Sleep disorders is a field that can cover just about any human condition—imagine if there was a field a “wake disorders.”Usually though, the bladder and sleep are used in the same sentence only in regards to older men with larg prostates. That is, waking up to urinate 1 to 3 times per night is quite common in this age group because the prostate makes it difficult to fully empty the bladder, so it fills up again more quickly.
A worse problem is NOT waking up to urinate. I saw JC again today, a 14 year old boy who has wet the bed almost every night of his life since being out of diapers. He has seen his pediatrician and worked with a urologist. He has had tests on his bladder—it is normal in all ways—and taken several medications. These medications are of various types to decrease bladder tension, increase tension in the bladder outlet, and to decrease the amount of urine made. Nothing has helped. The “bell and pad” method, wherein a mattress pad beeps as soon as it gets wet has not helped. Have any of you parents had experience with treatments for bedwetting? Have medications like imipramine, amiytriptyline, or DDAVP been successful?
Although most kids outgrow enuresis—and JC probably will in the next year or so—it is unusual to persist into teen age years, and JC looks even older than 14. It can be considered a sleep disorder because the urination occurs during the deepest stages of sleep—stages 3 and 4, also called slow wave sleep, or delta sleep. It’s kind of like sleep walking—there is a disconnect between the physical activity and the state of mind. The body just does it’s thing, even though the brain remains awake. JC snores, and sometimes snoring produces brain (EEG) arousals that trigger activities like sleep walking. We’ll see if treating snoring stops the bedwetting in this nice young man. It would be very interesting to know if others have had success with enuresis by treating snoring in children.
