Night incontinence means having bladder leakage at night, when you are asleep, or upon waking. It may also be known as bedwetting or nocturnal enuresis.
While this may be considered normal or common in early childhood, adult bed-wetting is also a commonly reported concern, and one person in every 100 may be affected throughout adult life.
Incontinence during the night causes many practical problems, such as constantly having to change wet sheets and bedding. It can affect staying away overnight, going on holiday, or business trips, and can affect sleep patterns, and often it causes frustration and exhaustion.
Bedwetting can also affect self-esteem which can put a strain on personal relationships.
While some people who experience incontinence during the day may also at night, the other way around is not systematic.
Why does this occur?
Children's night incontinence is often called Persistent Primary Nocturnal Enuresis. It is a condition that starts during childhood, where nighttime dryness has not been achieved for longer than six months. About 2 – 3% of adults over 18 years of age have this type of nocturnal enuresis.
Adult’s night incontinence is often called Adult Onset Secondary Enuresis and is defined as in which nighttime dryness has been achieved and may have occurred for many years, but then night time wetting suddenly begins at an older age. There are a number of reasons this may occur:
Our kidneys produce less urine overnight than during the day, meaning we can sleep for a long period without needing to empty our bladder. However, as we age our body produces more overnight urine, which can lead to more need to use the bathroom or more incontinence episodes in the night. This can also occur due to health conditions such as Diabetes Mellitus, or as a side effect of some cancers.
Some people with urge incontinence or “overactive bladder” may have sudden urge and incontinence in the night or when waking or getting out of bed.
Urinary tract infections can lead to increased urgency and frequency, and also incontinence.
Drinking large amounts of water, or particularly tea or coffee before bed can increase nighttime urination and incontinence.
What can be done to help?
There are different techniques that may be prescribed by your health professional, but some of these strategies may help reduce your night incontinence:
Keeping a bladder diary, which involves tracking your fluid intake and output over a number of days and nights. This can help to determine if there is excess urine being produced at night.
Reducing fluid intake before bed, especially tea, coffee, and soft drinks.
Setting alarms for toileting in the night.
Ensuring fully emptying bladder before bed.
Pelvic floor training may be helpful if you have pelvic floor muscle weakness contributing to your night incontinence.
Depending on the cause of night incontinence, medication may be prescribed
The recovery and prognosis for night incontinence are dependent on the cause or severity of the symptoms.
It is important to remember that night incontinence is not the same as daytime incontinence, and it can be a symptom of underlying health conditions.
If you develop new bed-wetting symptoms, let your doctor or Physiotherapist know right away.