Bedwetting in scientific perspective: Destructive myths

© 2010 – 2022 Gwen Dewar, Ph.D., all rights reserved

Myths about bedwetting? There are several, and they aren't helpful.

E'er heard the claim that kids moisture the bed out of laziness?

Or that kids require counseling — talking therapy — in order to suspension the "habit?"

Or how about the idea that wetting the bed is a sign of psychopathology?

If you lot know a child who wets the bed, pass the message along. The post-obit claims about wetting the bed (also known as "nocturnal enuresis") have been debunked.

Myth: Wetting the bed is an unusual problem

Reality: Every bit I note in my my prove-based guide to bedwetting, up to xx% of five-yr-olds have yet to achieve night-fourth dimension dryness, and many school-historic period children endure from the problem as well. Bedwetting in young children iscommon.

Myth: Wetting the bed is caused past laziness, or past a failure to pay attention to trunk signals

Reality: Bedwetting occurs during slumber, and research suggests that kids who wet the bed are physiologically different.

These children may have more than difficulty awakening at night in response to the signal of a total bladder (Nevéus 2017).

In addition, their bodies may produce less vasopressin, a hormone that suppresses the production of urine (Doscche et al 2016).

These traits may take a genetic basis, which would explain why nocturnal enuresis seems to run in families.

For the details, see my guide to bedwetting.

Myth: Wetting the bed is a sign that your child is psychologically disturbed, or predisposed to violence

Reality:  Information technology'southward true that bedwetting is sometimes associated with stress. And kids with sure beliefs problems are more than likely to experience bedwetting.

Just does a child's failure to awaken before urinating indicate that he or she is psychologically disturbed? No.

This false claim might accept originated with Sigmund Freud, who thought urination was erotic and that wetting the bed was a frustrated sexual human activity.

Later, in the 1960s, psychiatrist J. M. Macdonald proposed that bedwetting by the age of v, along with fauna cruelty and arson, was a sign that a child was at run a risk for becoming a trigger-happy sociopath (MacDonald 1963).

MacDonald's theory was that these three behaviors, occurring together, signal that a kid is under substantial stress. And astringent childhood stress makes kids more likely to become violent criminals.

Does it sound plausible? Perchance. But the evidence isn't supportive.

Yes, in that location is a link between bedwetting and attending deficit hyperactivity disorder ( opens in a new windowADHD). Children who have been diagnosed with ADHD are more than probable to experience bedwetting (Mahjani et al 2021).

In addition, in that location is show supporting the idea that bedwetters are more likely than non-bedwetters to suffer from confusing behavior disorders (Niemczyk et al 2015; Park et al 2013).

Merely most children who experience bedwetting don't take these behavior problems.

And it doesn't appear that these kids are at college take a chance for serious emotional problems, like depression or clinical anxiety (Wille and Anveden 1995; Shreeham et al 2009; Sureshkumar et al 2009).

Mostly what I've found are studies indicating that children suffer fromlower cocky-esteem, which makes sense, given the social stigma associating with wetting the bed (Wille and Anveden 1995; Longstaffe et al 2000; Shreeham et al 2009; Sureshkumar et al 2009; Phung et al 2015).

The bottom line?

Mod psychologists have rejected the hypothesis that wetting the bed is a red flag for futurity violent behavior.

Every bit forensic psychologists notation, "bedwetting is neither trigger-happy nor voluntary" and in that location is "fiddling or no empirical back up" linking it with psychological maladjustment (Parfitt and Alleyne 2018).

Myth: In that location's no point trying to cure bedwetting if a kid is depressed or anxious. You lot demand to care for the psychological symptoms commencement.

Reality:  Some kids who wet the bed are likewise distressed. But their psychological problems aren't necessarily preventing them from getting dry, and successful treatment of their bed wetting symptoms may improve their psychological bug.

In a study of children suffering fromboth psychological bug and nocturnal enuresis, researchers successfully treated the bedwetting problem beginning (HiraSing et al 2009). Not only did most kids become dry out, they also showed less psychological distress after treatment for bedwetting.

Myth: Kids should exist trained to "hold it in."

Reality: Information technology might seem plausible. If kids exercise "holding information technology in," they might expand their float capacity. And a larger float capacity might permit kids to go longer at night without having to relieve themselves.

However, based on the studies I've found, information technology's not articulate if this approach makes much difference. In controlled experiments, researchers randomly assigned some kids with nocturnal enuresis to exercise "belongings it in." Although the treatment did increment the children's float capacities, it wasn't associated with substantial reductions in bedwetting (Van Hoeck et al 2008; Van Hoeck et al 2007).

Myth: Parents can ignore the problem. Kids will eventually abound out of it.

Reality: In many cases — especially in cases where kids accept no other symptoms — kids do usually grow out of it (Jain and Bhatt 2016). But these children may nevertheless benefit from therapies. And other children may  have problems that require intervention.

Sometimes bedwetting is related to treatable medical conditions, similar constipation, urinary tract infections, allergies, slumber-disordered animate (snoring) and sleep apnea (Hsiao et al 2020; Lin et al 2013; Kaya et al 2018; Dominicus et al 2019; Nevéus et al 2020).

Then if your kid is wetting bed, it's wise to consult with your doctor and have your child screened for underlying medical bug. This is particularly important if your child has all of a sudden become incontinent subsequently going for at to the lowest degree 6 months without wetting the bed.

More information about bedwetting in children

Interested in treatment options? Penalisation is a bad approach. Offer rewards might exist a poor option, too.

Your pediatrician might prescribe medication, merely behavioral methods can exist fifty-fifty more than constructive. For more information, cheque out the Parenting Scientific discipline guide to the research nigh kids who moisture the bed.

