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Incontinence Advice

Bed Wetting in Adults: What Causes Nighttime Incontinence?

While many adults experience occasional night time disruptions, few realise that nocturnal enuresis—or bed wetting—may be more common than they think…
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Bedwetting is quite common in adults for a variety of reasons. However, it can be a frustrating experience and there is not always a straightforward answer. In this article, we will explore nocturnal enuresis in adults, a medical condition associated with involuntary urination at night. Don’t let your sleep continue being disrupted by untimely bed wetting - incorporate incontinence bed sheets to protect you and your bed.

Key points

  • Learn about nocturnal enuresis and how it affects adults.

  • Figure out the difference between persistent primary and adult onset secondary enuresis.

  • Identify factors like hormonal imbalances, bladder conditions, and lifestyle influences.

  • Understand how healthcare providers diagnose and assess the condition.

What is nocturnal enuresis?

Nocturnal enuresis, commonly referred to as bed wetting in adults or nighttime incontinence, is a condition that goes largely unspoken despite being relatively common. 


It affects approximately 1 in every 100 adults throughout their lives, many of whom remain quiet about it due to embarrassment. Nocturnal enuresis can disrupt sleep and impact personal relationships, yet with the right support, it is often treatable.
Nocturnal Enuresis - Causes of bedwetting in adults

Types of nocturnal enuresis

Nocturnal enuresis is made up of two primary forms:


  • Persistent primary nocturnal enuresis: This type begins in childhood when nighttime dryness has not been achieved continuously for more than six months. It persists into adulthood, affecting about 2-3% of the adult population.

  • Adult onset secondary enuresis: Here, an individual achieves nighttime dryness during their life but begins experiencing episodes of bed wetting at a later age, often triggered by other health issues or stress.

Causes of bed wetting in adults

There are many common underlying causes as to what can trigger bed wetting in adults. Traditionally, these causes arrive in the following forms: 


  • Hormonal imbalances: The body produces a hormone known as ADH (antidiuretic hormone) that helps regulate urine production at night. Insufficient ADH production or inadequate kidney response can lead to increased urine production. 

  • Medical conditions: Conditions like diabetes can affect ADH levels. Other medical issues such as bladder or prostate cancer, neurological disorders (e.g., multiple sclerosis, Parkinson’s disease), or physical problems like a blocked urethra or bladder abnormalities can also contribute to nocturnal enuresis.

  • Bladder capacity and overactive bladders (OAB): If the bladder cannot hold the urine gathered throughout the night, or if bladder muscles contract too frequently, it can result in involuntary leakage or overactive bladders.

  • Medications: Certain medications, including diuretics, sleeping pills, and some antipsychotics like Clozapine or Risperidone, may exacerbate or lead to bed wetting in adults. Those who handle sleep insomnia (or other sleep imbalances) or problems with their mental state, can also experience unwanted nighttime urination.


Other causes that can be less common are:

  • Blocked urethra

  • Constipation

  • Enlarged prostate

  • Sleep apnea

  • Pelvic organ prolapse

  • Problems with the bladder structure or from other urinary organs

  • Urinary tract infections or stones.

Diagnosing nocturnal enuresis in adults

To get a professional diagnosis to whether you are dealing with nocturnal enuresis, you should seek assistance from a healthcare professional who will perform a thorough examination to underline the signs, symptoms, and your medical history surrounding your night time incontinence. To aid the diagnosis, it's helpful to maintain a bladder diary to note the frequency and timing of bed wetting incidents, the volume of urine, fluid intake before bedtime, and any other relevant symptoms.

Diagnostic tests include:

Urinalysis

This test analyses a urine sample for signs of infections or abnormalities in the urinary tract which includes the kidneys, ureters, bladder, and urethra.

Urine culture

A laboratory test that identifies the presence of bacteria or yeast in urine, helping diagnose urinary tract infections.

Uroflowmetry

Measures the flow rate and volume of urine, providing insight into bladder and urethral function.

