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Why are two of my older children wetting the bed?

One of our directors, Leslie Miller, sat down with the mother of two children who completed treatment with us.  While she is happy her children are free from the burden of bedwetting, she remains frustrated that bedwetting is still misunderstood by doctors, and that there is so much misinformation on the internet that leads parents astray.  She is speaking out because she wants this to change, and we couldn’t agree more! (We are referring to this woman as “Mom” for purposes of this article).

Mom – When I told my pediatrician that my second child was wetting the bed–my daughter–it was the same response as when I sought advice for my son who wet the bed. I already knew I was going to enter her in your bedwetting treatment because it worked for my son, but I was just curious to see what he would say. He basically said not to worry, she would outgrow it. He never asked about how my son was doing with his bedwetting.

Parents need them to know about your clinic because you only work with bedwetting. And since the bedwetting is not the real issue, this can be very confusing. When I was so frustrated with the lack of direction from the pediatrician for my son, I decided to research the heck out of bedwetting! Your website came right up for me, and I read everything. The sleep part and the other symptoms, it described my son – and now my daughter. Pediatricians don’t know about you. They need to know about you.

Leslie – Some know about us, yet there are roughly 85,000 pediatricians in the United States, and we haven’t been able to reach them all….to educate them.  We have found over the past 44 years that pediatricians tell you not to worry and wait until your child outgrows bed wetting. This is the first and foremost suggestion.  The next step for a pediatrician is to rule out a physical cause, which leads to a referral to a urologist. Less than 1% of bedwetting is caused by a physical problem. There is nothing physical or psychological in origin about bedwetting.  Even if someone fell into the 1%, there wouldn’t be anything a urologist could recommend to remedy the problem. Fortunately, there are specialists who are in the know, and we have received referrals from physicians, psychiatrists, psychologists, and social workers.

Mom – They don’t know about you here in Texas. They should know. They should know it is a sleep problem. They think there is something wrong internally with the person. Like my son was six – bedwetting. Seven – bedwetting.  And then by age eight, the doctor said we will try something to stop the wet bed. I mean he’s 8 now. Living 8 years with bedwetting. And now he said we will give him pills and try to stop bedwetting. Then I researched the hell out of the pills, and you know what, they dry up the urine and dehydrate the body,  and have a ton of side effects.

Leslie – Was the medication called DDAVP? It actually slows down kidney function and may limit urine production temporarily.  It does not cure bedwetting. Thousands of parents have called us and reported trying DDAVP*.

If it worked for someone at all, they have seen the bedwetting return when they stop dosing. Or it doesn’t work to begin with even at the highest dosage.  The worst thing we hear is that a doctor assured someone their child can attend a sleepover and not worry about them wetting their sleeping bag because the drug will prevent it…and then the child actually does wet.  It’s disheartening, unfortunate, and unnecessary. The pediatrician is not looking at the root cause, they are looking at treating the symptom of bedwetting, and we all know that’s not an effective means to permanently change anything.

Mom – Exactly. They are really not a bedwetting specialists, are they. They are not paying attention to the impact the bedwetting is having on someone. It was having an impact on my boy. His sleep was terrible. He was difficult to get up in the morning–cranky and tired. That tiredness carried through his school day.  He was always worn out from using up his energy during school. Then he had a great deal of homework. We had to constantly keep him on track to finish his homework. And then this poor kid wakes up wet, does not know why, feels terrible, and we couldn’t bring much comfort to him. It was exhausting for the entire family. I know he was embarrassed and frustrated. He was refusing offers for sleepovers. I asked him what worried him the most and he said that he would be bullied for life. His friends would turn against him, and he would be alone. It broke my heart.

Honestly, I find it hard to recommend you to people. No one talks about it openly. When you gather around with friends, you don’t bring up “oh yeah, my ten-year-old still wets the bed”.  I mean really, nobody talks about it because it’s embarrassing. I want to talk about you and the success my son had because I know there are people who need your help. Out of all of this, I think the most important thing people need to know is how crappy the sleep is. It’s hard for them to put two and two together based on the misinformation you come across online.  For my son now, the fact that he is getting ridiculously good sleep impacted his life right away…in every way. Once you understand, bedwetting is really the secondary issue. I just don’t know how to phrase it in a way that will help others without embarrassing my son and my daughter.

