Sleep Incontinence

Sleeping urinary incontinence, also known as “Nocturnal Enuresis”, is a very common condition, it appears at the same rate all over the world and its incidence decreases with increasing age. 16% of 5-year-olds leak at night. We encounter it at a rate of 3% in adolescence and 0.5-1% in advanced ages. It appears more in boys than girls. It is the second most common chronic childhood disease after allergic diseases in children. Separation of parents is the third most important cause of depression after domestic violence in children aged 8-18. It seriously affects children’s school success. Nocturnal urinary incontinence is not usually psychological, but it creates serious psychological problems. Children who have urinary incontinence at night have a serious sense of shame and isolate themselves from social environments. In these times when appearance is very important, their self-confidence decreases due to these diseases and causes significant problems in their development. Despite this, 50% of the patients still do not get help from the doctor even under today’s conditions.

Why do children leak urine at night

Although the reason for nocturnal urinary incontinence is not fully understood, 82% of families think that their children are incontinence due to not being able to wake up at night and laziness.

In fact, 3 factors are important in nighttime urinary incontinence.

Sleeping problem: Here, the sleep is actually not very heavy, on the contrary, these children do not realize that their urine is coming because they cannot get enough quality sleep during their sleep. In other words, they are not in a deep sleep during their entire sleep, but only during the time they miss. During this period, they cannot give the necessary response to bladder contractions and sound.

Producing more urine than normal at night (Nocturnal Polyuria).

Bladder being smaller than normal or contracting too much.

Nocturnal incontinence has a genetic basis.It is known that 2/3 of the families of children with urinary incontinence have mothers, fathers or siblings who have urinary incontinence.

some behavioral problemsand attention deficit hyper-activity.

Sleep apnea

What awaits you when you apply to the doctor?

The doctor first takes a detailed history and performs a physical examination. It is very important whether there are daytime complaints in the history. Daytime urinary incontinence, rushing to the toilet by squeezing, urinating thin and straining, inability to urinate, urinating less than 4 times more than 7 times a day, and whether the child has a dry period for 6 months are questioned. Weight loss, growth and development retardation, vomiting, nausea, desire to drink too much water, snoring and suffocation symptoms are important and if any, the doctor should be told. The evaluation and treatment planning of children who only wet the bed at night and children whose nighttime bedwetting is accompanied by the above-mentioned complaints are completely different.

Diagnostic Tools

While only a simple complete urinalysis is performed in children without daytime complaints, other tests are required in children with daytime complaints.

Treatment

These children should seek help from a doctor as soon as possible after the age of 5.

If no treatment method is applied, 15% of them return to normal on their own every year.

First of all, we have some simple suggestions.

  • A review of nutrition and fluid intake habits.

  • It is recommended to drink a glass of water at least 6 times a day.

  • Caffeinated and carbonated drinks should be reduced at night.

  • The bladder should be emptied at night before going to bed.

  • If there is constipation, the amount of fiber taken should be increased.

  • It should be made a habit to go to the toilet regularly and reach the toilet quickly.

  • When the child leaks urine, constructive attitudes should be taken and active participation of the child should be ensured while the bed and laundry are cleaned.

  • Wet and dry nights should be marked on the calendar.

In some behavioral problems and in cases such as attention deficit hyper-activity, enuresis should not be treated only as a psychological problem;

If it does not go away despite these, a pediatric urology doctor should be consulted to be informed about other treatment alternatives.

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