It is a good idea to talk to your doctor about your bedwetting.  Sometimes there are physical abnormalities like diabetes or bladder infection that can cause bedwetting.  Even if your doctor does not find any physical problems, which is the case in 90% of bedwetters, that does not mean that bedwetting is your fault.  Bedwetters are thought to wet because they make more pee (urine) than their bladder can hold when they are asleep, and because they sleep really deeply. To put it simply, their bladder tank overflows before the night is done, and they fail to wake up to empty it. Some bedwetters also have an overactive bladder or a weak sphincter (the muscle that allows you to hold your pee).  These kids usually wet some during the day. 

There are several ways to keep the tank (bladder) from overflowing. The child or teenager can cut down on the amount he or she drinks in the evening. Cola drinks, and tea and coffee, cause even more pee to be made than other drinks. There is also a medication, called DDAVP, that your doctor can prescribe that decreases the amount of pee made during sleep, so the bladder doesn't overflow. To manage an unstable bladder, peeing every two hours as a routine is often recommended, and your doctor can also prescribe medications to calm the bladder, such as Ditropan. But if there is no wetting during the day, then "simply" learning to wake up when your bladder is full during sleep will usually keep the bladder from overflowing and stop the wetting. A lot of kids don't realize that they just need to wake up in the night when their bladder is full and go pee in the toilet. The feeling of a full bladder is the same during the night as during the day. So... if a child or teenager or even an adult has a small bladder or makes more pee than their bladder can hold during the night, then they will have to get up in the night and go to the toilet. And they will probably need to do this for the rest of their life. About 20 percent of people, even those who don't wet, have to get up in the middle of the night to go to the bathroom. And it also helps to make sure that the you pee in the toilet a half hour before bedtime and then again last thing before you go to sleep. This makes sure you start the night with an empty bladder.

Constipation is a very frequent cause of bedwetting.  Infrequent or hard bowel movements can cause stool to back up in a child's belly.  The child's lower intestine becomes dilated, so that only liquid bowel movements can pass around the large mass of backed up stool.  The result is soiling of the child's underwear, and also bedwetting.  There is so much stool in the child's abdomen that there is no room for the bladder to fill, so the bladder overflows during sleep and wetting is the result.  Backed up stool can be treated by your doctor with enemas, stool softening medicines, and increasing fiber and water intake in the child's diet.  Frosted Mini-Wheats and popcorn are good ways to prevent constipation.

Wetting during the daytime can be helped in many kids by just going to the toilet every two or three hours.  A vibration (silent) alarm watch can help remind them every two or three hours.  And there are medications, like Ditropan, that can calm an overactive bladder.

Even very deep sleepers can learn to wake up when their bladder is full. It is training to wake up just like exhausted soldiers train themselves to wake up in war trenches when they are attacked, or doctors train themselves to answer an emergency phone call in the middle of the night. But this can be quite hard to do for kids who are really deep sleepers. It takes real commitment and determination to accomplish this training. It is like to getting into shape for a sport. They have to tolerate the awful feeling of pulling themselves awake when they are really groggy. And somebody has to commit to help them, either a parent or good friend. It is called the "Dry Bed" wake up training procedure.

There are several ways recommended to do this training, but basically they all have the child wake up, usually to an alarm, like an alarm clock, earlier and earlier in the night, such as 3:00 AM to start with and then 1/2 hour earlier each night. Children sleep deepest in the first part of the night, so it is hardest to wake up then. The parent or friend must backup the alarm if the child fails to awaken themselves. Ask your doctor for a specific method to follow. A small reward for waking within a certain amount of time (e.g. 20 seconds), along with taking back part of a previous reward if they don't wake, often helps. Once the child can wake up to the alarm, then the next night they must wake up themselves, without the alarm, at a specific time, like 1:00 or 3:00 AM. It is really important for the child to close their eyes and say to themselves each night just before going to sleep, that "I will wake up at 2:00 AM, for example, or when the alarm goes off!" and really picture themselves doing this. Putting a sign, "I WILL WAKE UP!!" at the end of their bed often helps.

Kids probably naturally learn how to not wet the bed the same way they learn to not fall out of bed. How do they learn to not fall out of bed? They fall on the floor a few times! After that they stay away from the edge of the bed, even though they are deep asleep. Learning to not wet the bed when asleep is no different. If kids fell on the floor every time they wet the bed, they'd quit wetting pretty quick! Using a "wetness alarm" is sort of like hitting the floor, although not as effective. It abruptly wakes you up just when you start to pee, so you gradually learn not to pee during sleep. It's sort of like punishment for peeing when you are asleep. You can find information on some alarms on the ALARMS PAGE. But the alarm must(!) wake the child up, or it doesn't help. And, again, a parent must back up the alarm. Vibration alarms sometimes work for kids who are hard to wake up with noise alarms. And it's really important to not get overly tired.

Kids wet more when they are overly tired, perhaps because they sleep more deeply. So it is a good idea for kids to always get plenty of sleep and not do too many extracurricular activities, sports, or whatever. Teenagers need nine (9!) hours of sleep a night or they become sleep deprived and wet more. One study also showed that if teenagers lose just one hour of sleep a night for a week at the end of a week their IQ scores are 20 points lower.

It is also believed by many doctors that even if a child or teen is dry only one night every so often, that this shows that they do have what it takes to become totally dry at night. So when a dry night happens it's very important to ask what was different. One 18 year old told us that he stopped wetting when he didn't drink his usual two liters of soda in the late afternoon. What goes in must come out! He had never realized the connection.

Unfortunately, there is no magic bullet for stopping bedwetting. Again, it is just like getting into shape. It takes real determination, stick-to-it-ness, and encouragement by your parents. Make sure to ask you doctor or healthcare provider what is right for you. A Pediatric Urologist is a doctor who specializes in bladder problems like bedwetting.