Leslie – What do you think is the real concern here?

Mom – It’s like taboo. Nowadays people who are gay are coming out, but bedwetting is such a shame…still that it has to stay a secret. It is a stigma and sad. I was not about to have my son wet year after year and suddenly he is a teenager and wetting the bed.  I read about how teen bedwetting is on the rise because parents wait and wait. They aren’t to be blamed. They’ve just been brainwashed that that’s what there is to do. To wait. I found also that some people believe that the person who wets the bed has a problem…like they are doing it on purpose. I have heard people say bedwetters are babies, refuse to grow up, or have mental problems. Can you believe in 2018 that anyone would think that?  It’s truly unbelievable that few people know it’s a sleep problem – truly a sleep problem. Crappy sleep. How can someone do their best if they are not getting good sleep night after night on top of feeling terrible and tired, and for my daughter, feeling sad and as though something is really wrong with her, especially wearing pull-ups at age six. If everyone would just go to your website, it would become crystal clear.

Parents need to Google for an expert. You will show up and tell them everything. Everyone thinks you go straight to the pediatrician for this problem. Western society is like that.  They don’t give you a clear-cut plan or pay attention to everything that is going on with the sleep. They really don’t know, and they won’t admit they don’t know. I guess they also don’t have time.  You need to train the pediatrician about the cause, not just the symptom of a wet bed. I think underneath it all, they are interested in treating the source for their patients, but if they can’t get to it, they go with helping someone live with the symptoms of their illness or challenge, and that is truly unfortunate.  I think you need to go right to the medical schools and tell them what you know.

Leslie – What an insightful idea. Thank you so much.  And thank you for your time today. We appreciate you, and it’s been a delight to work with you and your children.

* https://www.kidney.org/patients/bw/BWmeds

* Desmopressin Acetate (DDAVP)

  • DDAVP is a drug to treat children with bed-wetting. Although DDAVP does not cure the condition, it does help treat the symptoms while the child is on the drug. Numerous studies report reduction in the number of wet nights.
  • DDAVP is a man-made copy of a normal body chemical that controls urine production. The therapeutic benefit of DDAVP might be due to a reduction in the overnight production of urine or possibly to an effect on arousal.
  • Many studies have attempted to identify those childrens most likely to respond to DDAVP. Older children are more responsive. Children with a normal bladder capacity are more likely to respond than those with a small bladder size.
  • The drug can be taken as a nasal spray or tablet. However, the tablet has several advantages. If your child has no problems swallowing pills, the tablet is more discreet for sleepovers and other special occasions. Additionally, the tablet has reported a better response rate. The nasal spray can be affected by a stuffy nose from colds or allergy. DDAVP should be given at bedtime. Because it works right away, it does not need to be given everyday to be effective.
  • DDAVP has few side effects. The most common side effects with the nasal spray are nasal discomfort, nosebleeds, tummy pain, and headache. The only serious side effect noted in children treated with DDAVP is seizure due to water intoxication. This serious problem is preventable with care not to overdo fluids on any evening that DDAVP is taken. Children should take only one eight once cup of fluid at supper, no more than 8 ounces between supper and bedtime, and nothing to drink in the two hours before bedtime. Early symptoms of water intoxication include headache, nausea, and vomiting. If these symptoms occur, the medication should be stopped and the child should be seen by a doctor immediately. Caution should be used in children with attention deficit hyperactivity disorder since they are often impulsive. These children might require especially close monitoring of their fluid intake.

What Can I Do About My Child’s Bedwetting

Dr. Wendy Glaberson’s April 10th, 2018 article in the Miami Herald, “What Can I Do About My Child’s Bedwetting?” is well intended, however, it is filled with myths that we at the Enuresis Treatment Center have seen all too often.

