During my early years as a psychologist I did a lot of research and study into bedwetting and I know exactly what causes bedwetting. In another video here on the channel, I talked about how to stop bedwetting. It’s really important to understand what causes bedwetting so that you can take the proper steps to address it. And there are two causes. Now to put the context around this, I did my doctoral dissertation on bedwetting. I know a few things about this. My research was published in the Journal of children’s healthcare because of what we found out and it has to do with one of the causes of bedwetting.
Now there are two. Let me be clear about this. It doesn’t happen without both causes being in place, because if one or the other is taken care of or resolved or cured then the problem goes away. Before we get into the causes I want to acknowledge that there are different kinds of bedwetting. What we’re talking about here today is referred to as primary nocturnal enuresis. Primary versus secondary. Primary means that it’s always been a problem, there has never been a significant period, I think defined as six months or more, where where the child or the person was dry. Nocturnal means at night, so they’re not wetting during the day only at night. That’s why we call it bedwetting, right?
Primary nocturnal enuresis and enuresis just means not being able to properly control elimination from the bladder. Now secondary is where there has been a period of dryness that meets the criteria and then they return to the wetting behavior later on. That’s secondary and then diurnal meand that it happens both during the day and at night. So what we’re talking about here is primary nocturnal enuresis okay, bedwetting and it’s never been cured for any significant period of time. Two causes. Cause number one has to do with your body chemistry. The body naturally creates chemicals and hormones that regulate certain bodily functions. One of those hormones is called ADH which stands for antidiuretic hormone. Now this hormone serves the purpose of drying us up at night. Oh cool, most people don’t have to get up at night and go to the bathroom they just sleep through the night and then go in and take care of business in the morning. Why? Because there’s a hormone that shuts down urine production. It actually causes it to be more concentrated and you don’t have to get up and go. Well, that’s handy, thank you for that, nice. Some people whose hormones are out of whack, like pregnant women for example or as we age and get older. sometimes those hormones don’t keep up with the needs of the body. Or there’s so many different hormones, like in the case of pregnancy, that it interferes with each other. Well they need to get up and go during the night. But most people don’t have to because they’ve got plenty of this hormone.
One of the causes of bedwetting is a deficiency of antidiuretic hormone, ADH. So with that in place, now what about this second cause? This is the one that I demonstrated with my dissertation research, deep sleeping. Every parent that I had talked to as I was in an earlier phase of my career, as I was working with little kids who wet the bed, every parent that I talked to said oh yeah they’re really hard to wake up, like harder than my other kids to wake up. It’s true. My dissertation research proved it and it had never been shown in the clinical literature prior to that point that these kids sleep more deeply, or more accurately, they are harder to wake up than normal age-matched peers. I demonstrated this with my research. It was kind of fun because I developed an apparatus. It was like a glorified alarm clock. We put this in kids rooms and it would come on with a white noise alarm sounded. Kind of like this, I know kind of a weird sound but we measured that and calibrated it to certain noise levels at the child’s pillow. And if they would hear that, they had to do certain tasks and respond to that in order to measure how responsive they were to this stimulus that happened during the night. See what we’re trying to do is determine, okay, probably their nervous system is working and they’re getting signals from the full-bladder downstairs that it’s time to get up and go, but it’s not waking up their sleeping brain. So used a different kind of a stimulus to test it. Here’s what we found. Kids who wet the bed, and I was testing kids from about age six up through about age 12, had a bunch of them and then we matched him up by age and other demographic variables so that we could get a good sense of this. What we found is kids who wet the bed are harder to wake up. They’re less, we call it task responsiv, they’re less responsive during the night or while they’re sleeping. To the stimulus that I just described to you.
Interesting. And by extrapolation we can say okay, they’re probably less responsive to the signals coming up from their own bladder too and they’re just not responding. So check it out, if we have a deficiency of the hormone, we’re going to need to get up and go during the night. If we’re sleeping to do deeply, we’re gonna sleep right through the signals that we need to get up and go and we’re gonna have a bedwetting incident. Well, what if we’re not sleeping that deeply? If we’re not sleeping that deeply then when the signals come up from the bladder we’re gonna respond to that and go to the bathroom. So if we’re not sleeping too deeply or if we have enough of the hormone we don’t have to get up in the first place and so it doesn’t matter that we’re sleeping so deeply. You have to have both both problems or causes in order to have the bedwetting problem.
Now this is important to know. Some of the traditional treatments for bedwetting are simply symptom treatments. There’s a nasal spray for example it’s actually a version of a synthetic hormone to mimic the action of the ADH it’s called DDAVP and it was used for years. I think they’re still using it to administer at night time before the child goes to bed and it dries them up for the night because it takes care of the hormone problem seeing then we don’t have the bedwetting incident even though they’re still sleeping deeply. My treatment program that I developed as part of my dissertation research addresses the other cause. It has to do with the deep sleeping and can we train that little brain to respond when those signals are coming up from the full bladder. We’ll get into this in more detail in another video and also there’s an e-book that I put together that summarizes my treatment program at finallydry.info. We’ll link to that down in the description so that you can get connected to that e-book. In it, it gives some of the approaches that we’re using. Remember if we can solve either one, we’ve solved the problem and statistically speaking most people grow out of the hormone problem by the time they’re teenagers. Now some people persist into the late teens and even adulthood. Those are a little more challenging to address but you know what, what if we can address this sleep problem? Then it doesn’t matter where we are with the hormone, you see where I’m coming from?
That that’s why it’s so important to understand the causes of it then we can get busy looking at what can we do about it.
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