Bedwetting and Incontinence Basics
Inability to hold urine is called urinary incontinence or enuresis however commonly known as bedwetting. Wetting the bed during the night is called nocturnal enuresis. Teens who have never achieved bladder control at night have primary nocturnal enuresis. Teens who stayed dry at night for at least 6 months before wetting the bed have secondary nocturnal enuresis. Incontinence, or bedwetting, becomes increasingly uncommon as teenagers progress to young adulthood.
Most teenagers have secondary enuresis due to underlying health problems or stress reactions. If your teenager is having nighttime incontinence issues the doctor should be consulted if bedwetting continues until the late teenage years.
Causes & Risk Factors
Stress reactions are a common cause of bedwetting during the teenage years. Incontinence can indicate that the teen is struggling to deal with divorce, loss of loved ones, moving, social situations, or other life events. The nighttime incontinence generally goes away on its own as the situation resolves or the teen begins to cope more effectively.
Teenagers may experience sleep apnea due to large tonsils and adenoids, and parents may notice that the teen snores loudly overnight. Sleep apnea causes increased urine production during the night and can cause nocturnal enuresis. Constipation can cause bedwetting due to pressure on the bladder from enlarged bowel. Excessive urine production during the night from kidney disease or hormone imbalance can also lead to nocturnal enuresis.
Erratic sleep patterns are commonly experienced during adolescence with too few hours of sleep. Napping during the day and sleeping late on weekends interferes with the brain’s normal sleep/wake cycles. The brain is less able to control bladder function during sleep and teens may be less able to awaken in response to a full bladder. Energy drinks, coffee, and other caffeinated beverages interfere with sleep and increase urine production during the night.
Talking with the Doctor
The doctor will ask about the teen’s medical history and urinary symptoms. A urine sample may be collected to check for a bladder infection or kidney disease.
Important symptoms to report:
- Pain or burning with urination
- Unusual thirst and excessive urination
- Significant weight gain or loss
- Dark, cloudy, discolored or foul-smelling urine
- Loud snoring with daytime sleepiness
- Numbness, tingling and pain in the legs
Helpful information includes:
- Frequency of bedwetting episodes
- Daytime urination patterns
- Daily fluid intake, especially afternoon/evening
- Psychosocial concerns
Bedwetting can make a teenager feel embarrassed and anxious. This can lead to low self-esteem and quality of life. Schoolwork and friendships may be affected. Teenagers cannot control bedwetting and nighttime incontinence is not their fault.
Parents should maintain a caring, patient attitude rather than shaming or punishing the teen. This will help to instill confidence and motivate the teen to remain optimistic about nighttime dryness. Parents can encourage teenagers to help clean up and assist with laundry.
This will help them to take responsibility with a feeling of empowerment.
Tips & Treatment Options
Basic interventions that can help prevent bedwetting:
- Eat a healthy diet to prevent constipation
- Avoid caffeine, carbonated drinks, and citrus juices
- Increase fluid intake during the day
- Scheduled bathroom use every few hours during the day
- Limit fluid intake after school and before bed
- Use the bathroom twice before going to bed
The teen may set an alarm once or twice during the night to urinate. A diary may be used to track wet and dry nights to determine which interventions are helpful. Regularly scheduled bathroom trips timed at increasing intervals will help the teen’s bladder become used to holding urine for longer periods of time.
Counseling may be beneficial for teens who are struggling with stress and anxiety. Medications may be used to treat bedwetting caused by a bladder infection, kidney disease, or hormone imbalances.
Disposable incontinence underwear can help teens sleep comfortably through the night. Wearing boxer shorts over incontinence underwear can help protect the teen’s privacy and self-esteem. Protective creams may be needed to prevent skin breakdown. A waterproof incontinence mattress is extremely helpful for easy morning clean-up and odor prevention.
American Academy of Pediatrics (2019). Bedwetting in children & teens: Nocturnal enuresis. Retrieved from
Bladder & Bowel UK. (2021). Bedwetting in older children and teenagers. Retrieved from https://www.bbuk.org.uk/blog/bedwetting-children-teenagers/
Children’s Hospital of Philadelphia. (2021). Bed-wetting (Nocturnal enuresis). Retrieved from
Continence Foundation of Australia. (2020). Bedwetting in teenagers and young adults. Retrieved from https://www.continence.org.au/information-incontinence-english/bedwetting-in-teenagers-and-young-adults
Mayo Clinic. (2017). Bed-wetting. Retrieved from https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685
National Kidney Foundation. (2021). Questions kids ask about bed-wetting. Retrieved from https://www.kidney.org/patients/bw/BW_faq
National Kidney Foundation. (2021). Secondary nocturnal enuresis. Retrieved from https://www.kidney.org/patients/bw/BWbedwetSecondary
University of Rochester Medical Center. (2021). Urinary incontinence (Enuresis) in children. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=p03083
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WebMD. (2020). Helping your bedwetting child maintain self-esteem. Retrieved from https://www.webmd.com/parenting/bedwetting-self-esteem#1