To be brief, here are Dr. Glaberson’s errors and our responses to them.

  1.  Enuresis most common cause is constipation leading to “dysfunctional elimination syndrome” that causes bedwetting.

ANSWER: Enuresis Treatment Center has successfully treated thousands of bedwetters throughout our forty three years of work.  A very small percentage        of our patients, regardless of their age, from five to fifty, also report constipation.  Our treatments 97% success rate is directed toward ending the underlying deep sleep/arousal disorder that is at the heart of the problem.  Patients suffering from constipation either remain so after the bedwetting is ended or no loner suffer from the problem due to the “fluid challenge” impact of our treatment program.

Our 43 years of treatment of enuresis has shown us that constipation and enuresis are not clinically related.  Constipation does not cause bedwetting.

  1.  ADHD or anxiety are causes of enuresis.

ANSWER:  Many of our patients present with one or both of the difficulties.  However, we have found that hyperactivity symptoms disappear when the underlying unhealthy deep sleep is treated, resulting in a return to more healthy sleep.

Also, many of our patients, regardless of their ages, experience anxiety which does not cause the bedwetting, but instead is the psychological result of the many stresses that the bedwetting produces – fear of discovery, feeling of failure, low self-esteem.

  1.  Enuresis can happen in the daytime.

ANSWER: Enuresis, i.e. bedwetting occurs only at night.  It is the involuntary release of urine during sleep.  Children who cannot control their bladder while awake are experiencing daytime accidents usually resulting from the bladder sphincter muscle’s weakness due to its frequent opening during sleep.  The bladder sphincter cannot remain closed during the day because it has not been kept closed automatically during the night.  Those bladders do not develop the strength to remain closed during the day when the urge to urinate first arrives.  Daytime accidents result.  They are a major source of anxiety that results from bedwetting, not the cause of it.

  1. Enuresis is caused by making large amounts urine overnight and having a bladder that does not relax properly to fill and store urine.

ANSWER:  Someone who wets the bed almost always has a very small bladder.  A small amount of urine can trigger the sphincter to open since the enuretics’s deep sleep cannot be aroused enough for the brain to send the “stay closed” signal to the sphincter.

As a result, the bladder does not grow or cannot hold the “large volume of urine” that Dr. Bladerson reports. Someone who wets the bed does not produce any more or less urine than non-bedwetters.  The difference between them is the brain-bladder connection with the deep sleep.

  1.  Dr. Glaberson recommends: 1) regular bladder emptying during the day and before bedtime, 2) use of laxatives to aggressively treat the underlying constipation, 3) behavioral therapy and positive reinforcement as methods to treat bedwetting.

ANSWER:  Regular bladder emptying can make the bed wetting problem worse.  Emptying bladders lead to the bladder’s failure to grow and retain urine.  The bedwetting process is accelerated by the proposed method and daytime accidents are much more likely to happen.

We have found that only by treating the underlying deep sleep/arousal disorder, regardless of constipation, if it presents at all, can bedwetting be permanently ended.

Behavioral therapy and positive reinforcement only works with difficulties that can be brought under the patients control.  Bedwetting does not respond to such treatments because it occurs when the bedwetter is not awake. It is involuntary.

Dr. Glaberson is correct when she opines that medication used to treat bedwetting “does not cure the problem but helps control the symptoms”.  Ending the medication often leads to a return of the bedwetting.  Should the medication be used lifelong?

  1. Dr. Glaberson recommends the use of pullups inside of a sleeping bag for enuretic children who attend sleepovers.

ANSWER:  While this method can work in the short term, it does very little to decrease the possibility of discovery and the shame it can bring.  The “logistics” of the recommended method are daunting.

Dr. Glaberson’s article remains a repository of the myths and misconceptions that the medical field unknowingly promotes.  Physicians can be wrong. Her article supports this opinion.

Author – Dr. Lyle Danuloff, Staff Psychologist, Enuresis Treatment Center

Dr. Glaberson’s article

What can I do about my child’s bedwetting?

