Sleep Disorders: Behavioral Treatments for Bedwetting
Behavioral Modifications continued...
One technique is to have your child rehearse the sequence of events involved in getting up from bed to use the toilet during the night prior to going to bed each night. Another strategy is daytime rehearsal. When your child feels the urge to urinate, he or she should go to bed and pretend he or she is sleeping. He or she should then wait a few minutes and get out of bed to use the toilet.
If your child has trouble with the self-awakening approach, you may need to awaken the child to go to the bathroom. In the parent-awakening approach, it is recommended that a parent or caregiver awaken the child, typically at the parents' bedtime, and have him or her go to the bathroom. For this to be productive, the child must locate the bathroom on his or her own and the child needs to be gradually conditioned to awaken easily with sound only. When this is done for 7 nights in a row, the child may be cured or is ready to re-try self-awakening or alarms (see below).
Bedwetting alarms have become the mainstay of treatment. Up to 70%-90% of children stop bedwetting after using these alarms for 4-6 months.
The principle of bedwetting alarms is that the wetness of the urine bridges a gap in a sensor located on a pad on the bed or attached to your child's clothes. When the sensor gets wet, an alarm will go off. Your child will then awaken, shut off the alarm, go to the bathroom to finish urinating in the toilet, return to the bedroom, change clothes and the bedding, wipe down the sensor, reset the alarm, and return to sleep.
These alarms take time to work; and, for them to be effective, the child must want to use them. The child should use the alarm for a few weeks or even months before considering it a failure. Alarms are often tried first before using medication.
Beware of devices or other treatments that promise a quick "cure" for bedwetting. There really is no such thing. Stopping bedwetting for most children takes patience, motivation, and time.
There are other behavioral treatments that may also be available and appropriate for your child. Talk to your doctor about the different options.