Many people have experienced waking up from a dream of going to the bathroom to find that they’ve either gone, are going, or really have to go. For most, this is a one-time occurrence and it’s nothing to worry about. If this is a repeated problem, however, you should seek help. It’s not the dream that’s causing the accident, it’s the fact your body isn’t waking up to its need to urinate.
“False Awakening”
It turns out this is a fairly common occurrence, one that happens to many people all around the world, old and young. In a false awakening, your dream of waking up is so vivid and realistic that you completely believe it, and then you behave as if you were awake, but you’re really still lying there asleep in bed. In a false awakening, dreamers often dream they are doing the regular things they need to do like getting up, getting dressed, brushing their teeth, and having breakfast. And, of course, peeing.
It’s like your body has two needs—to empty your bladder and to get enough sleep—and instead of sacrificing one (sleep) for the other (pee), it tries to take a shortcut: pee AND sleep. It’s like your brain’s lazy way of fooling itself into believing it can have it all.
Though it might seem like your dream made you pee, it’s likely the other way around, that your brain received the signal that you needed to go and then that stimulus provided the inspiration for your dream.
What to Do Now
If this has happened to you, you should know that you are not alone. Many people go through this experience without it becoming a recurring problem.
If it only happens once and does not occur again, don’t worry about it. It was a one-time thing, and there are thousands of other people who have experienced the same thing.
What Happens If It Doesn’t Stop
Bedwetting, also called nocturnal enuresis, is only a problem if it’s a regular occurrence. If you’re an adult experiencing frequent bed-wetting, this may be a sign of an underlying issue or problem. It’s important to seek out treatment to stop adult bedwetting, also known as sleep enuresis and treat the issue that’s causing it.
A lot of folks think bed-wetting is something that only happens to kids, but it’s a problem that can hit grown-ups, too. You may feel embarrassed to wake up to wet sheets, but it’s not your fault. It could be due to a medical condition, medicine, or a problem with your bladder. You’ve got lots of ways to fix it.
There’s no shame in recognizing that you have a problem with adult bedwetting. In fact, accepting that your body is not functioning the way you’d like it to be, is the first step towards treatment – and you’ll be happy to hear that real, effective treatments are available. Simply put, there’s no reason why anyone shouldn’t have a dry night – and that includes you.
Urine is produced by the kidneys and travels through the ureters to the bladder to be stored. The bladder is basically a muscular sac that holds urine until it is ready to be released into the urethra, the tube that connects the bladder to the outside of the body.
At the same time the bladder contracts, the urinary sphincter relaxes. The relaxed sphincter acts like an open door, which allows the urine to pass and exit the body. When there is a physical impediment or neurological disconnect, urination can become problematic or mistimed.
CAUSES OF ADULT BEDWETTING
There are several factors that can contribute to an adult experiencing nocturnal enuresis, or adult bedwetting.
GENETICS
The first place to check is family history. Evidence has shown that adult bedwetting is hereditary. One study has shown that someone with two bedwetting parents has a 77% chance of becoming a bedwetter. When one parent wet the bed as a child, his son or daughter was found to have a 40% chance of becoming a bedwetter. These probabilities carry into adulthood as well.
HORMONE IMBALANCE
Another factor may have to do with ADH, the antidiuretic hormone. Its main function is to signal the kidneys to decrease the amount of urine produced. Instinctively, the body normally produces more ADH to avoid nocturnal enuresis. However, some people do not produce the appropriate amount of this hormone at night, which leads to high urine production.
In other cases, the body produces ADH, but the kidneys do not respond and continue to produce the same amount of urine. This excessive production of urine during sleep is defined as nocturnal polyuria. This abnormality can cause nocturnal enuresis in adults, but it is also a symptom related to type I diabetes.
SMALL BLADDER
Patients with a “smaller” bladder are often dealing with primary nocturnal enuresis. The physical size of the bladder isn’t actually smaller, rather, the functional bladder capacity (FBC) can hold a smaller volume of urine.
OVERACTIVE BLADDER MUSCLES
If the muscles of the bladder, known as detrusor muscles, are overactive, nocturnal enuresis can occur. In fact, an overactive bladder muscle has been found in up to 70-80% of adult bedwetting patients.
Bladder irritants, such as alcohol and caffeine, can contribute to detrusor instability. Try tracking your diet and bladder activity in a bedwetting diary to see if you notice any correlations with what you eat and drink and wetting the bed.
