Tonsils and Bedwetting

Interesting study indicating that about half of the bedwetters (ages 5 to 18) with breathing difficulties while asleep (apnea or snoring) stop wetting the bed after a tonsilectomy. Those who stopped wetting “had significantly more arousals and obstructive apnea episodes but fewer awakenings than” those who continued to wet.

Confirming again a connection between sleep patterns and bedwetting.

Frequency

I’ve always had a few dry nights a month, sometimes two or three in a row.

Lately, I’ve had dry weeks. Last month, I had two dry stretches of over a week each.

When I was in high school, I had a similar pattern. After a few years of chronic wetting, I wet only a few times a year. I thought that I was finally done with it. But it came back. The cause was (and is) still there. There’s no current or likely treatment for it. Even if I stop wetting for a while, it will probably come back.

Still, it’s nice to wake up dry.

The kids are outgrowing their bedwetting. Except for a few isolated accidents, Emily has been dry for months. She’s taken pullups to camp again, but that and sleepovers have been the only times she’s worn them in a long time. Jake hasn’t had an accident or worn a pullup, even to a sleepover, in over a year. Megan is getting some dry nights. Maybe by this time next year, I’ll be the only bedwetter in the family.

What I learned from Mom: Childhood

Mom told me that her relaxed attitude toward our bedwetting was a combination of experience, necessity and bluff. She tried hard to keep her worries from us kids, so that our bedwetting (and dealing with our bedwetting) were much harder on her than it seemed to me.

Mom confirmed the genetic aspect: She wet the bed until she was a teenager. (She didn’t say anything about Dad, and I didn’t ask. But my nieces and nephews on that side are late bedwetters as well.) It had been hard on her – waking (and sleeping) in a puddle, feeling shame and inadequacy, fearing friends’ discovery, hearing the contempt of relatives, avoiding overnight stays, smelling the odor that lingered in a room and on clothes. Her parents did not allow her to wear protection, believing that would remove the incentive to stop wetting. They tried all the available cures: Drugs, alarms, waking, no drinks before bed, …

Because of that, she knew that bedwetting wasn’t something that one could control. She resolved to be relaxed, sympathetic and reassuring to her own children, and provide us protection against a wet bed.

She wasn’t at all concerned that my sisters wet the bed as pre-schoolers.

When my oldest sister was about to start first grade, Mom raised her bedwetting with our doctor. He confirmed that it was likely not something my sister could control, and that Mom and my sister should not be too concerned. Some kids took longer to outgrow it. While there were drugs that sometimes provided relief, he didn’t recommend them for children. They weren’t a permanent solution and they had side effects. He didn’t recommend alarms or waking, either. Sleep is just too important to children. Unless she showed symptoms beyond just wetting the bed, the only thing he would recommend was to manage the consequences.

Genetics

Something that came as a surprise to me (although it’s relatively old news): Geneticists claim to have identified the locus of genes that correlate with primary enuresis.

I knew that surveys (dating back to the 1970s) suggest that a child is very likely to wet the bed (about 75% probability) if both parents did. If one parent wet the bed, chances are about even that the child will. If neither parent wet the bed, a child generally will not; a child with no bedwetting in the family tree (parents, grandparents, uncles and aunts) is rarely a bedwetter. Those probabilities are for primary enuresis, that is, for a child over the age of 6 who has never been dry. Secondary enuresis (such as mine), which starts after being dry for some time, is not genetically correlated.

The interesting thing — to me, at any rate — is that geneticists have identified the locus of several genes that appear to be correlated between parents who were bedwetters and their children who wet the bed. Some genes appear to be dominant, some to be recessive.

Some of the genes appear to be sex-linked. That would explain why, as children get older, boys are more likely to still wet the bed than girls are. That’s reversed in my family: My sisters wet the bed to a much later age — 16 or 17 — than my brothers did, and my son was dry while his older sister was still wetting most nights.

A few caveats:

My degrees are in mathematical disciplines. I have a low regard for the rigor of medical studies based on surveys. I doubt that the surveys allow the reported precision of the correlations. I doubt that the samples are large enough or representative enough for the correlations to be very convincing. Still, if one allows a wide margin of error, even at an anecdotal level there is a basis for belief.

While I have a background in statistical methods, I’m no geneticist. My knowledge of biology is limited to 9th-grade public-school frog-chopping (for which I got the worst grade of my academic career) and (like most people with math degrees) I regarded biology as only slightly more respectable than alchemy. On the other hand, geneticists do appear to take science seriously and a pointer to an actual gene is interesting.

Causes and Cures

Take heart: Just because I wet the bed at 30-something (and probably will wet the bed all my life) doesn’t mean you are doomed to a life of Depends and wet sheets. Time is likely to cure your condition, even if it won’t cure mine.

Almost everybody outgrows bedwetting. Some of my brothers and sisters wet the bed until high school, but their bladders eventually matured.

I won’t outgrow it. I have an otherwise asymptomatic brain condition that is likely the cause.