Health Conditions

What causes it?

The exact cause of nocturnal enuresis is unknown. It appears to be caused by multiple factors, and there are several theories available to help explain what is going on.

• Genetics: A child with both parents who experienced nocturnal enuresis as children has approximately a 77% risk of having nocturnal enuresis. There is about a 43% risk in children with one parent that had nocturnal enuresis. The children whose parents did not have nocturnal enuresis have a 15% risk of experiencing it.

• Bladder Capacity: The bladders of children with and without nocturnal enuresis have similar amounts of room to hold urine (bladder capacity). The difference is that children with nocturnal enuresis have a smaller functional bladder capacity. Functional bladder capacity is the amount of urine that is voided after prolonging urination as long as possible. Having a smaller functional bladder capacity also means that there will be an increased residual volume (the amount of urine left in the bladder after voiding). The smaller functional bladder capacity and increased residual volume can make it harder for these children to hold their urine through the night.

• Bladder Dysfunction: At one time people believed that nocturnal enuresis was caused by problems with the function of the bladder. Current research, however, shows that the bladder of children that experience nocturnal enuresis functions the same as a child that does not wet the bed.

• Sleep: Parents of children with nocturnal enuresis consistently report having more difficulty arousing their children from sleep, compared to awakening their children without nocturnal enuresis. It is believed that this difficulty in arousal is what prevents them from awakening to go to the restroom.

• Psychologic Stressors: For a long time it was thought that nocturnal enuresis was caused by psychological problems in children. However, newer research shows that psychological problems, seen in children that wet the bed, are more likely the result of nocturnal enuresis and not the cause of it.

• Nocturnal Diuresis: There is a hormone released in the body that helps to regulate the amount of urine that is produced (antidiuretic hormone, ADH). An increase in ADH causes a decrease in the amount of urine produced. Most people release less ADH throughout the day and then have an increase at night. It is thought that children with nocturnal enuresis do not release high amounts of ADH at night and, thus, have an increased frequency and urgency to use the restroom at night.

• Other Causes: There are several other possible causes of nocturnal enuresis including: urinary tract infections, constipation, and delays in development. It can also be caused by an undiagnosed medical disorder, such as, diabetes or a seizure disorder. It is important to work with your child?s physician to rule these out as the cause of the nocturnal enuresis.

  << Back

  Who has it? >>