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Our 9-year-old son still bed-wets.

The problem is that he is an extremely heavy sleeper; when he needs to pee, he does not wake up - even manually trying to wake him up (either to try and pee preventively in the middle of the night, or to deal with 'accident' after-effects) is a major undertaking; it may take 5 minutes of effort to rouse him awake (this only applies during the night). This heavy sleepiness is not in any way correlated to him not getting enough sleep or rest - it is the same no matter if he slept more or less than average the previous days/weeks.

Sometimes he wakes up after peeing himself, but not 100% of time, and not always right away.

We have tried the following approaches, none of which seems to have any permanent effect at all:

  1. Physical approaches to reduce the need to pee overnight:

    • Reducing liquid intake before bed (and enforcing at least 30-60 minutes since last drink before bedtime).

    • Requirement to pee before going to bed (ideally, twice if he is going to bed late enough).

    • Eliminating pee-inducing food/drink during supper (e.g. no watermelon etc., no high sodium food) - plain water and plain food.

    All 3 of these helped to a small degree, in that he makes it through some rare nights without peeing himself. But that only helps in less than 30% of nights, even when applied 100% consistently daily.

  2. Psychological approaches

    We tried the usual stuff - praise for waking up dry, a prospect of a meaningful prize if he lasts a week or 2 without wetting the bed, etc.). He also has an aspirational example of a younger sister, who was waking up to pee at night since ~ 5 years old reliably - and we are always careful to not shame him by comparing them, but simply show him the benefits of not bed-wetting she is accruing.

    These have zero effect (not unexpectedly, as the issue seems to be not psychological - he definitely does not like to or wants to bed-wet. He simply doesn't wake up when he needs to pee).

  3. Physical environment

    We tried everything. Sleeping in bed and on the rocking chair (he loves the latter so at times he is permitted). Sleeping in diaper and without diaper. Sleeping in colder and warmer room.

    Zero effect from any condition changes.

  4. Waking him up in the middle of the night to pee, on a schedule.

    This has a predicted localized effect (if - after 5 minutes of trying to wake him up - he wakes up and goes to pee - he sleeps the rest of the night dry).

    However, it also had zero lasting effect - after months of consistently doing this, whenever we do not wake him up at the scheduled time, he would wake up on his own and go pee maybe less than 5% of the nights, at most.

Pertinent information: one of the parents had bed-wetting issues, but - to the best of family recollection - they stopped by 8-9 for sure, and nothing was done to achieve that that we haven't already tried with our son. Whereas our son shows very little sign of improvement by 9, compared to 8,7,5, etc.

His pediatrician is aware of the situation, but did not find any indications of anything worth worrying about from a medical standpoint.

Bed-wetting is not a new issue - there was never a sustained period in his life longer than 4-5 days where he would not bed-wet unless woken up by a parent to pee preemptively.

What else can we try to do to address the issue?

  • As a side note: this hasn't been a major issue as of yet, but he is getting to the stage where he will start being enrolled in overnight trips (e.g. with summer camp), where it will become a practical problem of a much greater magnitude than at home. – BWC_parent Jun 8 '15 at 2:36
  • What about some sort of wrist band watch that has a vibrating alarm so that he can wear it and it will wake him up at the desired time at night? I guess the key is - would it even wake him up? (There are lots of "Vibrating Watch" options on Amazon if you don't understand what I mean.) – user7678 Jun 8 '15 at 12:14
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    Welcome to the site! And thank you for such a detailed, well phrased and nicely formatted question! This is something we don't see often from new members and it's highly appreciated! – Stephie Jun 8 '15 at 17:40
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We had a similar situation. We survived. Most nights are dry now.

Let me get the bad news out first: There are a few children that will be bed-wetting until their teens. A few. Very, very few.

We had a similar problem and worked closely with our trusted pediatrician. There is one thing to keep in mind: Dry nights are a combination of

  1. reduced urine production during sleep
    (can be somewhat influenced by drinking the bulk of water earlier in the day, but only to a degree and in very hard cases chemically by prescription meds) and
  2. a wake-up reflex triggered by a full bladder.

Both are essentially brain functions that need to develop and there is little you can do to speed this up.

Contrary to popular belief, waking a child on a schedule can counteract the development of this mechanism - instead of letting the bladder trigger the wake-up, you do it even when it's not "full".

What helped us was watching / listening to our child. Shortly before the accident he would start to become restless, squirm or sigh in his sleep. Then we helped him to wake up "more" (not neccessarily fully awake - we can use the bathroom half-asleep, too) and go to the bathroom. We tried to let him do as much as possible himself, helping the synapses to grow. Had to steer him in the right direction occasionally, though.

The Bed-wetting "Alarms" or "Pads" work in a similar way: When a child needs to "go" and wets the bed, it wakes the child with a loud! alarm, trying to enforce the "need to pee" sensation with waking up, thus training the brain development. Your child falls into the typical age range where pediatricians start to recommend these tools (they don't work if the child is too young, they need to be "at the brink" of making the mental connection).

So either try the "vigil" (no need to sit next to him, a babyphone / open door will do) or talk to your pediatrician. Additionally, having his hormones checked could be a supporting strategy: The nightly urine production is regulated by a certain hormone which can, in some cases, be supplied.

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Not sure where you are based, but I know some parents who have tried a bedwetting alarm, which is basically a humidity detector connected to an alarm, which either wakes the child, or wakes the parents who then have to go and wake the child. (I guess it also requires that the bedwetting starts with a drip or a dribble and not the full Niagara)

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If there's no medical reason for the bed wetting I would suggest an alarm style system to wake the child up when they begin to wet the bed. I had the same problem for many years (into my early teens) and went to the doctors frequently but no issues were found, I tried several medicines to no effect. My parents tried most of the tactics you've tried and from personal experience it does nothing but make your child feel uncomfortable or bad about something they have no control over and want to stop doing anyway.

I went to an enuresis expert and got a little liquid sensitive alarm that you simply put between two pairs of underwear and attached the buzzer to a pyjama top. As soon as the alarm wakes you up you recognise the feeling of a full/bursting bladder and also stop peeing. After a fairly short time my body learned not necessarily to wake up to go for a pee per say but NOT to relax and start going when the bladder was full. It didn't change my sleeping pattern at all.

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