There is stigma attached to this rare condition of bedwetting even as adults. Doctors stress that consulting a doctor is absolutely important if it happens regularly.
Despite the stigma attached to it, doctors stress that consulting a doctor is important in the case of adult bedwetting (Supplied)
In an interesting account shared on X by Dr Sudhir Kumar, a renowned neurologist from Apollo Hospitals in Hyderabad, the joyful beginning of marriage took a sudden turn when a newlywed woman’s long-standing health issue disrupted her first night.
Twenty-four-year-old Mini (name changed) was ecstatic to marry her childhood crush, Manoj (name changed). Despite initial resistance from her parents due to caste differences, the wedding proceeded smoothly, with many friends and family in attendance.
Exhausted from the day’s festivities, the couple fell asleep quickly after the ceremony.
The “first night” turned into a “nightmare” for a newlywed woman
24-year old Mini* was really happy to have married her childhood crush Manoj* and was excited about spending the rest of her life with him. There were a few hiccups before marriage. Her parents were against this… pic.twitter.com/DwbUEimRJa
— Dr Sudhir Kumar MD DM (@hyderabaddoctor) June 14, 2024
However, their blissful night was abruptly interrupted when Manoj was jolted awake. To Mini’s horror, she realised she had wet the bed, a problem she had been struggling since childhood.
Although the frequency of her bedwetting had decreased over the years, it had never completely stopped. Mini had kept this issue to herself, feeling too ashamed to seek help during her teenage years, which led to low self-esteem and depressive symptoms.
Seeing Manoj’s initial reaction, Mini feared the worst and thought her marriage might be over before it had even begun. However, after explaining her history of bedwetting, Manoj’s anger turned to compassion. The couple decided to seek medical advice immediately.
Dr Kumar diagnosed Mini with nocturnal enuresis, commonly known as adult bedwetting.
Speaking to South First, Dr Kumar explained nocturnal enuresis refers to an involuntary urination during sleep in adults. He said the prevalence of this condition is two to 3 percent in adults. However, it is more common in children.
“In children aged five to 15, the prevalence of this condition in India is seven to 12.6 percent.
In other parts of the world, the prevalence ranges from six percent to 42 percent. Dr Prashanth Ganesh, Consultant Urologist, Transplant Surgeon and Andrologist at Apollo Hospitals in Bengaluru said that night bedwetting in adults is very rare.
He explained that in many cases, no specific reason is found. However, several risk factors need to be considered while treating this condition, said Dr Kumar.
“These include psychiatric condition such as anxiety, stress and depression, urological problems related to bladder and prostate also needs to be excluded. Uncontrolled diabetes can be another risk factor,” he added.
Meanwhile, Dr Ganesh explained that reasons like hormonal issues — such as deficiency in the hormone called Anti-Diuretic Hormone (ADH) — can lead to excessive urine production in the night. “Because there won’t be any reabsorption of the sodium in these cases,” he said.
He explained that people with small bladder capacity — such as those who have suffered from Tuberculosis previously, or in some cases, those with a small functional bladder capacity from the beginning — cannot hold much urine in the night and tend to wet the bed many times.
Dr Ganesh agreed that overactive bladder due to nerve irritation can also cause bedwetting in adults during night. He said that the bladder sometimes is irritated by any reason, like UTI that may cause some irritation of the bladder, which can also cause temporary night bed wetting.
Those with diabetes generally produce large amount of urine due to excessive blood sugar in their body. This can lead to an increase in area and decrease in area secretion in the night. Kidneys can produce enormous amounts of urine output, which can cause night bedwetting.
Meanwhile, there are studies that have shown about seven percent of these people with sleep apnea usually have multiple frequent urine urge in the night and tend to bed wet, especially because they feel like they are sleeping, but they may not be having proper sleep cycle.
Also, those taking diuretics and other medications can also lead to this problem. Doctors explain that those with neurological problems like Parkinson’s, seizures, etc., tend to wet the bed a lot.
Interestingly Dr Vishal, consultant Urology at Fortis Hospital in Bengaluru told South First that chronic constipation causes incomplete emptying of the urinary bladder and this too can lead to bed wetting.
He said that the actual percentage of people with this condition may be higher than being reported.
“Actual number might be higher because it’s a condition many feel embarrassed about and don’t report more often,” he said.
Doctors said that though living with adult bedwetting can be challenging, it can definitely be addressed. They also stress that with the right treatment, which includes certain medications and lifestyle adjustments, significant improvement can be seen in this condition.
They said that it is crucial to know if stress or anxiety contributed to the problem.
Like in Mini’s case, doctors suggest various lifestyle management techniques along with counselling and medication to deal with this condition.
Drink less water
It is important for the families to be supportive of such patients, explain doctors.
Dr Ganesh said, “lifestyle treatments we could suggest for patients who are symptomatic include drinking less water at night after 7 pm. Especially, two to three hours before going to bed, they must limit any liquid intake.”
Doctors suggest stopping alcohol, sugary drinks and caffeine as well during this time.
Keep alarms
Dr Ganesh said that one could keep moisture alarms every three hours. Once the functional capacity of three hours is achieved, then we could extend the time to four hours.
So naturally, in this way, the bladder can be trained to hold more over a long time and make regular urination as part of the routine.
Treat for UTIs, diabetes and prostate issues if any
Urinary Tract Infections (UTIs) can irritate the bladder and hence getting it checked and treated with medication can prevent night bedwetting if that’s the cause.
Meanwhile keeping diabetes under control will help in reducing the urine production. Interrupted breathing should also be addressed to avoid sleep apnea which can affect bladder control.
Doctors suggest that the patient should inform their doctors if the diuretics are leading to this condition.
Dr Kumar took to X , sharing that people with nocturnal bedwetting should know the following:
Nocturnal bedwetting in children above five, adolescents and adults is not normal and needs to be evaluated by a doctor. Underlying urological and psychological risk factors need to be excluded.
Medical treatment is helpful in cases of idiopathic (no identifiable cause) nocturnal enuresis.
(Edited by Shauqueen Mizaj)
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