BY WENDY GLABERSON, M.D.

April 10, 2018 04:06 PM

Enuresis, also known as “urinary incontinence” or “bedwetting,” can be extremely distressing for both parents and children. It can lead to lower self-esteem in children, frustration among caregivers, and disruptions in sleep for both.

Enuresis is a common problem in the United States with approximately 5 million children affected, with boys experiencing it three times more often than girls do. Enuresis can run in families — often times a parent will come to the office and say that he or she also “wet the bed” when younger. In most children, it will resolve by the age of 6 years. When it persists much past that age, particularly when a child begins sleeping outside the home, at sleepovers, is typically when it becomes most distressing.

There are some known risk factors for enuresis. One of the most common ones is dysfunctional elimination syndrome. This syndrome represents a collection of abnormal urinary patterns associated with constipation. For example, it can mean your child is holding his or her urine for too long and overstretching the bladder, or having difficulty relaxing the bladder outlet during urination, straining the muscle. Other risk factors for enuresis are breathing problems such as sleep apnea, or neuropsychiatric disorders such as attention-deficit hyperactivity disorder (ADHD) or anxiety. Constipation and sleep apnea should be treated by your child’s pediatrician or another specialist. Children with ADHD should be reminded to empty their bladders every few hours.

Enuresis can happen during the daytime, but it is more common overnight. There are two forms of enuresis, primary and secondary. Primary enuresis is more common and means that your child has never been completely dry. It can be caused by making large volumes of urine overnight, having a bladder that does not relax properly to fill and store urine, and lower than normal levels of a hormone which causes water retention by the kidney. With secondary enuresis, your child was previously dry for a period of at least six months and is now experiencing symptoms. Causes include bladder infections, things that cause large volumes of urine such as diabetes, and emotional stress or trauma in a child’s life such as a family divorce, bullying at school or the loss of a beloved pet.

If your child is experiencing enuresis, see your pediatrician first. He or she can likely make the diagnosis with a simple history and physical examination. In addition, your pediatrician may want to screen your child’s urine for infection or excess glucose. Imaging studies are rarely needed to make the diagnosis.

Most parents recognize enuresis but don’t know what to do to treat it. Parents should understand the natural history of the problem — that it’s developmentally appropriate in young children, and that most children will “grow out of it.” If enuresis is a stressful problem in your household, here are some of the available treatments to discuss with your pediatrician:

  • Minimize the amount of fluids your child drinks after dinnertime.
  • Encourage your child to empty the bladder regularly during the day and before bedtime.
  • Treat constipation aggressively with laxatives such as polyethylene glycol. Stool should be soft like a banana and come every one to two days.
  • Some families find success using a bedwetting alarm: a device which is placed in the child’s bed and will activate if it becomes wet. This type of device is used every night and improves arousal from overnight bladder filling and storage of urine, through repeated conditioning.
  • There are also formal programs developed by pediatric psychologists that use behavioral therapy and positive reinforcement —often in conjunction with bedwetting alarms. These programs are more successful when implemented consistently.
  • If your child is over the age of 6, your pediatrician may refer you to a specialist with advanced knowledge in medications to treat incontinence such as a nephrologist or urologist. These specialists can prescribe medications which are taken every night to help keep your child dry. These medications do not cure the problem, but they help control the symptoms. One type of medicine called desmopressin leads to decreased urine in the bladder, another type called imipramine causes the bladder to retain urine overnight, and still another called oxybutynin relaxes the bladder muscles allowing it to fill more normally and empty completely with regular voiding. These medicines are often successful.

What can you do for your older child in the short term who wants to stay at a friend’s house without suffering embarrassment? One suggestion is to send your child with a pull up inside of his or her sleeping bag. This technique offers a little more housework for a parent, but allows your child not to miss out on fun with friends. Finally, a closing note — if your child or your family dynamic is suffering from incontinence, we can offer hope — 99 percent of cases spontaneously resolve without the use of medications.

