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Most parents are concerned when their
school-going children have nocturnal enuresis, i.e. persistent
bedwetting at night.
The Facts about Nocturnal Enuresis
1. The skill of being dry at night is
inborn and does not depend on training.
2. Most children become dry by the age of 5, a time when societal
contacts with friends become important.
3. Among school starters, approximately one or two children in each
class will be bedwetters. The prevalence of bedwetting at age 5-6 is
about 8-10% and at 7-10 is about 7%.
4. Nocturnal enuresis is more common in boys than in girls with a ratio
of 2:1 up until the age of 12.
5. Each year, approximately 15% of children will have their nocturnal
enuresis resolved. However, in 1-2% of these children, nocturnal
enuresis persists into adulthood.
The Myths about Nocturnal Enuresis
1. Bedwetting occurs in deep sleep
resulting in the child’s inability to wake up to void. Studies in sleep
research have not confirmed that nocturnal enuresis is an “arousal
disorder”. Recent researches also show that bedwetting occurs during
both deep and light sleep.
2. Chinese parents regard nocturnal enuresis as a “weakness of the
bladder” and the fold remedies they use to treat this are either a brew
of pig’s bladder with hot pepper or soup with ginko nuts.
3. Indian parents believe that there are “spirits” that cause
nightmares resulting in night time bedwetting. They will perform
special prayers to drive away the “evil spirits”. Some will also give
special bracelets for the child to wear or use some herbal remedies to
“cleanse the body from all evil”.
The Underlying Causes of Nocturnal Enuresis
1. Hereditary factor
If one parent had a history of childhood bedwetting or nocturnal
enuresis, there is a 50% increase likelihood that the child will also
have the same problem. If both parents were childhood nocturnal
enuresis sufferers, this likelihood increases to 70%.
2. Bladder muscle instability
3. Organic causes such as urinary tract infections
Note that in the absence of any other day time symptoms, both the above
are not causes of isolated nocturnal enuresis though.
4. Abnormal circadian phenomenon
Some children (20-30%) lack the normal increase in endogenous
production of antidiuretic hormone (ADH) during sleep. ADH is important
for urine concentration and hence smaller urine volume.
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