Nocturnal enuresis is defined as the involuntary act of peeing while sleeping. It is considered normal in children up to 5 years old and is common for it to occur up to 10 years old. Children with nocturnal enuresis have excessive urine production at night, poor ability to wake up, that is, very deep sleep, and reduced bladder capacity. Additionally, children with nocturnal enuresis often have incontinence or need to urinate many times during the day. There are two types of enuresis, primary and secondary. A child with primary enuresis will wet the bed from a young age, while someone with secondary enuresis begins to wet the bed or have problems at least 6 months (even years) after learning to control their bladder.
The emotional impact on both the family and personal level is significant. Numerous studies indicate feelings of anxiety, shame, low self-esteem, affectation of interpersonal relationships, quality of life and school performance. In this Psychology-Online article, we will talk about secondary enuresis in children and its psychological causes.
Psychological causes of secondary enuresis
Some of the possible psychological or emotional causes of secondary enuresis in children are:
Evolutionary stage or role transition
Life can be very stressful for both adults and children, and nothing is more stressful than having new responsibilities, starting to do new things, the birth of a sibling, changing schools, etc. These changes can lead to enuresis, but children should know that it is not their fault.
problems at home
Sometimes bedwetting is seen as an unconscious sign that the child does not perceive the house as a safe place. It may be due to parental divorce, neglect, abuse, alcoholism, etc. Some studies indicate that sexual abuse is a risk factor important for developing enuresis. Unfortunately, these cases are difficult to detect due to the taboos present on these topics.
Post-traumatic stress disorder
Bedwetting may be a psychological response to trauma. Natural disasters, wars, robberies, a sudden hospitalization and the death of a family member can trigger a . Some studies showed that children who had survived a traffic accident later reported having enuresis and showed other symptoms of post-traumatic stress.
Secondary enuresis: other causes
Secondary enuresis may be indicative of an underlying medical problem. Sometimes the exact cause of enuresis is not exactly known. Some of these possible causes are:
Sleeping problems
The feeling of having a full bladder causes many children to wake up in time to go to the bathroom to urinate. But some children sleep so soundly that they are not able to get up in enough time, and they pee in their sleep.
Obstructive sleep apnea
Although very rare, apnea can also cause secondary nocturnal enuresis. The presence of large adenoids is the most common reason for obstructive sleep apnea that can develop enuresis.
Bladder problems
Some children have small bladders that cannot hold a lot of urine. Others may need to pass a lot of urine at night. In some children, too many muscle spasms can prevent the bladder from holding a normal amount of urine.
Overactive bladder
This is a common cause of secondary enuresis in preschool children. Children with an overactive bladder need to pee more times than is considered normal, often have to run to get to the bathroom on time, and often wet their pants.
Medical problems
Bladder infections, constipation and diabetes can also trigger secondary nocturnal enuresis. Having difficulty pooping can also aggravate enuresis. Children who have diabetes can also develop enuresis due to the large amount of urine they produce and excessive thirst.
Hormonal problems
A hormone called antidiuretic hormone causes the body to produce less urine at night. But some bodies do not produce enough of this hormone, causing their body to need to eliminate more urine while they are sleeping.
Genetics
Some children have a parent who also has this problem. There are researchers who talk about specific genes that cause enuresis.
Risk factors for secondary enuresis
The appearance of this type of disorders is multifactorial origin. This implies that there are no indicators that determine the appearance of secondary enuresis but rather that there are certain predisposing or risk factors, among them we find the following:
- Being a boy and having a family history with enuresis problems
- Medical problems such as bladder, kidney, or neurological problems
- Sleep apnea
- Chronic constipation
- sexual abuse
- Drinking excessive fluids before going to bed
- Urine infection
- Some medications or substances, for example caffeine.
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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