Bedwetting - causes, cures and failures....

[babykeiff]

Causes (simplified)

Bedwetting, or more correctly called secondary nocturnal enuresis is caused by normal growth and deep sleep issues.

Prior to being toilet trained, the bladder did not expand, and the sphincters used to open via reflex - i.e. from the signals of either:-

• a stretching bladder wall

OR

• urine being deposited into the bladder.

OR

• drinking, hearing running water

 

The bowels would also void by reflex - either :-

 

• smell of food being prepared
• being fed
• shortly after eating

This reflex action became reflex after birth following training - a baby is trained to ignore the feeling of any fullness in either its bladder and/or bowels and just to relax and void. Most babies still fuss before wetting / messing prior, during and after the event. Some will hide before it messes its diapers.

Toilet training reverses this behaviour, and the child learns to 'hold' it until it can find a potty. This is taught via the praise & reward on success, and disappointment on failure. What was added to this training was baby is bad big boy/girl is good and  big girls / boys do wee wees / poos in potty... only babies wear and wet / mess diapers. Big boys/girls dont have pacifiers/plushies/blankies...

This type of training teaches the child to typecast diapers, plushies, blankies etc as only for babies and associate that being a baby is bad. This is the recipe for stress and a very confused child as his/her source of comfort is gone!

Overnight, the child has to wait until the production of vasopressin is high enough to be able to ‘hold’ it overnight.

This works for a while until one of the following occur :-

• stress increases in the child’s life - the child has no outlet to relieve this stress
• not enough rest time for the child’s age is acquired - the child is overworked trying to behave as the 'adult' and not a 'baby'
• pre / during / post puberty (where the location of the nerve / muscles move) 

This is a failing of the toilet training methodology, not a fault of the child - the same toilet training that is envoked worldwide.  To some, the toilet training was rushed (so that the child at x age can be admitted to daycare / school etc at a specific date on the calendar), forced the child to focus on a specific feeling in a specific location. As a result, at puberty, when the location moves, day and night wetting can occur since the child is not aware of the actual need to void. Overnight, lack of sleep can cause the child to sleep even deeper, thus relaxing all muscle and weeping urine.

Awareness

A bed wetter is unaware of the fact that they wet during sleep. It does not wake them. Even when they awake, they are unaware that they are wet. It is not until they check - via touch / smell - do they realise that they have wet during their sleep. Due to the fact that we only remember the dream we had just before we wake, if we have the classic 'pee dream' it is our subconscious telling us that we have wet sometime while we slept. Some think that if we wake during that event, we could prevent the bedwetting. Since the 'pee dream' is information of a past event, we wet, probably 3-4 hours ago, even if we wake during the pee dream, we would wake to a wetting that occurred 3-4 hours ago. Most bedwetting occur not due to an actual wetting, but more due to the total relaxation of the relevant muscles - which takes on average 30-90 mins before one is in a deep enough sleep. As a result, the bladder weeps. One doesn’t instantly recall the 'pee dream'. It is not until we have checked if we are in a wet bed do we remember the dream. This is how the conscious mind works - give it a trigger (similar to a key word search) and the subconscious mind will search for an event that matches the key word. The most recent match will be the 'pee dream'. If you ask the subconscious to search again only deeper, it will not find the wetting event. It really does not know when you wet, as you wet when you were in such a deep sleep to relax all muscles (including your bladder sphincter).

Some here sleep in diapers, and wake needing to wet and after checking, find that their diaper is already wet, so just wet it and return to sleep. That is common. It is not the need to wet that woke you, but something else. If you check, you will find that it is at roughly the same time every night, and it is an noise made by a neighbour / mechanical device that is going on / off at that time that woke you. The fact that you need to wet is based on how full your bladder is, and that you sat up a bit, thus changing the pressure on your bladder and increasing its need to void. Your sphincter is only in the partially open position, so your bladder is only partially empty. It really doesn't matter if you got up to go to a bathroom or not, you would never make it - as you stand / move to stsand, the contraction of the muscles will increase the , the pressure on your bladder and it will fully empty. Without the diaper, at that stage, you would wet the bed / floor / self before moving one step from the bed.

Cures & Failures…

Medical intervention suggest the use of the tablet form of *vasopressin.

