Bedwetting – Symptoms & Risk Factors

Symptoms

If your child is older than five years of age and has primary bedwetting they may:

• Urinate by accident during sleep at least twice a week
• Regularly stay dry during sleep for a period of at least six months in the past

If you or your child is older than five years of age and have secondary bedwetting they may:

• Urinate by accident during sleep at least twice a week
• Regularly stay dry during sleep for a period of at least six straight months in the past

It is also important to know if there is something else that is causing the bedwetting. It may be a result of one of the following:

• Another sleep disorder
• A medical condition
• Medication use
• A mental health disorder
• Substance abuse

Risk Factors

Primary bedwetting is present at the following rates in children and teens:

• 10% of six-year-olds
• 7% of seven-year-olds
• 5% of 10-year-olds
• 3% of 12-year-olds
• 1% to 2% of 18-year-olds

Primary bedwetting is more common in boys than in girls. The rate of children with primary bedwetting who get better on their own is about 15% each year. 

There appears to be a genetic link to primary bedwetting. Children are more likely to have it if their parents and/or siblings had it as children. Bedwetting is reported by 2.1% of older adults in assisted-living homes. It is more common among women than men.

Some people may also urinate by accident when they are awake. This tends to be related to a physical problem. Social or mental stress is rarely the cause of primary bedwetting. But it does occur more often in the following children:

• Children with attention-deficit/hyperactivity disorder
• Children living in disorganized families

Secondary bedwetting occurs more often in children who have recently faced a strong social or mental stress. This includes the following:

• Parental divorce
• Physical or sexual abuse
• Neglect

Children with secondary bedwetting are also more likely to have constipation and to soil their pants. 

A disorder such as confusional arousals (waking during a very deep stage of sleep) may involve a child urinating in a strange place during sleep. Otherwise, this child tends to keep a dry bed at night.

Secondary bedwetting can occur at any age. It can be related to or caused by any of the following:

• An inability to concentrate urine, as in sickle cell disease or some forms of diabetes
• An increase in urine production caused by the use of caffeine, diuretics, or other substances
• A urinary tract problem, such as urinary tract infections or an irritable bladder
• Chronic constipation and involuntary soiling of the pants
• A neurologic problem, such as seizures and epilepsy
• Obstructive sleep apnea (OSA)
• Social or psychological stress
• Among older adults, it may be related to symptoms of the following:
• Congestive heart failure
• Obstructive sleep apnea (OSA)
• Depression
• Dementia