Help for adult bedwetting

Dear Alice,

When I was a child, I used to wet the bed. This finally cleared up when I was about twelve. In the last month or so, it has come back — except it's even more embarrassing now because I'm twenty-eight and share my bed with my husband! It started when I had a bad cold, so I thought perhaps it was just stress incontinence caused by coughing while asleep. I do suffer somewhat from stress incontinence, but I learned to deal with it when awake by clamping my legs together whenever I cough or sneeze. I talked to my doctor about this, and he also thought it was due to coughing while asleep. He treated my cough and assured me that once the cough was gone, the bedwetting would be, too. Well, my cough has cleared up, but I am still wetting the bed almost every night! It's mortifying, and I feel like my husband finds me disgusting (not that I really blame him). He says it doesn't matter to him, but I feel like I ought to be put in a nursing home. Is there anything I can do to stop this?

Dear Reader, 

Props to you for sharing your story about adult bedwetting. Although it may feel awkward, you’re certainly not the only person to have this experience. From what you’ve shared, your history of stress incontinence may have resulted in nocturnal enuresis (NE), or involuntary urination while sleeping. NE can occur at any point in life, although it’s more common among children and affects around two to six percent of the adult population. When NE reappears in adulthood after clearing in childhood, it’s called recurrent nocturnal enuresis or RNE. 

Some causes of adult bed-wetting can include: 

  • Urinary tract blockage 
  • Urinary tract infection (UTI) 
  • Bladder problems (such as having limited capacity) 
  • Obstructive sleep apnea 
  • Diabetes 
  • Enlarged prostate 
  • Side effects of medication 
  • Neurological disorders 

It’s important to note that stress incontinence is more common in women than in men. Studies have concluded that, for those with a vagina, stress incontinence is a factor in the development of NE. Stress incontinence is unrelated to psychological stress and is, instead, usually a result of muscle weakness. In fact, stress incontinence occurs when the muscles and other tissues that support the bladder and regulate the release of urine, or pee, become weak, often as a result of growing older. Some factors that can worsen stress incontinence include illnesses (such as your cough), obesity, smoking, or high-impact activities. 

Because NE may be affecting your quality of life, you might consider speaking with a health care provider about what you’re experiencing so you can get checked out for any underlying concerns. If none can be found, consider reaching out to another provider or specialist for a second opinion.  It’s possible that your condition may require a visit to a provider who specializes in the systems that may be causing your symptoms. In which case, your current provider may offer you a referral to a gynecologist or a urologist. You might also consider a urogynecologist which is a specialist that focuses in diagnosing and treating problems at the intersection of urology and gynecology. These providers may be able to do a more thorough evaluation to determine the cause and recommend next steps. 

In the meantime, your health care provider may recommend: 

  • Pelvic floor exercises: Also called Kegel exercises, which work to strengthen and train the muscles in your pelvic floor that control urine flow. 
  • Prescription medications: One such medication, desmopressin, appears to help control the amount of urine a person produces. While this medicine is usually used to control symptoms of a certain type of diabetes, it’s been shown to be helpful for people who wet the bed as well. 
  • Lifestyle modifications: Since smoking and obesity can both contribute to the problem, your provider may recommend making lifestyle changes to improve symptoms. 
  • Fluid intake: It can be helpful to pay attention to how much, what types, and when you consume liquid. You may find certain patterns help or hinder wetting the bed. 

Here’s to dry days (and nights) ahead! 

Last updated May 12, 2023
Originally published Sep 28, 2001

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