One of the failures of medical science, it does not address the 'deep sleep' issue (the core problem), but tries to reduce the amount of urine being produced (the symptom) by adding chemicals to effect water balance in the body. This is counter-productive due to the methodology of the human body. If one adds a chemical to the body that in itself, changes the balance of that chemical in the body, the body mechanism will decrease its own production of said chemical. Also, the body will create a chemical to decrease the medical form. As a result, the body will become ‘immune’ and/or dependant on the pseudo medication for natural balance. One can see this in patients’ on pain medication – one has to progressively increase the dosage for the pain killer to become effective. As a result, most common ‘pain killers’ used are normally blood thinners instead of pain killers to avoid patients’ become ‘hooked’ on the pain killer.

The result of this ADH is that the child will become dry, but before the week is up, will be wetting as much, if not more overnight as they did as a chronological baby / toddler. This is an issue as most toddlers overnight oversaturate their diaper to the fact that it leaks. When the child in question was a baby, this was dealt with by changing the child’s diaper normally before the parents / careers went to sleep themselves (usually midnight / 1am).

As a result, the addition of ADH will only increase the child’s need for diapers (and a midnight diaper change*), which can regress the child to toddler / baby voiding behaviour. The body will completely stop vasopressin production, stop ‘holding’ it overnight / during the day and revert to the reflex action of wetting when urine either enters the bladder / when the bladder starts to stretch. There is no need for a diaper wearing baby to reduce its urine production if doing so would cause it to wake, and since there is no need to wake – one can just wet the diaper that they are wearing which stays warm, why not.

Infantilising / chastising / belittling the child.

This is also counterproductive. Most children, when belittled etc., tend to seek, in their mind, a time and place where the issue that they are dealing with (bed wetting / waking up soaked in the morning) was fully accepted -  i.e. regress.

This creates desire for ABDL i.e. seeking a time when bedwetting / pants wetting was accepted - and the feeling of waking up in a warm squishy diaper was euphoric.... and the associated love and care given to you by another as they changed you out of your night diaper into another diaper for you to make warm and squishy all over again.

For others, it elevates their stress levels, which increased the amount they wet overnight.

Both create daytime leaks, which also increases the stress.

Actual Cure

The most effective cure to bedwetting is letting the body deal with it.

Diapers / pull-ups are reinforcement to regress and void by reflex. It is common for bed wetters who wear pull-ups etc. at night to develop weak daytime bladder issues and visa-versa (those with daytime bladder control issues who wear protection during the day to develop night time issues which will revert to full autonomic voiding based on triggers). Some revert to messing their pull ups / diapers also.

To cure bedwetting is easy - remove the stress and increase the time spent in bed = increase the length and quality of sleep. The normal intervention some parents do when they have a bedwetting child adds to the stress levels of the child, which increases the tiredness of the child, deepens the level of sleep of the child, and increases the bedwetting. One has to create a total stress free environment for the child by accepting that bedwetting is part of childhood - and that given the proper environment, the child will grow out of it. A disposable under pad will protect the bed, and allow the child to place same before sleep / and remove and dispose of it in the morning. Letting the child sleep in the nude / without bottoms removes the need for laundry of pyjamas, plus the under pad being disposable, the associated smell of a urine is never allowed to grow. A morning shower with the same shower gel etc. as used by parent (not being bathed by parent), removes smell - and also enforces the 'adult' behaviour. This is treating the child as if s/he is an adult - where the act of wetting the bed is being totally ignored as if it doesn't exist.

Regression

Contrary to what P&G advertise, a baby does not wake from a wet / messy diaper.  The diaper is warm and comfortable, the baby has been taught to use diaper for its eliminations, and the baby is happy doing so. What wakes a baby is a disturbance - either noise or light or temperature. Once the baby is awake, might cry for attention - since it has been taught to do so - after it fills its diaper - and another will take care of it. That is IF it is aware that it has filled its diaper. Most babies are unaware of that since the baby filled its diaper during its sleep. It is their parent / career that notices such, and changes the baby. The baby is aware of the warm squishy feeling between its legs, and will explore (play) with that feeling. Since this 'feeling' is repeated so often (after every nap / sleep) almost 4+ times per 24 hours (or greater depending on the amount of naps a baby takes) for a period of 2+ years, approx. 3000 times, this feeling is euphoric to the baby, and also the ABDL.

