Medical Progress

Could Stress or Anxiety Be Causing Your Child’s Bedwetting?

A move across state, a baby, a divorce — each can create a lot of stress, especially for kids. For a child who wets the bed it can be even harder. Symptoms that were in check may get worse, and dry nights could become more rare.

So does that mean stress and bedwetting are linked? The answer is no. And yes.

The Basics of Bedwetting

There are a lot of myths about bedwetting: That kids do it because they’re lazy. That if they just tried harder they could stop. And that stress or anxiety will cause a child who has never wet the bed to start.

Like a lot of myths, none of these is true. Wetting the bed — also called nocturnal enuresis — isn’t a behavioral issue kids can control. It’s genetic and often runs in families; if not a parent, then an aunt, uncle, or grandparent likely wet the bed.

For most kids, bedwetting is simply “a maturational lag,” says Martin Scharf, in his book Waking Up Dry: How to End Bedwetting Forever. A child’s bladder may be too small for the amount of urine they’re producing, or the muscles that contract the bladder may be stronger than the sphincter muscles that hold urine in.

And although stress can indirectly affect a child’s bedwetting, most experts believe it isn’t the reason a child starts wetting the bed. There’s just “no major association between anxiety, stress, and bedwetting,” says Anthony Atala, MD, chair of urology at the Wake Forest University School of Medicine.

Stress and Bedwetting: What’s the Connection?

The association between stress and bedwetting is actually one step removed, says Atala. Although stress doesn’t cause a child to start wetting the bed, behavior the child engages in when under stress can make bedwetting worse, or make a child who was mostly dry experience wet nights. These behaviors include:

  • Eating a high-salt diet
  • Not emptying the bladder at night
  • Drinking fluids right up to bed time

Like many adults, kids may seek the comfort of food when they’re stressed, foods like salty snacks. But start eating a lot of salty foods and you’ll start retaining fluids. Start retaining fluids, and if you’re already likely to wet the bed because of a too-small bladder, you may wet even more.

Stress or anxiety may also cause a child to drink too much late at night, or they may forget to urinate before bed — but it’s not the stress or anxiety causing the problem, it’s the behavior, Atala says.

Bedwetting and Stress: Sleep Deprivation

Sleep deprivation resulting from stress can also cause a child to wet the bed.

That’s because bedwetting mostly occurs in people who are deep sleepers, and if friends, school, or things at home have a child so keyed up they’re losing sleep, they can easily become sleep deprived — and end up going into an even deeper sleep. The result may be bedwetting.

But “again, there’s no major association between bedwetting and stress,” Atala tells WebMD. People attribute an increase or reoccurrence of bedwetting to stress, when it’s behaviors caused by stress that’s the problem.

The Stress of Bedwetting: Helping Kids Cope

For the 5 million U.S. children over age 6 who wet the bed, stress itself doesn’t cause bedwetting, but bedwetting definitely causes stress. And that stress can be hard for kids to manage. There are bound to be activities a child feels they’re missing out on, they may be dealing with teasing by friends, or they may suffer from low self-esteem. Fortunately, there’s a lot you can do to help your child physically and emotionally.

First, if your child was dry for awhile, try again the methods that got them dry before. If bedwetting alarms, behavioral changes, getting your child up at night to go to the bathroom, or a combination of these worked before, try them again. Experts at the American Academy of Family Physicians as well as urologists like Atala also offers these tips:

  • Always be supportive of your child.
  • Make sure they know that bedwetting isn’t their fault.
  • Don’t blame or punish your child for wetting the bed.
  • Let your child know bedwetting tends to run in families.
  • Encourage your child to use the bathroom at night, then provide nightlights to make that easier.
  • Urge your child to do the same things other kids do, like going to camp and sleepovers.
  • Reward your child not for dry nights, but for following their bedwetting treatment plan.
  • When bedwetting accidents occur, praise your child for trying to stay dry, and for helping to clean up.

That last point confuses some parents. Won’t it add even more stress or embarrassment if you ask your child to help change their bed and do laundry?

To the contrary, Scharf says. Sharing responsibility for wetting the bed helps a child feel they’re actively tackling the problem. It can even give them a sense of pride because they’re able to handle an aspect of bedwetting on their own.

When is Bedwetting Considered Cured?

A child doesn’t just stop bedwetting one day, Atala says. Usually the journey to dry is a progression: A child may wet the bed every night, “then maybe five nights a week, then maybe only three or four….It’s a transition.”

Although chances are good that bedwetting won’t recur, a change in diet or behavior could cause a child to start wetting the bed again. But that’s rare, Atala says. With bedwetting, “the rule is that they just outgrow it.”

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