Dr. Wendy Glaberson is a pediatric nephrology fellow at the University Of Miami Miller School Of Medicine. For more information or to find a doctor, contact the UHealth Pediatric Nephrology department at 305-585-6726. 

Read more here: http://www.miamiherald.com/living/health-fitness/article208490119.html#storylink=cpy

 

Stop Bedwetting – Happy 10-Year-Old Boy

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“First of all, I can’t pull this part to I say thank you to the whole team over there. I think it’s only those families who are in the same situation as we were What a huge relief it is for everybody really to get to this point to have a child who is not wetting the bed anymore.

I can say now that I have a happy 10 year old boy who is highly intelligent and proud and confident and happy! For me to be able to see my boy going to a birthday party and sleep over night and have no fear of wetting the bed at someone else’s house is the most important to me.

There was a time when I thought maybe we would maybe never get to this point, but we did it. It’s only because we got into this program to end bedwetting, which i think is wonderful. I had Claudia –wonderful Claudia–all the way supporting us.

I had my moments when all the family found it difficult to keep on going and do the practice and do everything that we were asked to do, but it was worth it….more than worth it.

I would encourage all the families in the world to try this method–to go after the problem– because bedwetting is not something that will just disappear by itself. This is something we are told; that it will disappear through time. I think this is the biggest problem–that we believe in it–and we keep waiting and waiting.

I just couldn’t understand why we didn’t find your bedwetting program sooner.

I’m glad we found it. It’s so logical.”

Miriam G

Sarasota, NY

Our whole team thanks you for sharing your experience with the Enuresis Treatment Center for Bedwetting.

To listen to additional audio testimonials click here

To watch videos click here

 

16-Year-Old Continued Wetting the Bed – Why Trust Us?

Bedwetting counselor, Claudia, works at Enuresis Treatment Center

 

We are always grateful when a family wants to share their experience with other parents searching for help for their child, especially a teenager, to stop wetting the bed.  Here is the written version of this mom’s conversation with her counselor, Claudia, as they were completing treatment.

MOM: I’m so unbelievably grateful, and also just to this company. Words can’t begin to describe how truly thankful we are for all it has done.

After so many years of dealing with this problem, I can’t believe it’s no longer an issue in our house. I have a very healthy, happy, dry 16-year-old, so we just want to sincerely say thank you.

Our previous experience was with a company called Pacific International. It was a very long and draining experience that we had, and it was also unsuccessful. We started the program when my son was nine years old, and were very optimistic that it was going to help him.

We tried on our own, but knew we needed help at that point.

I’m sure as anyone knows who is dealing with this bedwetting problem, it’s very heartbreaking to see your teenager wake up wet every morning.

Pacific International told us that the program should work anywhere between one and two months to six months to a year at the longest.

My son was on that program for four years. At that point we said that that was enough, and we asked for a refund. They pushed off that request, and asked if we could try a couple more things.

Of course we did. We wanted to try more things because we wanted our son to be dry more than anything. The money wasn’t that important; we just wanted to get him dry.

The things they asked us to do were things we had already done and that hadn’t worked the first time, but we still tried.

After another long period of time–probably more than six months at least–we called it quits. To this day, we never received a refund that was promised, and I know we never will.

But we stayed with that program for so long–probably over the course of six years–because we wanted for our son to be dry.

We honestly didn’t know what else to do at that point. We just had no other answers. We were hoping and praying that he would grow out of it on his own, but he never did.

So for about a year, we just did nothing. Sometimes he would have long stretches of dry periods, and sometimes he would have long stretches of wetting. At this point, he was approaching 16 years old, and we knew we needed help, and that’s when we found the Enuresis Treatment Center.

CLAUDIA: Wonderful! So why did you trust us? What made you trust us?

MOM: First of all, we loved how the company began…by a woman looking for a solution to help her daughter. Gaile was wonderful on the phone. We knew a lot went into finding and researching solutions that worked, and we were just very impressed by all the people we spoke to.