A baby wets / messes its diapers exactly the same way a bed wetter wets. It cannot recall when it wet/messed. All it knows is that it's diapers are warm and squishy. It does know (sometimes) when it is wetting / messing - but the trigger are to make it laugh from the feelings, and let it happen. The baby was told, from birth, that it is expected to wet / mess in its diapers - so the baby just does that. 

Summary & Conclusions

Bed wetting is naturally curable / avoidable when you are a child. However, if you chose to regress at that time / later, be prepared for the diaper usage to extend to daytime as well... AND the diaper wetting usage to increase to messing same diaper. Bowel control is primarily controlled by diet, not anal sphincter. One's anal sphincter cannot hold back liquid - as most here can attest to from a bout of diarrhea. If, overnight, you get used to the warm squishy feeling of the morning diaper, and delay the change until after your morning meal - later and later in the day (as on a day off / weekend / working from home etc), that messy diaper of that day is the start of complete diaper dependance... and for some, a goal.  Adult behaviours are habits and very difficult to break. One cannot usually convince an adult mind as easily as one can convince a child's. However, adult behaviour will very quickly regress to baby behaviour - as it is something the adult 'knows' and 'trusts' to work. This is due to adult laziness, a behaviour that was learnt at school - where a teacher got you to do something that was not fun. As a result, if an adult does not enjoy X, the adult will regress to the baby form of doing X.

 

*secondary nocturnal enuresis = secondary (after one has been reliably dry) nocturnal (at night) enuresis (wetting)

*vasopressin or antidiuretic hormone (ADH) or arginine vasopressin (AVP) is a nonapeptide synthesized in the hypothalamus. Science has known it to play essential roles in the control of the body's osmotic balance, blood pressure regulation, sodium homeostasis, and kidney functioning. Simply, it causes the kidney to reduce the amount of water (increase urine concentration in the bladder) entering the bladder.

[Wet Knight]

As a life-long bedwetter, it is only in the last couple of years that I have become damp enough in the day to warrant swapping underpants for an all-in-one nappy.

[oznl]

A lot of information there!

I guess I can comment because I’m one of those who has somehow made themselves a bedwetter after prolonged nappy usage (somewhat to my own amazement).  Technically, I am experiencing secondary onset enuresis, a phenomena that would doubtless invoke considerable medical investigation were I to bring it to my practitioner's attention.

6 hours ago, babykeiff said:

A bed wetter is unaware of the fact that they wet during sleep. It does not wake them. Even when they awake, they are unaware that they are wet. It is not until they check - via touch / smell - do they realise that they have wet during their sleep.

Generally, my experience concurs with this.  If I’m in a securely fitted nappy, there is little to no sensory cue that I’m wet.  Even a small leak will generally go unnoticed until morning.  A wet bed is a different story (and I’ve experienced unplanned wet beds through testing if my bedwetting would appear outside the context of being diapered).  In my experience, a wet bed swiftly becomes a cold bed and will wake me.  I guess it can be argued that it’s the cold that rouses me rather than the pee.

I HAVE noticed upon being wakened by my wet bedding that my first thought was not “Oh, I peed the bed” but a rather confused “Why is everything all wet?” reflecting a lack of insight to the event.

Sometimes however I will be woken by the wetting event.  This tends to happen where there is a significant sensory feedback occurring (a loose nappy resulting in an obvious “trickling” sensation is a big one).  I will emerge from sleep confusedly to discover that I’m peeing (or just finishing one).  I've also had a nappy-free bedwetting event wake me.  There is more sensory feedback wetting a bed than from wetting a nappy.

6 hours ago, babykeiff said:

Due to the fact that we only remember the dream we had just before we wake, if we have the classic 'pee dream' it is our subconscious telling us that we have wet sometime while we slept. Some think that if we wake during that event, we could prevent the bedwetting. Since the 'pee dream' is information of a past event, we wet, probably 3-4 hours ago, even if we wake during the pee dream, we would wake to a wetting that occurred 3-4 hours ago.

