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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.



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.

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.

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.

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.