I’m going to be very honest with you. We were very skeptical about this program –as you can only imagine — after all we had been through. We were also very tired and drained from working so hard at this for so long with no results.

As much as we were hopeful and optimistic that this was finally our answer, we went into this without that brand new excited energy that you might have when you start something new, but something felt different, and we knew that we were going to give it a shot.

CLAUDIA: Do you have any difference you want to share with us?

MOM: There were a lot of differences to the program actually that we found. While some of the methods were actually similar in nature, ETC had a lot of positive differences. For one, just the equipment in general. It was so much more comfortable for my son and so much easier to use. Also, a couple of the simplest exercises that he did on your program were so effective, and he had never done that before in the past –they were never presented to him. That was a great step, and obviously that worked.

One other big difference that comes to mind. On the other program, the only communication we had with our caseworker was through the mail. If we had problems or concerns, we would call, but it was not on a regular basis. Only as needed.

Here with you, we were assigned a wonderful caseworker who I spoke with every two weeks. It was wonderful; so personable. I was able to ask questions–even the smallest ones– regarding my son in particular. It was personal in nature, which was great. It was a great process.

Listen to the audio version of this conversation here http://172.81.118.1/~nobedwetting/testimonial-audio/

Case Study of Adult Bedwetting Patient

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This is a case review of a 42-year-old Caucasian male, who we will refer to as William. He was suffering from bedwetting for his entire life.  Bedwetting is also known as nocturnal enuresis and primary nocturnal enuresis.   William reached out to our clinic after reading about our expertise in solving adult bedwetting.  He commented about his experience of relief while reading our website information, and that it made so much sense.  He then knew unequivocally that his heavy, deep sleep had to be the underlying issue, not only for his years of nighttime accidents, but also for his teenage son’s bedwetting.

Family History of Bedwetting:  

William’s father experienced bedwetting into his teen years.  William’s grandfather also wet the bed as a teenager.  His father’s father experienced teenage bedwetting as well.  Now William’s son continues to experience nighttime bedwetting as a teen.  He has always wet the bed – never been dry at night.

In recent years, William’s father was diagnosed with sleep apnea, and he currently wears a c-pap device, also know as a continuous positive airway pressure therapy, to help regulate breathing.  This is not an uncommon diagnosis stemming from the sleep disorder with which we work.   Also, not uncommon is the sleepwalking and night terrors experienced by his aunt.  These are symptoms that cannot be eliminated.  The only possibility is to manage these symptoms as best as somebody can.  Since bedwetting was “outgrown” by his dad and aunt, the detriment it poses is that these other untreatable conditions can surface and affect quality of life.

We know  a new pattern of sleep is needed which will not only eliminate bedwetting; it will also cut off the possibility that the untreatable conditions will arise.   

Dr. Roger Broughton, a neurologist and foremost sleep researcher from McGill University in Montreal, is an expert upon whose findings have led to our initial protocol.   He highlighted a condition called deep-sleep bedwetting.  The sleep study conducted by Dr. Roger Broughton is titled, “Sleep Disorders: Disorders of Arousal? Enuresis, Somnambulism, and Nightmares Occur in Confusional States of Arousal, not in “Dreaming Sleep.”

The result of this study shows the differences in normal sleep patterns and those of a bedwetter.  In normal sleep, people fall slowly from Stage 1 (lightest sleep) into Stage 4 (deepest sleep), and then back to lighter stages where it’s easy to awaken.  A full cycle takes approximately 90 minutes to achieve.  A person who wets the bed falls quickly into deep sleep and stays there for longer periods.  This is the problem.  The brain is not supposed to stay in Stage Four for very long.  Cycling doesn’t take place consistently throughout the night, and the bedwetting occurs as a result.

The study’s findings concluded that all bedwetters share a deep sleep pattern. Our center has decades of clinical and anecdotal experience, which proves that the only effective treatment and cure for bedwetting is to change the pattern of sleep. Chronic bedwetting is the symptom caused by the inherited sleep disorder. This same sleep disorder causes sleep apnea, excessive snoring, sleepwalking, night terrors, insomnia, and bruxism.

