Dr Catherine
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8-15 years

Hi, my daughter is 9 and a half years old and has not yet stopped wetting the bed. We have seen our GP who recommended we start her on a nasal spray to "dry her up" overnight, but both my husband and myself didn't think that giving her medication like that was appropriate as it wouldn't help us to find the reason she was wetting the bed. We are concerned for her as she's going into Grade 5 next year and there will be school camps. We don't think we will be able to let her go as other children are so mean these days and we don't want her to have to deal with that. Is there something we can do? We feel we have tried everything except for medications. Is there a way to check her ADH levels to know if she isn't producing enough of the hormone? Any help would be greatly appreciated!! Thank you, Nat.

Dear Nat, bedwetting can be incredibly frustrating particularly when you feel like you have tried it all and still your child continues to wet at night. The three most common causes of bedwetting include (1) an overproduction of urine overnight – children who have low-levels of ADH (antidiuretic hormone) produce four times the amount of urine as those who have the hormone and are therefore at a greater likelihood of exceeding their bladder capacity overnight (there are blood and urine tests that can be conducted to assess ADH levels). If this is the cause children generally stop wetting their bed when their ADH levels return to normal; (2) Difficulty arousing from sleep in response to a full-bladder – these children are unable to detect the signals sent from their bladder to their brain telling it it is full and needs emptying. These children will stop wetting when their body matures to a point where they can wake-up in response to their full bladder; and (3) a genetic disposition – children who wet the bed are more likely to have a family member who also wet the bed as a child. The cause of a child’s bedwetting will often inform how best to progress when it comes to treatment. There are a number of different bedwetting treatments currently available the most successful of these is the conditioning alarm with 75% of children achieving continence. Alarms can take up to 3 cycles of use so do not be disheartened if it does not work at first. The nasal spray medication that you refer to is like a synthetic version of ADH (antidiuretic hormone), which is designed to inhibit the amount of urine produced by the kidneys overnight. While some children do stop wetting the bed after its use, a common problem with this form of treatment is that once children stop the medication the bedwetting often resumes. While I completely understand your reluctance to use this, it can be particularly useful for situations like sleepovers and school camps – as it is very important that children do not restrict their social activities as a result of their bedwetting as it can impact negatively on their self-esteem. This form of treatment has met with more success when used in conjunction with a bedwetting alarm so that may be a better way to go. All the best, Dr Cathrine