Enuresis
Enuresis means involuntary urination during sleep or waking hours. In children it is usually called bedwetting, and it is far more common than many families realise, affecting roughly 15% of five-year-olds and around 1—2% of teenagers. Most cases resolve on their own, but persistent enuresis can affect a child’s confidence and sleep quality for the whole household.
Medicine used to treat Enuresis
What drives it
The causes vary by age. In younger children, delayed bladder maturation and deep sleep patterns are the main factors. A smaller bladder capacity, reduced production of the hormone that concentrates urine at night (ADH), or simply not waking to a full-bladder signal all contribute. Stress, constipation, and urinary tract infections can trigger or worsen episodes at any age. Secondary enuresis, bedwetting that returns after at least six dry months, warrants a check for an underlying cause such as diabetes or a sleep disorder.
Treatment options
Behavioural approaches come first: moisture alarms (the most evidence-backed method), fluid restriction in the evening, and timed voiding routines. When these are not enough, or where a short-term solution is needed (a school trip, for instance), medicine can help. Imipramine, a tricyclic from the antidepressants category, has been used for decades to reduce nocturnal wetting, it lowers bladder contractility and alters sleep arousal. Response rates are reasonable, though relapse on stopping is common, so it tends to work best as a bridge alongside behavioural strategies.
If bedwetting starts suddenly in an older child or adult who was previously dry, or is accompanied by pain, unusual thirst, or daytime symptoms, a doctor’s review is worthwhile.