This type of deep, heavy sleep produces a poor-quality sleep rather than a high-quality sleep.  The infographic below illustrates the effects of sleep deprivation:

sleep deprivation

Initial Assessment:

A thorough assessment, required for preparing for one of our programs, revealed  that he also experiences difficulty awakening in the morning, had sleepwalking episodes as a child, and was prescribed Ritalin during his late teen years to help with focusing and hyperactivity.

When we discussed the frequency that the bedwetting is occurring, William claimed he has wet the bed every week of his life.  In the past year he has seen an increase in the frequency of the bedwetting with a pattern of two to three times a week on average.  

Currently he has no medical issues other than seasonal allergies.

He has previously – during childhood and even as a teen – been examined by two pediatricians, three urologists, and a neurologist to determine a cause of the bedwetting, also know as primary nocturnal enuresis.  At no time was a physical symptom diagnosed.  Enuresis workups included:  Urinalysis, urethral obstruction scope, several ultrasounds, and an MRI.  

According to the American Pediatric Association, less than 1% of bedwetting is caused by a physical problem.

He stated that typically the physicians’ focus of bedwetting treatment was placed upon managing the bedwetting rather than a full resolution.  After a failed attempt using a bedwetting alarm, being told to wait and do nothing until puberty when he is likely to stop wetting was the direction his parents were given.   Clearly it turned out to be inaccurate (as it is with most of our patients)

He did not recall a physician providing any statistics regarding the length of time he would suffer from bedwetting, and of course he was not provided the statistics for primary enuresis: 1-30 for teenage bedwetting or 1 -100 adults who would continue wetting the bed as an adult.  

No medications were prescribed until he reached age 24.  Over time, he was placed on three different drugs, which included Ditropan and Tofranil to no avail.  His last desperate attempt was with Desmopressin.  William researched the side effects of Desmopressin when the dosage was increased to three pills each night, and when he started regularly feeling queasy and irritable, which he said was not typical.   William lives in a warm climate, is physically active, and knew how important hydration was to his well-being.   Desmopressin is meant to purposely cause dehydration in the body in an attempt to eliminate the bedwetting.  When his discovered the extensive list of side effects of Desmopressin, as well as the ineffectiveness, he stopped taking the drug immediately.

What makes drug intervention for bedwetting a completely ineffective approach is because it doesn’t remotely touch the causal factor of the core issue – sleep.   

Below is a list of some of the side effects of Desmopressin.  

Source  https://www.rxlist.com/ddavp-side-effects-drug-center.htm

Also known as DDAVP, it is an antidiuretic and anti-hemorrhagic drug used to treat bed-wetting, central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma. DDAVP is also used to treat bleeding due to platelet dysfunction. DDAVP is available in generic form.

Common side effects of DDAVP include:

Headache, nausea, upset stomach or stomach pain, diarrhea, or flushing of the face (warmth, redness, tingly feeling). DDAVP can infrequently cause low levels of sodium in the blood, which can be serious and possibly life-threatening. Seek immediate medical attention if you have symptoms of low levels of sodium in the blood, including:  loss of appetite, nausea, vomiting, severe headache, muscle weakness/spasms/cramps, weight gain, unusual tiredness, dizziness, severe drowsiness, mental/mood changes (confusion, hallucinations, irritability), loss of consciousness, seizures, or slow/shallow breathing.

Physicians continued to tell him he was not trying hard enough, which he confided was scarring his self-esteem, and resigning him to the point of view that he would have to live out his life continuing to wet the bed. He expressed a deep resentment over the dismissal of this problem of wetting the bed, and was amazed and confused that it would even be intimated that he hasn’t done his part to end the stress of this condition.  