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References: Debunking bedwetting myths

References

Collier J, Butler RJ, Redsell SA, and Evans JH. 2002. An investigation of the bear on of nocturnal enuresis on children'south cocky-concept. Scand J Urol Nephrol. 36(3):204-viii.

Dossche 50, Walle JV, Van Herzeele C. 2016. The pathophysiology of monosymptomatic nocturnal enuresis with special emphasis on the circadian rhythm of renal physiology. Eur J Pediatr. 175(vi):747-54.

HiraSing RA, van Leerdam FJ, Bolk-Bennink LF, and Koot HM. 2002. Outcome of dry bed training on behavioural problems in enuretic children. Acta Paediatr. 91(8):960-four.

Hsiao YC, Wang JH, Chang CL, Hsieh CJ, Chen MC. 2020. Association between constipation and childhood nocturnal enuresis in Taiwan: a population-based matched example-control study. BMC Pediatr.20(1):35.

Jain S and Girish Chandra Bhatt GC. 2016.  Advances in the management of main monosymptomatic nocturnal enuresis in children. Paediatr Int Child Wellness. 36(1):7-14.

Kanaheswari Y, Poulsaeman V and Chandran V. 2012. Self-esteem in six- to 16-year-olds with monosymptomatic nocturnal enuresis. J Paediatr Child Wellness. 48(10):E178-82.

Kaya KS, Türk B, Erol ZN, Akova P, Coşkun BU. 2018. Pre- and mail-operative evaluation of the frequency of nocturnal enuresis and Modified Pediatric Epworth Calibration in pediatric obstructive sleep apnea patients. Int J Pediatr Otorhinolaryngol. 105:36-39.

Lin SY, Melvin TA, Boss EF, Ishman SL. 2013. The association betwixt allergic rhinitis and sleep-matted breathing in children: a systematic review. Int Forum Allergy Rhinol. iii(6):504-9.

Longstaffe S, Moffatt ME, and Whalen JC. 2000. Behavioral and self-concept changes afterwards six months of enuresis treatment: a randomized, controlled trial. Pediatrics. 105(4 Pt 2):935-40

Macdonald JM. 1963. The threat to kill. Am J Psychiatry 120:125-130.

Mahjani B, Koskela LR, Mahjani CG, Janecka K, Batuure A, Hultman CM, Reichenberg A, Buxbaum JD, Akre O, Grice DE. 2021. Systematic review and meta-analysis: relationships between attending-deficit/hyperactivity disorder and urinary symptoms in children. Eur Kid Adolesc Psychiatry. 2022 Feb 26. doi: 10.1007/s00787-021-01736-iii. Online ahead of impress.

Nevéus T. 2017. Pathogenesis of enuresis: Towards a new understanding. Int J Urol. 24(iii):174-182.

Nevéus T, Fonseca E, Franco I, Kawauchi A, Kovacevic L, Nieuwhof-Leppink A, Raes A, Tekgül Due south, Yang SS, Rittig S. 2020. Management and handling of nocturnal enuresis-an updated standardization certificate from the International Children'south Continence Society. J Pediatr Urol. 16(1):10-19.

Parfitt CH and Alleyne Due east. 2020. Not the Sum of Its Parts: A Critical Review of the MacDonald Triad. Trauma Violence Abuse 21(2):300-310.

Park S, Kim BN, Kim JW, Hong SB, Shin MS, Yoo HJ, Cho SC. 2013. Nocturnal enuresis is associated with attending deficit hyperactivity disorder and conduct bug. Psychiatry Investig. 10(3):253-viii.

Phung P, Kelsberg Grand, Safranek S. 2015. Clinical Inquiry: Does master nocturnal enuresis affect childrens' self-esteem? J Fam Pract. 64(iv):250-9.

Shreeram S, He JP, Kalaydjian A, Brothers South, and Merikangas KR. 2009. Prevalence of enuresis and its association with attending-deficit/hyperactivity disorder among U.Southward. children: results from a nationally representative report. J Am Acad Child Adolesc Psychiatry. 48(1):35-41.

Su MS, Xu L, Pan WF, Li CC. 2019. Electric current perspectives on the correlation of nocturnal enuresis with obstructive sleep apnea in children. World J Pediatr. 15(ii):109-116.

Sureshkumar P, Jones G, Caldwell PH, Craig JC. 2009. opens in a new windowRisk factors for nocturnal enuresis in school-age children. J Urol. 182(6):2893-nine.

Van Hoeck KJ, Bael A, Lax H, Hirche H, Bernaerts K, Vandermaelen V, and van Gool JD. 2008. Improving the cure rate of alarm handling for monosymptomatic nocturnal enuresis by increasing float capacity–a randomized controlled trial in children. J Urol. 179(iii):1122-6; discussion 1126-vii.

Van Hoeck KJ, Bael A, Van Dessel E, Van Renthergem D, Bernaerts Thousand, Vandermaelen V, Lax H, Hirche H, and van Gool JD. 2007. Practice holding exercises or antimuscarinics increase maximum voided volume in monosymptomatic nocturnal enuresis? A randomized controlled trial in children. J Urol. 178(5):2132-6.

Weatherby GA, Buller DM, and McGinnis, K. 2009. The Buller-McGinnis model of serial-homicidal beliefs: An integrated arroyo, Journal of Criminology and Criminal Justice Research and Education, three(1).

Wille S and Anveden I. 1995. Social and behavioural perspectives in enuretics, old enuretics and not-enuretic controls. Acta Paediatr. 84(one):37-twoscore.

Content last modified 4/2021

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Source: https://parentingscience.com/bedwetting/

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