National Sleep Foundation

Chapter 6: Parasomnias

Treatment of Enuresis (Bedwetting)

Most children outgrow enuresis on their own. Any underlying causes (i.e., sleep apnea) should be addressed before other treatments for enuresis are attempted.

Non-pharmacological Treatment

Treatment for sleep enuresis is mainly behavioral and includes changes in habits, bedwetting alarms, and retention control.

Changes in habits include limiting how much fluid the child drinks before bedtime; encouraging the child to use the bathroom before going to bed; and avoiding caffeinated beverages, which stimulate the bladder. 

The bed-wetting alarm emits a noise when the child wets the bed, and has been shown to be remarkably effective in many cases.1  Retention control, which aims to increase functional bladder capacity, involves the child holding his or her urine for gradually longer periods and training voluntary start and stop of the urine stream during the day.2

Pharmacological Treatment

Pharmacologic treatment of sleep enuresis for children over age six includes desmopressin (DDAVP) and imipramine.

DDAVP is a synthetic analog of arginine vasopressin, which decreases nocturnal urine volume. The anticholinergic effect of imipramine decreased intravesical pressure. Both desmopressin and imipramine are more effective than placebo in increasing the number of dry nights, but they do not completely eliminate enuresis, however, and discontinuation of either treatment results in high relapse rates.3

References

  1. Glazener CM, Evans JH. Simple behavioural and physical interventions for nocturnal enuresis in children. Cochrane Database Syst Rev. 2004;2:CD003637.
  2. Thiedke CC. Nocturnal enuresis. Am Fam Physician. 2003;67:1499-1506.
  3. Thiedke CC. Nocturnal enuresis. Am Fam Physician. 2003;67:1499-1506.