What causes primary betwetting?
Primary bedwetting probably indicates immaturity of the nervous system. A bedwetting child does not recognize the sensation of the full bladder during sleep and thus does not awaken during sleep to urinate into the toilet. Primary bedwetting is also viewed as a delay in neurological maturation. The cause is likely due to one or a combination of the
following:
Maturational delay - delayed functional maturation of the central nervous system, which reduces the child's ability to inhibit bladder emptying at night. The child's bladder will fill, but the sensory output resulting from the stretching of the bladder is not perceived or is not sent to the brain and, thus, central cortical control over the urinary sphincter contraction does not occur. Failure of the arousal mechanism may also contribute to the inability to inhibit micturition.
Genetic (hereditary) factors - A family history of nocturnal enuresis is found in most children with the condition. If both parents wet the bed when they were younger, three out of four of their children will have bedwetting problems. If only one parent wet the bed as a child, the odds decrease to slightly less than half. If neither parent wet the bed as a child, the odds that a child will wet the bed drops to one out of seven. Recently, researchers have pinpointed chromosome 13 as the home of the bedwetting gene. Further research continues in this area.
Hormonal problems - A hormone called antidiuretic hormone, or ADH, causes a person's body to produce less urine at night. But some people's bodies don't make enough ADH, which means their bodies may produce too much urine while they're sleeping. Under normal circumstances, the body's level of a hormone that decreases the production of urine by the kidneys (antidiuretic hormone) rises during sleep, causing the bladder to fill more slowly. In some children who wet the bed, this nighttime rise in antidiuretic hormone does not happen as expected. Therefore, the amount of urine made remains the same as during waking hours, so the bladder continues to fill as much as it would during the daytime.
Behavior and Psychologic Factors - Psychologic factors are an unlikely cause of primary enuresis in children. However, things such as divorce, the death of a friend or family member, a move to a new town and adapting to a new school and social environment, or family tension can all feel overwhelming. It's not uncommon for people to feel stressed out during their teenage years, and stress can disturb sleep patterns. |
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