Forms of Behavior
Modification in Treating Bed Wetting
One of the most beneficial
ways to treat bed wetting from a behavioral perspective is by
way of a bed wetting alarm or moisture alarm.
These useful devices can be purchased
for anywhere from fifty to one hundred dollars and should be
carried by most drug stores as well as medical supply stores.
There are also ways to purchase the alarms from catalogues
available over the Internet. Research into moisture alarms has shown that they
have tremendously helped children in remaining dry night after
night.
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A Look at
Desmopressin Acetate
(DDAVP)
One of the most
commonly prescribed
medications for primary
nocturnal enuresis is
Desmopressin Acetate
(abbreviated to DDAVP).
This drug is a man-made
form of an antidiuretic
hormone in the body
known as vasopressin
and it can be
administered either in
tablet form or more
commonly as a nose
spray. This medication
decreases the amount of
urine manufactured by
the kidneys and
therefore decreases how
much urine exits the
body.
It is important to
take this medicine
right before bedtime
and if you are using
the nasal spray, to
blow your nose before
you use it. It is
important to
familiarize yourself
with the directions
before using the nasal
or nasal solution and
always use as directed.
This medicine should
not be used on children
who are under six
years. This medicine
starts to work promptly
and is considered
fairly safe to use
although it does have a
few possible side
effects. The most
common three side
effects are headaches,
nausea and stomach
pain. If you develop a
headache taking a mild
pain reliever is likely
to bring relief from
the discomfort. To
avoid nausea eat small
but frequent meals
instead of large meals.
As well chewing gums or
sucking hard candies
can lower the chance of
nausea.
For adults taking
this medicine there are
precautions you should
be aware of in regard
to it. First of all
alcohol should be
avoided while taking
this drug. This means
all kinds of beer, wine
and any hard liquor.
Alcohol may interfere
with the proper
functioning of the
drug. If you are
pregnant presently or
are trying to get
pregnant make sure your
doctor is made aware of
this. As well women who
are breast-feeding are
not advised to use this
drug. If you are
allergic to anything it
is important that your
doctor or health care
provider knows this,
even if it seems
insignificant to you.
Explain how the
allergic reactions you
suffered in the past
affected you, such as
if you experienced any
of these symptoms-
itching, rash, hives,
cough, shortness of
breath, wheezing,
swelling of the face,
throat, lips, tongue,
etc.
If for some reason
you forget to take a
dose at the specified
time then take it as
soon as you remember.
However if it is close
to the time for the
next dose then opt for
the regular dose and
just skip the one you
missed. Go back to your
regular schedule of
taking the dose at the
appropriate time and
don’t worry about it
too much. Whatever you
do never take two doses
at once or extras as
this can over load the
body and be harmful to
the system.
DDAVP is considered
to be safe and
effective for most
patients and has a
success rate that is
somewhere between
twenty-five to
sixty-five percent.
This drug is fast
absorbing and if it is
helping the patient
then it can be
administered every week
for three to six months
and then on a gradual
basis it can be
decreased. For example
it can be dropped down
to four or fives doses
a week and then down to
two or three and
finally it can be
dispensed with all
together. There are
sometimes relapses with
this drug but for the
most part it does what
it is supposed to for
the bed wetter.
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It is important to have a patient and supportive family
unit when undertaking this form of treatment for bed
wetting as it could take anywhere from a few short weeks to
many months for the alarm to be successful in its goal. It
is important to note that moisture alarms show very few
relapses as opposed to other forms of treatment and their
projected long-term success rate is high.
A moisture alarm is basically a
clip-on sensor probe that is attached to the outside of
underwear, pajama bottoms, a nightgown or is strategically
placed under the bed sheet close to a child’s bottom. When a
child begins to urinate in the night, the sensor sets off the
alarm which then wakes the child up and lets them know that
they need to go to the bathroom and empty their bladder. After
this the child can return to bed and reset the alarm in case
the urge to urinate again later in the night arises. After
being awakened enough times by the alarm, the brain becomes
conditioned to respond as promptly as possible when the brain
sends out the signal that the bladder is full and needs to be
emptied as soon as possible. There are some cases where
children, especially toddlers, sleep so soundly that they do
not hear or feel the alarm going off at all. In this case it
would be necessary for a sibling sleeping in the same room or a
parent to wake the bed wetter up. If this happens on too many
occasions then it is not likely to be the best form of
treatment for this particular problem.
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A Look at Primary
Enuresis
Primary enuresis or
primary nocturnal
enuresis (PNE) is when
a child has easily
developed the ability
to control their
bladder during the
daytime but still after
a six month period
cannot control their
bladder at nigh while
they sleep. Bed wetting
affects approximately
five to seven million
children every year,
more of these boys than
girls. Primary enuresis
is particularly common
in children who are six
years and younger and
in most cases it is
something that children
will outgrow. Studies
have shown that
approximately every
fifteen out of one
hundred children who
are chronic bed wetters
simply stop doing the
behavior and do not
require a visit to the
doctors or any form of
treatment
whatsoever.
Most children who
suffer from this
chronic problem are
embarrassed and
troubled by it. It is
important to reassure
children who suffer
from this chronic
problem that this is a
problem that will go
away in time. Also make
your child aware that
bed wetting does not
mean that he or she is
strange or abnormal in
any way, not physically
and not
psychologically. For
some children it is a
natural part of their
development and bladder
control is not achieved
at the same age for
every child.
Be aware that
primary enuresis is
often believed to
happen for one of two
reasons. First the
child has an immature
bladder either in a
physical sense or a
neurological one and
secondly, the child
falls into a very deep
sleep and is unaware
that the bladder has
sent a message to the
brain that it is full
and needs to be
emptied. As well
primary enuresis is
believed to have a
genetic link and may
not be something a
person can help.
Some children who
suffer from primary
enuresis wet their beds
night after night
without fail while
others tend to do it
some night but not
others. Sometimes there
is a pattern for the
latter and sometimes
there is not. A great
deal of children
experience bed wetting
more when they are at
home in their own beds
then when they stay
overnight at a family
member’s, a friend’s or
when the family is on
vacation. This is
believed to be a
psychological problem.
Most chronic bed
wetters are very aware
of their problem and
are therefore overly
anxious and
uncomfortable about it.
This anxiety can cause
a child to sleep very
lightly or hardly at
all when they are
sleeping somewhere
other than their own
bed. The fear of
wetting in a different
bed keeps them awake or
cognizant of the worry
and therefore less
likely to do it.
Many doctors believe
that the best way to
stop bed wetting is to
retrain your brain to
either wake yourself up
in the nigh when the
need to empty your
bladder arises or keep
you asleep and able to
hold the urine until
you rouse in the
morning. These
imperatives can be
achieved by way of
special exercises for
the bladder, such as
reading books about
staying dry at night,
visualizing yourself
waking up dry, holding
off using the toilet
until later in the
daytime and even using
a special alarm that is
attached to a pad
placed in your
underpants while you
sleep. If your bladder
begins to empty while
you are still asleep
the alarm will sense it
thereby causing the
alarm to buzz, vibrate
or in some cases both.
This will quickly and
easily wake up the bed
wetter.
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Counseling is sometimes used
for children who suffer a great deal of angst and anxiety in
coping with their bed wetting. Also if this stress is
interfering with treatment methods, counseling might be in
order.
Many doctors recommend a
combination of therapies for optimum results, such as combining
simple behavior modification in the form of positive
reinforcement and a bed wetting alarm.
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