry Nights

Nocturnal enuresis, also referred to as primary nocturnal enuresis, is the medical term for bedwetting.

Nocturnal enuresis describes children who consistently wet the bed, as opposed to the other forms of bedwetting, including secondary enuresis (which is when a child has not wet the bed for at least six months and then begins bedwetting again).

Bedwetting is much more common than you might think. In fact, up to 20% of five year olds and up to 5% of ten year olds wet the bed. Around 97% of children have grown out of bedwetting by the age of 12, so most cases are nothing to worry about and simply require some love and support.

The most common cause of bedwetting is usually common bladder development delays which will usually fix itself over time.

What Are Primary And Secondary Nocturnal Enuresis?

Bedwetting refers to uncontrolled urination – children who are going through bedwetting are not doing it on purpose nor consciously. Primary bedwetting happens when young children lack bladder control from infancy. Persistent bedwetting, which is when the child wets the bed at least once or twice a week, is typically not an issue until your child reaches school-age. Secondary nocturnal enuresis (SNE) happens when a child or adolescent can manage proper control over their bladder during the night for at least six months or more then begins bedwetting again. Secondary bedwetting makes up around 25% of all bedwetting cases, with the percentage of children with secondary bedwetting increasing with age. Secondary bedwetting is often unexpected and can add extra stress for all for both the children and family members. Children who took longer to stop primary bedwetting are more likely to go through secondary bedwetting.

What Causes Nocturnal Enuresis?

Nocturnal enuresis can be caused by different things and it will vary by child. Below are the most common causes of nocturnal enuresis:

  • Neurological development delay: If your child’s nervous system is still developing, the bladder may not be able to signal the brain to wake up for a bathroom visit.
  • Genetics: There is a 75% chance that the child of two parents who wet the bed as children will experience bedwetting. This decreases to 40% if it’s just one parent, and 15% if neither parent experienced bedwetting.
  • Under-production of anti-diuretic hormone (ADH): ADH is a hormone that regulates urine production while we sleep. Some children do not produce enough ADH, which causes their bladders to become full during the night.
  • Small bladder capacity: Sometimes a delay in bladder development can result in low capacity and cause the need to urinate during the night.

How To Manage Nocturnal Enuresis?

Bedwetting can be a source of emotional distress to children dealing with bedwetting and cause a negative impact to self-esteem. It is important to continue to provide lots of love and emotional support during this time, and this will help reassure your child.

  • Explain to your child that bedwetting is very common and something that they’ll eventually grow out of.
  • If they’re old enough to use the internet, help them look up bedwetting causes and ways to manage it – being informed and seeing the information for themselves can help them feel more in control of the situation.
  • Never punish your child for wetting the bed, as no child is doing this on purpose. Punishing them can lead to greater feelings of shame, anxiety, and confusion.

What Causes Secondary Enuresis?

Causes of secondary enuresis can vary but fit into two categories; emotional and physiological. In most cases the cause will not be a medical issue.

  • Urinary tract infection (UTI): UTIs can cause frequent urination and/or the need to urinate urgently in the sufferer. A urine test can be used to identify an infection, and then can usually be treated with antibiotics.
  • Diabetes: Frequent urination is a symptom of type 1 diabetes. Talk to your doctor and they will be able to run a test to see if this is the cause.
  • Neurological abnormalities: Even the smallest imbalance in the nervous system can cause secondary enuresis.
  • Constipation: Blockages in the rectum can reduce the bladders capacity by putting pressure on it.
  • Obstructive Sleep Apnea (OSA): OSA can cause increased nighttime urine production, leading to secondary enuresis.
  • Emotional stress: Big changes in a child’s life can cause emotional stress, which is a common trigger for bedwetting.

What To Do If Your Child Is Suffering From Secondary Enuresis?

There are several things you can do if your child has begun bedwetting again.

  • Talk to your child and discuss anything that has changed when the bedwetting started again. Write down everything that you all have thought of and have a discussion with your child and their doctor.
  • Note whether your child is displaying any other sign of stress, such as irritability, headaches, outbursts or tantrums which are out of character, crying, or social withdrawal.
  • If you do think it could be a medical issue, you should visit a doctor as soon as possible and discuss the required tests with your doctor. Even if you strongly think it’s a psychological  cause, it can still be good to rule out any potential medical issues.

Secondary Enuresis Treatment

Treatment for secondary enuresis varies based on the cause. Some medical conditions, such as UTIs are easy to treat and will usually go away with a course of antibiotics, while others may be more serious.

Bedwetting caused by emotional stress can sometimes be tougher to deal with and might require setting up an appointment with a counselor or therapist for your child. Less traumatic emotional triggers, such as anxiety about a school exam or moving houses, generally fix themselves over time, but it’s always important to be supportive and try to help ease their anxiety.

You should always consult your child’s doctor for guidance on how to treat secondary enuresis.

Bedwetting Products

There are many different bedwetting products available to you, which can help reduce stress for both parents and children. If your child is old enough, discuss these products with them and let them choose which ones they feel comfortable using.

  • Goodnites® Nighttime Underwear: These absorbent underwear are designed specifically for bedwetting and provide more protection than the leading training pants while being discreet.
  • Mattress protector: A good mattress protector is a smart investment while your child is going through bedwetting.
  • Goodnites® bedwetting mats: Absorbent bedwetting mats add an extra layer of protection to decrease the number of sheet changes and are a good option to consider if your child’s bedwetting has become less frequent and they don’t wear nighttime underwear every night.
  • Night light: A night light can help your child make the bathroom trip at night and decrease the number of bedwetting incidents.