Post-void residual measurement:

Determines the amount of urine remaining in the bladder after urination, which can indicate issues with bladder emptying.
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Treatments for nighttime incontinence in adults

Natural treatments for nocturnal enuresis in adults can often be done from a lifestyle perspective in order to alleviate symptoms. Whilst you can adjust to these in your everyday life, you can also consult your healthcare professional for further information on which option is right for you: 


  • Bladder retraining: Scheduled trips to the bathroom both day and night can help increase bladder capacity. Gradually extending the time between bathroom visits trains the bladder to hold more urine.

  • Fluid intake: Limiting fluid intake in the hours before bedtime reduces urine production at night. It's also advisable to avoid caffeine, alcohol and other diuretics that are classed as foods and drinks that irritate the bladder.

  • Bedwetting alarms: These devices detect moisture and alert the individual at the first sign of wetting, helping condition the brain to respond to bladder fullness.

  • Setting waking times: Using a random or scheduled alarm to wake up and empty the bladder during the night can prevent incidents. Varying these times can help prevent the body from adapting to a set schedule, thus improving the effectiveness of this strategy.


Also be sure to avoid drinking right before bedtime as this will most likely trigger nighttime incontinence.

How to deal with wetness in bed

Managing bedwetting in adults involves more than just the right products; it also includes daily practices to protect the skin and bedding:


  • Waterproof protection: Using waterproof mattress covers or pads helps protect your bedding from moisture. This barrier not only keeps the bed dry but also extends the life of your mattress.

  • Absorbent underwear: Wear absorbent underwear such as incontinence products specifically designed for overnight use to reduce the risk of leakage.

  • Skin care: Maintain skin care by using gentle, MoliCare® skin cleansing foam, barrier creams, and other skin friendly lotions. This helps prevent irritation that can be caused by exposure to moisture.

  • Consult your healthcare professional: If initial treatments do not work, consult your healthcare provider. Managing adult bed wetting sometimes requires trying different strategies or products before finding the most effective solution.
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How HARTMANN Direct and MoliCare can help with bed wetting

Our day and night incontinence range are the perfect products for those that have to handle unwanted urinary incontinence during the day or even at night. Whilst it can be a challenge to sleep comfortably whilst wearing incontinence pads, our range is designed to rapidly absorb leakages whilst remaining comfortable on the wearer. Maintaining a suitable horizontal sleeping position is still possible whilst wearing these.

Supportive clothing

Unlike daytime outfits, nighttime clothing tends to be less structured, which may cause incontinence products to shift. Fortunately, these MoliCare® net and fixation pants provide the perfect solution, with a secure fit made up of a two-piece fixation system, ensuring that the product stays in place all night. 

For those that still remain active whilst handling incontinence, these products are also the perfect solution for those concerned about potential leakages during exercises such as weightlifting and other sports with incontinence.
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Further reading:

It is clear that nighttime incontinence is strongly tied to certain lifestyles and other incontinence issues. For an expanded understanding of bed wetting in adults, try these articles:
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  • Sometimes consuming the right bladder friendly drinks can help make your bladder feel less irritated and prevent bed wetting.

  • There is a strong correlation between nocturnal enuresis and stress; understand stress indigestion symptoms and how this could affect your bladder and bowels.

  • Develop a healthy lifestyle for over 50s to combat issues that often come with old age including, but not limited to, bed wetting.

FAQs

When should I be concerned about bedwetting as an adult?

You should be concerned about bedwetting as an adult if it occurs suddenly or regularly, as it could indicate an underlying medical condition such as urinary tract infection, diabetes, or neurological disorders. Consult a healthcare provider if adult bedwetting persists or is accompanied by other symptoms.


Can stress cause bedwetting in adults?

Yes, stress can cause bedwetting in adults. Stress and anxiety can disrupt normal bladder function and sleep patterns, leading to incidents of bedwetting. Addressing the underlying stress or emotional issues may help resolve the problem.


When to worry about bed wetting?

Worry about bedwetting if it is recurrent, sudden in onset, or associated with other symptoms such as pain, discomfort, or changes in urine colour or frequency. These could be signs of a more serious health issue, and it would be advisable to seek medical evaluation.

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