Sleep Series: Bed Wetting and Other Problems

As your child gets older and you’re no longer sleeping with one eye open to make sure they’re still breathing, different sleep problems begin to arise.  The most common of which include night mares and night terrors as well as bed wetting.

Night Mares and Night Terrors

Night mares and night terrors are more common in children aged 18 months to 6 years due to immaturity of sleep patterns.  Night mares occur mainly in the second half of the night when your child is in Rapid Eye Movement (REM) sleep.  Your child will usually wake and remember that they have had a bad dream and may need to be comforted before going back to sleep.  In contrast, a night terror usually occurs in the first half of the night when your child is in deep sleep.  They will usually not awaken during a night terror but may thrash around or get out of bed.  They usually do not remember that they’ve had a night terror when they wake in the morning.  If your child is having a night terror, do not wake them, instead gently guide them back to bed and stay close by to ensure they’re not going to hurt themselves.  Both night mares and night terrors are normal and your child will grow out of them.  However, if they are frequent or violent, causing you or your child concern or occurring with other sleep problems such as breathing difficulties then you should see your GP.

Bed Wetting   

Another common sleep problem in children is bed wetting.  If you’re a parent you’ll be familiar with concept of bed wetting and if not yet a parent you may even remember a time when you yourself wet the bed as a child.  Bed wetting is a common problem in many households with young children and is part of the normal maturation of sleep.  Bed wetting occurs when your child produces enough urine over night to fill their bladder without waking up to empty their bladder in the toilet.  When this happens, the bladder will empty whilst your child is still asleep resulting in a wet bed.

The incidence of bed wetting naturally decreases with age.  At 4 years of age 1 in 3 children will wet the bed, by 6 years of age this number will have fallen to 1 in 10 and by 10 years of age 1 in 20.  This means that a number of school aged children will still wet the bed regularly which can unfortunately be associated with feelings of embarrassment or shame.

Whilst bed wetting may be unpleasant for everyone involved, it is important to remember that this is a normal occurrence in a young child and usually does not require treatment.  Furthermore, bed wetting is not a behavioural problem and you should not punish or make fun of your child when it occurs – nor should any brothers or sisters.  However, if your child is older than 6 and bed wetting is frequent or persistent and causing you or your child to feel concerned or frustrated it is a good idea to see your GP to ensure there is no underlying cause.  Your GP can also provide you with tips to encourage night time dryness in your child.

The treatment, if required, for bed wetting usually involves training using a mattress bedwetting alarm.  These can be purchased or hired from GP clinics or paediatricians.  The training is a simple system by which wetting the bed sets of an alarm and wakes the child.  The child is then encouraged to quickly go to the bathroom to finish emptying their bladder.  Training usually takes 8-10 weeks and has an 80% success rate for achieving dryness.  Once dry, most children will stay dry.  For those children who fail this treatment, medication can be considered.  The medication, DDAVP (minirin), is a synthetic version of the hormone anti-diuretic hormone (ADH) which the body usually produces more of overnight to reduce the production of urine.  This reduces the amount of urine your child will produce overnight and therefore reduce the risk of over filling the bladder.  This medication can be particularly helpful for overnight stays at friend’s houses or school camps.

In summary, most of the sleep problems that occur in young children are part of the normal maturation process and do not require treatment.  However, if sleep problems are persistent, disruptive or causing you or your child concern see your GP for a check-up and advice.