I do believe that at least some of my occasional “pee dreams” are concomitant with a voiding episode rather than retrospective narrative.  The reason for this is that occasionally, a voiding event will wake me as it is occurring due to the aforementioned sensory feedback.  Sometimes when waking, I will recall a dream narrative that was in some way attempting to rationalise what I was doing.

It's not an "all the time" thing.  Plenty of times I will wake up wet and dimly recall a pee dream.  Still other times (such as last night), I will wake up wet with no recollection at all of any relevant waking or dreaming pee experience.

6 hours ago, babykeiff said:

Most bedwetting occur not due to an actual wetting, but more due to the total relaxation of the relevant muscles - which takes on average 30-90 mins before one is in a deep enough sleep.

I have some experience that corroborates this.  If I go to bed in a dry nappy (making the chronology of the first unplanned void much more obvious), I’ve generally stirred and found myself to be slightly wet within 2 hours of falling asleep.  The void volume (low) and timing (within 2 hours of last known voiding) suggests this event was not precipitated by a full bladder.  Having been on occasion woken by these events as I mentioned, I'd comment that whilst definitely abnormally  "low pressure" voids, they seem to be more than weeping or dripping - at least a rapid dribble.

Interesting to read your perspective on this.  Thanks!

 

[justforfun]

On 9/24/2022 at 10:26 AM, babykeiff said:

Causes (simplified)

[...]

Summary & Conclusions

Bed wetting is naturally curable / avoidable when you are a child. However, if you chose to regress at that time / later, be prepared for the diaper usage to extend to daytime as well... AND the diaper wetting usage to increase to messing same diaper. Bowel control is primarily controlled by diet, not anal sphincter. One's anal sphincter cannot hold back liquid - as most here can attest to from a bout of diarrhea. If, overnight, you get used to the warm squishy feeling of the morning diaper, and delay the change until after your morning meal - later and later in the day (as on a day off / weekend / working from home etc), that messy diaper of that day is the start of complete diaper dependance... and for some, a goal.  Adult behaviours are habits and very difficult to break. One cannot usually convince an adult mind as easily as one can convince a child's. However, adult behaviour will very quickly regress to baby behaviour - as it is something the adult 'knows' and 'trusts' to work. This is due to adult laziness, a behaviour that was learnt at school - where a teacher got you to do something that was not fun. As a result, if an adult does not enjoy X, the adult will regress to the baby form of doing X.

[...]

 

There are a lot of... claims... there.  All I can say is that I trained myself to be a bedwetter over 20 years ago, in my mid-twenties.  It took time, of course, but I convinced my brain that it's ok to pee when ever and where ever I am.  If I fall asleep, or nap, there's a good chance I'll wet.  I have tried to reverse that twice, actively trying to become dry at night.  Both times failed.

So far (20+ years...) I have had no issues during the day in the form of wetting or messing.  So, I guess I can only say that the claim that everyone who re-trains bedwetting will had day-time wetting and messing problems is not accurate, at least for n=1.

So I'm not sure what you're trying to say here?

 

[babykeiff]

1 hour ago, justforfun said:

 

There are a lot of... claims... there.  All I can say is that I trained myself to be a bedwetter over 20 years ago, in my mid-twenties.  It took time, of course, but I convinced my brain that it's ok to pee when ever and where ever I am.  If I fall asleep, or nap, there's a good chance I'll wet.  I have tried to reverse that twice, actively trying to become dry at night.  Both times failed.

So far (20+ years...) I have had no issues during the day in the form of wetting or messing.  So, I guess I can only say that the claim that everyone who re-trains bedwetting will had day-time wetting and messing problems is not accurate, at least for n=1.

So I'm not sure what you're trying to say here?

 

Bedwetting (secondary nocturnal enuresis), although you trained yourself to do so, is caused by two combined factors:-

• reduced production of ADH
• auto relaxation of the sphincter - to such an extent, one either weeps urine when asleep AND one reverts to voiding automatically (similar to the way a baby voids) as soon as any pressure is on the bladder.

