Bedwetting is a common problem that several people experience at some point. Also known as nocturnal enuresis, bedwetting is involuntary urination during sleep in children over five. It affects almost five to seven million kids in the country and five to ten percent of all seven-year-olds. It can be upsetting and uncomfortable for parents and children, especially if it happens to older children. Even though it is more prevalent in boys than girls, it can affect children regardless of gender.

Causes
Several factors may contribute to this problem.

Constipation
Not having a bowel movement every day can affect the child’s bladder. The bladder and the colon are located near the body. If the colon is not emptying or moving regularly, the stool may get backed up and push on the bladder. This pressure on the bladder makes it impossible for the child to store urine well.

Overactive bladder
An overactive bladder is a condition wherein the child finds it hard to keep the urine in their bladder for too long. Hence, they may have to rush to the bathroom more than usual. Consequently, they tend to wet the bed at night and also pee more often in the day, leak pee, and feel urgency anytime they have to go.

Anxiety
Children with anxiety issues are more susceptible to bedwetting than those without the issue. Anxiety may be an outcome of an ongoing or chronic state of distress.

Eating and drinking habits
Some drinks and fruits are diuretics, meaning they help produce more urine. Some children are also more sensitive to diuretics than others. Caffeine found in tea and coffee is a diuretic.

Urinary tract infections
At times, children wet the bed when they have a UTI. Some prevalent symptoms associated with UTI include unexpected and frequent urination and bladder inflammation, which can result in bedwetting. Even though UTIs are treatable, they may go undiagnosed in children who cannot often comprehend or explain the symptoms.

Sleep apnea
In sleep apnea, the breathing stops during sleep. It is prevalent in adults, but research shows kids are at risk too. The atrial natriuretic peptide is the hormone that leads to sleep apnea. This hormone causes the kidney to produce excess urine during sleep, resulting in bedwetting.

Less common but more severe bedwetting causes are:

Kidney issues
Kidneys have a significant role in urine disposal and production, so enlarged or chronic kidney disease might sometimes lead to bedwetting.

ADH insufficiency
The human brain produces the antidiuretic hormone (ADH) that slows the rate at which the kidneys generate urine at night. When there is insufficient ADH production or the body does not respond or properly access the ADH, urine production will not sufficiently slow at night, resulting in bedwetting.

Diabetes
In untreated patients, diabetes can cause the body to dispose of the sugar via urine, resulting in hyper-frequent urination. It is one of the first signs of diabetes in children.

Beyond this, factors like ADHD and being a deep sleeper could also be the potential reason for bedwetting.

Treatment options and home remedies
The treatment choice predominantly depends on the underlying cause of bedwetting.

• Moisture alarms
  These alarms are battery-operated, small devices that connect to a moisture-sensitive pad onto the child’s bedding or pajamas. So, anytime the pad senses wetness, the alarm goes off. The moisture alarm generates a sound as soon as the child starts urinating. Hence, the child wakes up to control their urine stream and rushes to the toilet.
• Avoid foods and beverages with caffeine
  Caffeine stimulates the bladder and should be avoided by children, especially in the evening.
• Encourage double voiding before sleeping
  Encourage the child to urinate once when they accomplish all their daily activities and then again before going to bed.
• Encourage frequent toilet use
  Encourage the child to empty their bladder every two hours to avoid any urgency feelings.
• Prevent rashes
  To avoid rashes from wet underwear, help the child wash their genital and bottom area every morning. Further, conceal the affected area with a cream or protective moisture barrier at bedtime.
• Use a plastic mattress
  Cover the mattress with another layer and make cleaning faster.