How to deal with a bedwetting teenager?

Question

My 13 year old still wets the bed. Over the years we have tried alarms, medication, waking him up at various times, controlling his drinking, charts (behaviour modification). He hates it and wants to stop. He can sometimes stop for a couple of nights - he has been on school camps and managed two - but always starts up again. (And I suspect then he doesn't sleep properly to stop himself going into a deep sleep.) He does his own laundry. He has been checked to see if there is anything physically causing the problem. Does anyone have any advice?

Answer 1

He has been checked to see if there is anything physically causing the problem.

By whom? It sounds like it's past time to see a specialist about this, or a different one if you've already seen one.

For our daughter (7 right now), we have to use a multi-pronged approach:

• Controlling liquid intake: No more than a sip or two of water after dinner. Even liquid intake during dinner time is checked. No caffeine, at all. No colas/sodas. Low sugar drinks, and no more than 1 at a time. When I make Kool-Aid at home, I use the unsweetened packets and use 1/2 cup of sugar instead of 1 cup for a half-gallon of Kool-Aid.
• Controlling sodium intake: Too much sodium in the diet will also contribute to increased urine production. As a general rule we don't add salt (or very little) to food prepared at home, which helps.
• Use the bathroom right before bedtime: It's rather obvious, but we make her try to go, even if she thinks she doesn't need to.
• Wake her up to use the bathroom: I wake her up about 2 hours after bedtime to go to the bathroom. Even if she doesn't go, your enforcing a consistent routine will help his body create one of its own.

The most important thing is to keep doing these things, even when it doesn't always seem to be helping. I still have nights where the bed is wet before 10 p.m., I even have nights where the bed is wet more than once, but this combination of things has helped us get to a place where we have more dry nights than wet ones.

No wait, the most important thing is to not get upset, disappointed, or frustrated with him. I'm sure that he hates this (and possibly, by extension, himself) at least as much or more than you do. I also know that this is easier said than done -- I'm sure I'm not the most pleasant person in the world when I'm being shaken awake at 3 a.m. to help change sheets.

Another thing to look into is if there's any other sources of stress in your son's life. There's a possibility that there's something else going on in his life that's really bothering him and bed wetting is an expression of that strong emotion. However, getting that information may be easier said than done with a 13 year old.

Answer 2

My boy was waking up wet a lot older than is typical, and here is what we did. We happened to have some plastic graduated beakers that held about 800 ml and were clearly marked to measure volume. I showed him how to read the volume on them and we kept them in the bathroom. I encouraged him during the day, when he was home and could go to the bathroom whenever he wanted to, to try to hold it a little longer each time and see what he could get that volume up to. This is sometimes described as "bladder stretching" but I think it was really more about being aware of the sensation of needing to pee, but not immediately peeing in response to it. We are talking about a child old enough to understand 3 digit numbers, a child who goes to school and goes on sleepovers etc. Not a 3 year-old, more like 5+ or 6. Old enough to pee into a cup, note the number, pour the pee into the toilet and rinse the cup.

The theory was that over time, he would not just pee while asleep, but would resist the urge until it got a little stronger, strong enough to wake him up. And in the meantime he would feel that he was doing something towards waking up dry.

Did it work? Of course. Well, something worked. Perhaps time passed and his bladder got larger. Perhaps he learned to wake up or he learned to sleep through. Perhaps doing something about it got the message across that he could change this, without making him feel bad for what was happening. Whatever the cause, he began to wake up dry more often than not, and then the whole thing was just a memory.

Certainly a teen is old enough to buy into something like this. It's not behaviour mod or sleep alarms, and clearly he has either less bladder capacity than those who can sleep through, or less awareness of the need to pee than those who wake up. So perhaps such an exercise can help.