We can see more about how the problem with doctors saying bedwetting will be “outgrown” can cause psychological havoc to its victims, attacking self-esteem, increasing a sense of failure, and feeling “different”.   For many of our adult patients, they tend to live more solitary lives because they feel too uncomfortable disclosing the bedwetting to a potential mate.  Unfortunately, intimacy often becomes what they feel is an impossibility to them.   We understand it can be difficult to open up to somebody about this condition.  Many adults in our program have expressed anger or sadness or regret for having “missed out” on opportunities as a result of having to hide an extremely sensitive and often shameful part of their lives.

He was highly motivated to enter as well because his wife had recently filed for divorce.  One of the reasons involved her perspective on William’s bedwetting.  She eventually began to accuse him of deliberately wetting the sheets.   In fact, in a most unfortunate experience for William, his wife used this perspective and had her attorney introduce it publically in divorce court.   We have the utmost respect for William to ride that through, and then do whatever it would take to eliminate a problem that he thought he had no control over, and that has clearly impacted his life to the extent of being publically humiliated.  

Enuresis Treatment Center

Years of research and development dictates a two-week meeting schedule in order  to properly develop a  personalized plan.  We assign to our patients one of our staff counselors to work closely with them and facilitate their plan.  Our counseling staff includes a school psychologist, nurses, and teachers.  William was offered the opportunity to conduct his appointments via Skype.  He chose instead to have phone contact because, as he described, “the pain and embarrassment is too deep to face anyone”.

Our protocol dictates that our Director of Treatment reviews each case before a customized program is designed.  It was determined that a male bedwetting counselor would work with William throughout his program.  

Focus was placed upon ending the heavy and problematic sleep that had caused the continuation of the nocturnal enuresis.   Besides the enuresis, William presented with always feeling unrested, having difficulty focusing, being exhausted upon awakening rather than refreshed, and becoming more and more withdrawn over the years.  

We found out that William had symptoms of urgencies, a need to empty his bladder multiple times during the day, and we know this was attributed to the bedwetting itself.  It was determined that this is an actual a symptom of the bedwetting because the bladder tends to remain underdeveloped as a result of emptying regularly in the night.   We therefore developed and implemented a seriesces of targeted exercise, introduced at varies segments of his program ,develop to needed to fully support him and thus eliminate excessive needs to urinate during the day.   

In week six of our progressive and holistic approach, William began to see a change in his wetting pattern, and he was thrilled.  Of course, he would be!  For the first time in his life, he began to see progressive results leading to an end to the bedwetting.  He told his counselor that he was able to see progress and the finish line was in sight!

What is required for each appointment is pertinent data as it relates to the bladder development and the sleep intervention training.  Incremental changes are often difficult for the patient to detect, but the job of the bedwetting counselor is to identify and design the next step to maintain progress.

Enuresis Treatment Center’s sleep training protocol focuses on the relationship between the deep sleep and the disconnect with the bladder signals.  

As we know, the brain becomes less malleable as we age, and it was known that Williams program would possible take longer than it would take a child’s brain to respond.  

William’s counselor noted that he followed all directives in a timely fashion.  The Reinforcement Phase took longer, as was anticipate, but completed.  His counselor was satisfied, via current data, that his new sleep pattern had emerged.  The bladder and brain synchronized and the adult bedwetting ceased to be a problem.

William entered his teenage son into one of the Enuresis Treatment Center’s specialized teenage bedwetting programs four week after he finished his program.   
Source of graphic:
http://jonlieffmd.com/wp-content/uploads/2012/07/800px-Effects_of_sleep_deprivation2-300×220.png

Author Michael Stallsmith, M.A., Sp.A.

The Enuresis Treatment Center’s Director of Treatment is also a school psychologist.  Michael Stallsmith has, over the past 20 years, been involved in over 20,000 cases.  He is responsible for overseeing the counselors on our staff who work directly with the patients, and he is effective at implementing what’s needed for any challenging situations that may arise during treatment.

Michael continues his outreach with the medical community and school systems educating them about bedwetting and its relationship to the non-arousable sleep disorder.  Michael has been on staff at the Enuresis Treatment Center since 1982.