Since the body has reverted to voiding as a baby while asleep, i.e. autonomically - the nervous impulse that one needs to void is no longer transmitted to the brain. This is slightly incorrect as as soon as the bladder starts to fill, there is an signal transmitted to the brain of the need to void. This signal increases in urgency, the fuller the bladder gets. Since overnight, one is voiding as soon as there is a miniscule signal, it is not unusual for, during daytime, the bladder/sphincter to mimic this behaviour.

If this is not the case with you, then it is most likely that your self training was highly customized to only work when you are asleep = you have been hypnotised to become a bed wetter and as a result, if reversable to some stage, but since you have been doing this for 20+ years, your production of ADH will take time to reach the levels needed to keep you dry overnight.

However, since behaviour is habit forming, and due to the fact that the body will highly optimize its actions, I suspect that it is only a matter of time before you discover daytime issues also. I suggest that you measure your bladder capacity, and will probably find that it is in the range of 200ml or less. Since your bladder capacity is almost half of what it should be (although you are realatively young), within the next 5+ years, you may find that its capacity will reduce even further, close to 50-100ml combined with reduced ability to fully empty same (part of aging = muscles lose ability to fully contract), = daytime weeping and the need to wear some form of protection. Since you are hypnotised to wet when asleep, you need to know the specifics of that trigger - is it only asleep OR is there more to this trigger?

Most peoples bladder control weakens with age, but wiht a 'normal' functioning bladder, this is not apperant until 60-70+ years old - however, wiht you and your reduced bladder capacity, this will show a lot earlier.

In relation to bowel control - this only exists due to diet and habit. It is very easy to 'let go' bowel control when in diapers 24/7 and presume that it is only passing wind.     

 

 

[stevewet]

I grew up a chronic nightly bedwetter and wasn't reliably dry at night until my early 20s Throughout my adult life I had episodes of bedwetting. Some lasting longer than others. Then I had a long dry spell lasting almost 10 years. My bedwetting came back out of the blue in my late 40s and this time it was here to stay. That was almost 10 years ago and now I wet every night again.

[babykeiff]

6 hours ago, stevewet said:

I grew up a chronic nightly bedwetter and wasn't reliably dry at night until my early 20s Throughout my adult life I had episodes of bedwetting. Some lasting longer than others. Then I had a long dry spell lasting almost 10 years. My bedwetting came back out of the blue in my late 40s and this time it was here to stay. That was almost 10 years ago and now I wet every night again.

Have you associated issues within your hypothalmus which would manifest itself in some of the following -

• sensitivity to heat
• anxiety
• irratability
• mood swings
• tiredness
• headaches
• *assoiated blood presure / heart issues
• *thirst
• forgetfullness
• *dry skin
• *dry eyes
• *breathing difficulity / easily 'out of breath'
• obesity

- if so, I would suggest that you get that addressed / checked out. Issues within the hypothalmus normally result in reduced ADH production / imbalance in the osmotic level within the body. One of the first signs would be secondary nocturnal enuresis due to the imbalance / failure to produce / regulate ADH (vasopressin).

The items above with the astrix* are due to low water levels.

Also, stress combined with sleep deprivation can also cause these issues. @stevewet In your case, your history suggests that external stressors may have been the trigger. The fact that your bed wetting came back in your late 40s may also be due to the  other controlling factors / triggers in your life - i.e. your awarness of others in similar situation such as this community, which convinced your subcontious that it is OK to wear diapers over night rather than deprive you of sleep. I doubt that your bed wetting actually went away, but was only supressed by disturbed sleep - getting up many times overnight to void combined with depriving yourself of fluids to such an extent that it was adding to your stress levels - what your subcontious knew and addressed.

I suspect that your balance is much better today, and that you are happier in yourself all due to the fact that you do not deprive yourself of fluids nor sleep - and secretly are happy diapering yourself each and every night knowing that you will have a good nighs sleep and the diaper will keep you warm and cozy.

It is still a good idea to find out more about the functions of your hypothalmus (from a medical professional in this field)- not to reduce / remove your bed wetting since, but more to avoid further complications now and in the future. It is probabably agood idea, if you wish, either not to discuss your bed wetting and/or inform this medical professional that you are NOT trying to address the bed wetting, just your hypothalmus. Due to the fact that the hypothalmus regulates water balance in the body, maybe for you, directly managing your fluid levels (increasing the amount of water you drink) could address this.