Adult bed wetting (also called nocturnal enuresis or nighttime incontinence) affects 2 to 6% of adults.
Sometimes, bedwetting as a child may persist into adulthood.
Or, it may recur in adulthood after you stop wetting the bed as a child.
This can cause certain problems, such as shame, sleep deprivation, anxiety, mood swings, low self-esteem, and depression.
If you wet the bed as an adult, there is usually an underlying cause.
Depending on the cause, your nighttime incontinence can be treated.
Keep reading to learn more about the causes of adult bed wetting and the treatment methods used.
What causes adult bed wetting?
Adult bed wetting can be caused by many different factors. These could be:
1) Hormone problems
You may have an imbalance in your hormones, particularly the antidiuretic hormone (ADH).
ADH helps the kidneys to make less urine and store water in the body. The body produces ADH at night to decrease the amount of pee you make while you’re asleep.
But, in some people, the amount of ADH in their body is not enough. So, they tend to produce excess urine and wet the bed.
An example of a condition in which there is less production of ADH is diabetes insipidus.
2) Urinary tract infections
Your urinary tract is the passageway for urine in your body. A urinary tract infection (UTI) can cause bed wetting in adults.
3) Kidney or bladder stones
Kidney or bladder stones can cause obstruction and could lead to a frequent urge to urinate. This can cause you to wet the bed.
4) Prostate abnormalities
Older men could have an enlarged prostate gland (benign prostatic hyperplasia). BPH can lead to urinary incontinence, which causes you to involuntarily release urine.
BPH can also be associated with an overactive bladder.
Another prostate problem that may lead to bedwetting is prostate cancer.
5) Bladder abnormalities
Some people may have certain problems with their bladder. These can cause leakage of urine in the nighttime.
One example is an overactive bladder.
An overactive bladder is an abnormality in the muscles of the bladder. These are called the detrusor muscles.
You feel a sudden urge to pee often, which can be quite problematic both during the day and night. You may unintentionally wet the bed.
Also, a small bladder can lead to nocturnal enuresis.
6) Family history
Genetics plays an important role in many disease conditions, and this is no exception. You are more likely to wet the bed in adulthood if you have a close family member with nocturnal enuresis.
If you have a close family relation who wet the bed, you have a 90% chance of getting nighttime incontinence.
This does not mean that you cannot get nocturnal enuresis if you do not have a positive family history.
7) Certain medical conditions
Certain medical conditions like diabetes mellitus can lead to adult bed wetting.
If you have diabetes, you have high levels of glucose in your blood if it is not treated. As a result, you make excessive amounts of pee, and you may need to have frequent trips to the bathroom. This can lead to bed wetting.
Some people who have obstructive sleep apnea can have frequent urges to pee. This may lead to leakage of urine in the nighttime.
8) Neurologic disorders
Some disorders that cause problems in your nervous system can cause nocturnal enuresis. Examples are seizures, multiple sclerosis, Parkinson’s disease, etc.
If you are on certain medicines, you may experience bedwetting as a side effect. These include risperidone, clozapine, and thioridazine.
Anxiety and stress may cause you to start wetting the bed as an adult.
Caffeine and alcohol can cause your kidneys to produce more urine. In addition, they can irritate the bladder (bladder irritants).
They also cause contraction of the detrusor muscle, leading to urine leakage.
Possible testing for nighttime incontinence
If you start bedwetting as an adult, you need to visit your doctor. You need help to find the cause and start an appropriate treatment.
Your doctor will inquire about your symptoms and health during a thorough consultation.
Then, a physical exam is done, and some tests are conducted. Here are the possible tests that you may need if you wet the bed:
- Urinalysis to look for infection and other abnormalities in the urine.
- Urine culture to look for infections.
- Post-void residual volume is used to measure the amount of urine left in your bladder after you pee. It is a non-invasive test.
- Uroflowmetry measures the rate of your urine flow, the amount of urine you pee out, and how much time you spend peeing.
Also, your doctor may ask you to do some blood tests, an ultrasound scan, or an x-ray. This will help to find out what is causing your symptoms.
Treatment for nocturnal enuresis
Treatment of adult bed wetting depends on the underlying cause. If the problem causing your symptoms is found, the problem can be solved or at least managed.
Meanwhile, there are also some actions that you can take to manage the condition.
Several drugs are available to treat adult bed wetting. The drug used depends on the underlying cause.
If your bedwetting is because of a decrease in ADH, your doctor may recommend desmopressin. This drug acts like ADH, thus helping to reduce how often you pee.
Your doctor may also prescribe you antibiotics if you have a UTI.
For an overactive bladder, your doctor may recommend anticholinergic like oxybutynin or solifenacin.
If you have BPH, you may receive Finasteride or another 5-alpha reductase inhibitor.
Surgery is the last option to treat detrusor muscle problems. It is considered when all other non-invasive treatment methods have proven futile.
Different procedures are available. You should discuss each in detail with your doctor.
Some of the procedures are detrusor myomectomy, sacral nerve stimulation, and clam cytoplasty.
You will need to make some adjustments in your day-to-day activities. This will help you to avoid wetting the bed at night or even in the daytime.
Reduce fluids right before bedtime
Control the amount of fluid you drink, especially in the evening and night. This can help reduce the number of times you need to pee in the night.
Use a bladder diary
A bladder diary can help you keep a record of how much fluid you take and how much you pee both day and night.
Get your FREE bladder diary
- Daily bladder diary
- Better understand your urinary symptoms
- Step-by-step guide
Set up a bedwetting alarm system to help you wake up at certain times of the night to urinate. This can reduce the number of times you wet the bed.
You can also set a schedule for times to urinate to help train your bladder.
Reduce alcohol and caffeine
Reduce how much alcohol and caffeine you drink. These are bladder irritants and can cause you to pee often.
Use incontinence products
Use appropriate size diapers, absorbent briefs, or mattress covers. These help to avoid soiling your bed.
Some of these materials are disposable or can be reused.
You can also get skincare products to help you prevent skin irritation.
Adult bed wetting often causes anxiety and shame. If you are experiencing this, you need to seek medical attention.
Nocturnal enuresis could be caused by problems relating to your hormones, bladder, prostate, or infection.
Thankfully, you can get help for this. The treatment option you will receive depends on the cause of your bedwetting.