The Bedwetting Blues
Don't Get Mad, Get Help
Sensors, Alarms, and Buzzers continued...
After several weeks of this, the child's brain should learn to avoid the unpleasant circumstance of being awakened in the middle of the night by not urinating during sleep. This method has a nearly 95% success rate, says Greene, but requires commitment on the part of both parents and children who will need to wake up frequently until the child can stay dry.
A variation of this approach (that doesn't require a sensor) is to set an alarm clock for a few hours after bedtime (and subsequent times during the night) so the child can wake up, go to the bathroom, and then go back to sleep. Again, parents also need to wake up to make sure the child doesn't just shut off the alarm but actually gets up. Over a few weeks, the child will stay dryer longer and the amount of time between alarms can be increased. "Eventually, the body gets to a point where it is conditioned to hold its urine all night long," says Brownell.
Pills and Potions
When these behavioral approaches don't work, medication can be considered. The two most commonly used to treat bed-wetting are imipramine and Desmopressin.
Imipramine is an older antidepressant whose basic effect is to keep kids from reaching deep sleep. It's usually used in combination with the behavioral therapy methods above. In theory, children on this medicine will be more likely to awaken when they need to go to the bathroom. However, it has many troublesome side effects including nervousness, intestinal problems, and excessive tiredness during the day. And as with many medications, an overdose can be fatal.
The newer drug treatment, Desmopressin is a hormone that is chemically similar to ADH and works by inhibiting urine production. Taken before bedtime, it can help children make it through the night without wetting. It is available in nose drops, nasal spray, and tablet forms. Headaches, nausea, upset stomach, and nasal irritation (from the drop and spray forms) are the most common side effects. In some cases, depression, agitation, dizziness, and a reduction in the ability to produce tears can occur.
While using medications may sound easier than getting up every few hours, parents should be aware that they only have a success rate of around 50% and don't train the child's body to hold its urine on its own, says Greene. Therefore, many kids revert to bed-wetting after they stop taking the drugs. Still, these medicines can be a good option when a child faces an overnight trip away from home, at camp or a sleepover, for example.