Dear Doctor Sleep

My family is in a crisis! We have 14-year-old twin daughters who wet the bed almost nightly. For many years professionals and friends have told us that they will grow out of it, but they have not. Both girls are normal and healthy in all other ways, but the nightly wetting is ruining their self-esteem and making such regular events, like sleepovers impossible for them. Our family secret has caused distress for us all and is jeopardizing the girls’ relationships with their peers and their own feelings of self-control and self-worth.

We have tried oral and nasal spray medications as well as behavioral strategies including forced awakenings with no success. Both girls sleep very deeply and the forced awakenings destroy their sleep cycles. They have no other developmental problems and are both bright and otherwise healthy girls. Is there any help you can give us?

Claudia S. North brook, IL

Dear Claudia,
You are not alone; thousands of families deal with the problem of bedwetting. Bedwetting (nocturnal enuresis) is a family problem. It is not an “attention seeking” behavior on the part of the child or a deliberate attempt at manipulation in most cases. This is a medical condition that consists of a number of essential and associated symptoms. Essential features include spontaneous and involuntary urination in sleep, excessive deep sleep or disturbed sleep and daytime fluctuations in alertness. Associated symptoms may include attention and concentration problems, depression, anxiety or disturbance in behavior.

Enuresis is usually not a disorder of the urination system (bladder size or function), but rather a nervous system “software” problem. Treatment is now available and success rates exceed 80% in 30-90 days in most published research. It is a combination of behavior modification, sleep stability medications, and hygiene. It is also very important to make these treatments specific to each child. Please contact our Enuresis Clinic at the Sleep and Behavior Medicine Institute at (847) 673-8005 or call the Sleep and Health Hotline (847) 673-6770 for treatment options.

Alexander Golbin, MD, PhD.