URINARY TRACT INFECTION
An infection in the urinary tract can sometimes cause bedwetting
MEDICATIONS
Medications are also known to increase bedwetting in adults. Side effects from hypnotics, insomnia medications, and psychiatric medications such as thioridazine, clozapine, and risperidone can increase your risk. Be sure to talk to your healthcare provider about any medications prescribed and their side effects.
STRESS
Stress or anxiety can sometimes cause people to wet the bed.
OTHER HEALTH ISSUES
As for secondary nocturnal enuresis, there is plenty of research that suggests an underlying health issue is at the root of the bedwetting. Such problems can be associated with the prostate in men or pelvic organ prolapse in women.
Some other possible causes are:
- Blocked urethra (tube that carries urine from the bladder)
- Constipation
- Diabetes
- Obstructive sleep apnea
- Pelvic organ prolapse
- Problem with the structure of your bladder or other urinary organs
- Enlarged prostate
- Urinary tract stones or infection
How Is Bed-Wetting Diagnosed?
Your doctor will do an exam and ask about your symptoms and health history. Keep a diary so you’ll have the answers to his questions. Write down things like:
- How often and what time your bed-wetting happens
- How much urine comes out (a lot or a little?)
- What and how much you drank before bed
- Any other symptoms you’ve had
- Any existing recurrent urinary tract infections
- The number of wet versus dry nights
- In addition, note any other symptoms associated with nocturnal enuresis such as night sweats
Your doctor will do tests to diagnose the problem, such as:
Urinalysis. It checks a sample of your urine to look for an infection or other conditions of the urinary tract — the collection of organs that are involved with urine like the kidneys, ureters, bladder, and urethra.
Urine culture. Your doctor sends a small sample of your urine to a lab, where technicians put it in a special dish with nutrients. This test looks for bacteria or yeast in your urine. It can diagnose a urinary tract infection.
Uroflowmetry. You pee into a special funnel to measure how much urine you make and how quickly it flows out.
Post-void residual urine measurement. This test measures how much urine is left in your bladder after you pee.
Medications
Four primary types of medications are prescribed to treat adult bed-wetting, depending on the cause:
- Antibiotics to treat urinary tract infections
- Anticholinergic drugs can calm irritated or overactive bladder muscles
- Desmopressin acetate to boost levels of ADH so your kidneys will stop producing as much urine at night
- 5-alpha reductase inhibitors, such as finasteride (Proscar), shrink an enlarged prostate
How Do You Treat Bed-Wetting?
Your doctor may suggest you start by making a few changes to your daily and nightly routines:
Try bladder retraining. Go to the bathroom at set times during the day and night. Slowly increase the amount of time between bathroom visits — for example, by 15 minutes at a time. This will train your bladder to hold more fluid.
Don’t drink right before bed. That way, you won’t make as much urine. Avoid caffeine and alcohol, which can stimulate your bladder.
Use an alarm clock. Set it to wake you up at regular times during the night so you can use the bathroom.
Try a bed-wetting alarm system. You attach it to your underwear or a pad on your bed. It will alert you as soon as you start to wet the bed.
Take medicines. Several can help with bed-wetting. Desmopressin (DDAVP) reduces the amount of urine your kidneys make.
Other drugs calm overactive bladder muscles, such as:
- Darifenacin (Enablex)
- Imipramine (Tofranil)
- Oxybutynin (Ditropan)
- Tolterodine (Detrol)
- Trospium chloride
- Fesoterodine fumarate (Toviaz)
- Solifenacin (VESIcare)
BEHAVIORAL MODIFICATIONS FOR ADULT BEDWETTING
- Monitoring Fluid Intake. Limiting intake of fluids in the late afternoon and evening before bedtime causes a decreased amount of urine produced at night.
- Bedwetting Alarm System. Multiple variations of the alarm exist, ranging from vibrating to sounding alarms and wet-detection devices that can be attached to the underwear or a pad on which the individual sleeps.
- Waking. This involves randomly setting an alarm to go off in the night in order to wake one for urination. The randomness keeps from training the bladder to need to empty at a set time.
It’s worth noting that bedwetting in adults is actually different than what children go through. And while that might not remove the embarrassment, you must know that nocturnal enuresis is involuntary and not your fault.
Make an appointment with a doctor to discuss what’s happening. They’ll review your symptoms, health history, family history, medications and previous surgeries. The doctor may order a series of tests to look for an underlying cause. Finding a treatment will provide relief by limiting or stopping bed-wetting and any other symptoms you’re experiencing.
