Antidiuretic hormone (ADH) signals your kidneys to slow down the production of urine. Your body produces more of the hormone at night to prepare you for sleep. This helps limit your need to urinate while you’re asleep. However, some people don’t produce enough ADH or their bodies don’t respond to it well. ADH abnormalities seem to he a role in nighttime bed-wetting, although there are several theories that suggest a variety of factors combine to cause the problem.
A combination of problems with ADH, difficulties in waking and sleeping, along with daytime bladder issues, often lead to this condition.
A simple test can measure the level of ADH in your blood. If the level is low, your doctor may prescribe a medication such as desmopressin (a laboratory-made ADH). Your doctor may also look for underlying conditions that could be impacting ADH levels.
Small bladderA small bladder isn’t actually smaller in size than other bladders. Instead, it feels fuller at lower volumes, meaning it functions as if it’s smaller. That means you may need to urinate more frequently, including at night. A small bladder may be tricky to manage during your sleep, and bed-wetting may occur.
Bladder training is helpful for people with a functionally small bladder. This strategy helps your body anticipate regular voiding by holding urine for longer stretches of time. You may also want to set an alarm for overnight and wake up to urinate.
Overactive musclesDetrusor muscles are the muscles of your bladder. They relax when your bladder fills and contract when it’s time to empty. If these muscles contract at the wrong time, you may not be able to control urination. This condition can be called overactive bladder (OAB).
Your bladder muscle contractions may be caused by abnormal nerve signals between your brain and your bladder or an irritant to the bladder, such as alcohol, caffeine, or medications. These products can make the muscles less stable. That may make you need to urinate more frequently.
Check out these natural remedies for OAB.
CancerTumors from bladder and prostate cancers can block or obstruct the urinary tract. This may lead to an inability to hold urine, especially at night.
Diagnosing cancer may require a physical exam, as well as some imaging tests. A biopsy is usually necessary to identify cancer. Treating the cancer can help shrink or eliminate the tumor. That may help prevent future episodes of bed-wetting.
Diabetes mellitusDiabetes with uncontrolled blood sugars can change urination. When blood sugars are high, the amount of urine increases as the kidneys try to manage sugar levels. This can lead to bed-wetting, excessive urination (more than 3 liters per day), and frequent urination.
Treating diabetes often eases the variety of urinary symptoms. Treatment of diabetes typically requires a combination of lifestyle changes, oral medications, or insulin injections. Your treatment plan depends on the type you he and your overall health.
Sleep apneaObstructive sleep apnea is a sleep disorder that causes you to stop and start breathing repeatedly. One study found that 7 percent of people with this sleep disorder experience bed-wetting. Urinating during your sleep may become more frequent as the sleep apnea worsens.
Treating sleep apnea with continuous airway pressure therapy will help you breathe and sleep better. It can also reduce secondary symptoms, such as bed-wetting.
MedicationSome prescription medications can make you urinate more frequently and increase bladder contractions. This may lead to bed-wetting. These medications include sleep aids, antipsychotics, and others.
Switching medications may stop nighttime urination. If the medication is necessary to treat another condition, lifestyle changes may help you prevent bed-wetting. Never stop a medication without talking with your doctor.
GeneticsBed-wetting is commonly shared from generation to generation. It’s unclear which genes are responsible for passing down this condition. But if you he a parent who experienced nocturnal enuresis, you’re more likely to experience it as well.
Before a doctor will diagnosis unspecified nocturnal enuresis, they’ll conduct several exams and tests to rule out other possible causes. Treatment for unexplained bed-wetting relies on treating symptoms and preventing future episodes. This can include lifestyle changes and medications.
Neurological disordersThe following neurological disorders may impair bladder control:
multiple sclerosisseizure disordersParkinson’s diseaseThis can lead to frequent or uncontrolled urination while you sleep.
Treating the disorder can help ease symptoms, as well as secondary complications like bed-wetting. If the bed-wetting doesn’t stop, your doctor may prescribe specific treatment. This can include lifestyle changes, medications, and more.
A blockage or obstruction in your urinary tractBlockages can impair the flow of urine, such as:
kidney stonesbladder stonestumorsThis may make voiding difficult. At night, this can cause unexpected urine leakage and bed-wetting.
Likewise, pressure from a stone or tumor may make muscles in the bladder contract unnecessarily. This can lead to frequent and uncontrolled urination.
Sometimes a procedure is needed to remove larger stones or break them down. Smaller stones typically will pass on their own.
Cancer treatment can shrink some tumors, but others may need to be removed with surgery. Once the blockages are removed, you should he greater urinary control and less bed-wetting.
Urinary tract infectionA urinary tract infection (UTI) can cause frequent and unexpected urination. A UTI often causes inflammation and irritation of the bladder which can further worsen incontinence and bed-wetting at night.
Treating the UTI should stop the enuresis. If you he recurring UTIs, you may experience bed-wetting more frequently. Work with your doctor to find an underlying cause for the recurrent UTIs so you can prevent future infections and bed-wetting.
AnatomyUrine flows from your kidneys through your ureter to your bladder. When it’s time to urinate, your bladder will contract and send urine through your urethra and out of your body. If any element of that system is narrowed, twisted, kinked, or misshapen, you may experience symptoms or difficulties with urination. This includes bed-wetting.
Your doctor can use imaging tests, such as an X-ray or ultrasound, to look for abnormal structures. Some may be fixed with surgery. In other cases, your doctor may suggest lifestyle treatments and medication to help you stop urinating in your sleep.