Sleep Enuresis Causes And Treatments

Sleep Enuresis Causes and​ Treatments
Sleep Enuresis, more commonly known as​ Bedwetting, refers to​ the​ lack of​ ability to​ maintain urinary control during sleep. This recurrent involuntary urination is​ also called Nocturnal Enuresis, which is​ characterized by at​ least two occurrences per month in​ 3 to​ 6 years old infants and​ at​ least one occurrence per month for​ older children.
Though it​ is​ considered normal for​ children below 7 years old to​ have enuretic episodes, 5% of​ 10 year old and​ 3% of​ 12 year old children, and​ as​ many as​ 13% of​ 18yearold teenagers may continue to​ experience this disorder.
Primary and​ Secondary Enuresis
Primary Enuresis is​ involuntary urination that occurs from infancy with at​ least two episodes a​ week, and​ comprised of​ 7090% of​ all cases. Secondary Enuresis, on the​ other hand, refers to​ a​ relapse after experiencing an extended period of​ dryness. Adults are more likely to​ suffer from the​ secondary type.
Causes of​ Sleep Enuresis
Sleep Enuresis can be caused by many factors including hormonal, dietary, or​ emotional factors.
One of​ the​ most common causes of​ Sleep Enuresis is​ the​ inability to​ develop the​ antidiuretic hormone cycle in​ some people. in​ this cycle, which is​ typically developed by individuals by the​ age of​ 2 to​ 6, the​ pituitary gland releases a​ hormone at​ night that promotes water retention in​ the​ kidneys, thereby reducing urine output till sunrise. Failure to​ develop this hormone cycle naturally leads to​ Sleep Enuresis.
An overactive bladder can also cause Sleep Enuresis in​ many children. By nature, muscle spasms occur in​ the​ bladder during urine retention and​ removal. When these spasms become too active or​ uncontrollable, the​ bladder is​ incapable of​ holding the​ normal amount of​ urine, which eventually results in​ accidental urination during sleep.
Another common hereditary factor is​ failure to​ develop an awareness that enables a​ person to​ awaken before urinating on bed. This awareness is​ normally developed by children during the​ natural process of​ learning how to​ control the​ bladder while awake.
Besides these common causes, medical disorders such as​ diabetes, urinary tract infection, sleep apnea or​ epilepsy and​ psychiatric disorders may also cause individuals to​ develop Sleep Enuresis.
Simple behavior modifications can be very effective treatments for​ children with enuretic episodes. for​ example, intake of​ liquids and​ dietary bladder irritants such as​ citrus products should be discouraged before bedtime. Taking note of​ when the​ enuresis actually occurs, and​ waking and​ taking the​ child to​ toilet before that hour, can also be very helpful.
Psychological treatments such as​ encouragement of​ selfreliance, participation in​ management, inculcation of​ selfrespect and​ responsibility are also recommended by many experts. Physical punishments and​ coercion, on the​ other hand, are considered to​ be the​ most counterproductive measures and​ should be avoided at​ all costs.
Using devices such as​ bedwetting alarms and​ moisture alarms, combined with bladder muscle exercises, dietary changes, retention control training etc can also be helpful remedies in​ treating Sleep Enuresis.
For some of​ the​ more severe cases that cannot be treated by behavior modification, alarm devices and​ other treatment methods, using medications such as​ Desmopressin, a​ synthetic substitute for​ the​ missing antidiuretic hormone discussed earlier, is​ found to​ be very effective. Desmopressins such as​ DDAVP, Stimate, and​ Minrin can easily be administered nasally or​ intravenously.

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