Bedwetting, also known as nocturnal enuresis, is an uncontrollable leakage of urine while asleep.8 In children aged ≥5 years, enuresis is considered abnormal.

Bedwetting is a common childhood condition, with approximately 5–10% of 7 year-olds regularly wetting their beds and the problem may persist into teenage and adulthood9

In most cases Bedwetting is caused by over-production of urine at night or reduced capacity of the bladder. An inability to wake up can be another cause.2,3,4 Bedwetting does not have a psychological cause.2,3,4

An increased association between bedwetting, brain and psychological functioning as well as sleep issues is well documented10

Successfully treating bedwetting removes the emotional burden placed on the child and improves day time functioning, including social and school performance11

Bedwetting is a common medical condition that has a serious impact on a child’s self-esteem, emotional well-being and day time functioning, including school and social performance.2,3,4,5,6 Bedwetting is nobody’s fault, and families and doctors should be able to discuss the condition without embarrassment or guilt. However, the impact is often underestimated and trivialised, so help is not sought or offered.7 By raising awareness of bedwetting as a common condition that can and should be treated 1, WBD aims to encourage families to discuss bedwetting with their doctors and obtain the help they need.

Bedwetting experts from the ICCS (International Children’s Continence Society) and the ESPU (European Society for Paediatric Urology) give their answers to a wide range of questions submitted from this site. Start by choosing from the following topics.

My son does not wake up at night but just wets the bed when sleeping. Is he a deep sleeper?

It is well known that children with bedwetting are unable to wake up when they pee at night. It has been believed for many years that the sleep of bedwetters is too deep but recent research has indicated that bedwetters have poor sleep quality with many incomplete arousals (awakenings). They also seem to have many ‘periodic limb movements’ during sleep, a sign that may be related to the arousal attempts.

My 6 year old grandchild has always wet the bed and his parents had the same problem - is bedwetting a genetic disease?

Bedwetting is clearly an inherited disease and in approximately 70% of cases there is at least one other family member who has or had the same problem as a child. For example, if a mother was a bedwetter as a child, there is a 7 times increased risk that her children will also suffer from enuresis. A specific gene that causes enuresis has not been identified yet but current research is focusing on this assignment.

I was told by my neighbour that my child’s bedwetting is caused by psychological disturbances. Is it true?

Normally, enuresis is not caused directly by psychological disturbances but having enuresis may cause psychological problems, especially affecting quality of life and self-esteem. These changes normalize after successful treatment of enuresis.

What are the most common causes of bedwetting and is it possible to identify the underlying cause in my child?

Increased night-time urine production (=”nocturnal polyuria”) and reduced night-time bladder capacity are the two most common causes of bedwetting. It is important to know that these two causes may occur at the same time in a child. It is possible to recognize which of these two factors play a role in your child by simple home recording tools. By identifying the largest voided volume on a home diary (="frequency-volume-chart") it is possible to ascertain whether a child is suffering from ‘reduced bladder capacity’ (by comparing with published normal values).

By home recording of nocturnal urine volume it is possible to evaluate whether the child has nocturnal polyuria. With this method, diapers are weighed at bedtime and again the following morning. The difference in diaper weight plus the volume of any urine produced during the night plus the volume of the first urine produced in the morning constitutes the total night-time urine volume. Also, there are internationally accepted normal reference values for nocturnal polyuria.

Why do we have to see our family doctor for this condition?

Although most children with bedwetting since infancy have no underlying disease in either the nerve system that controls bladder function or in the anatomy of the urinary tract, this should be ruled out by a visit to your doctor. Also, the doctor will determine whether bedwetting is the only problem or if there are other issues that need to be addressed. This could be wetting during day-time, signs of ‘overactive bladder’ (frequent and strong sensation to void), faecal incontinence and constipation, and recurrent urinary tract infections. If these conditions are present they should be treated before any treatment for bedwetting is initiated.