My kids just left for summer camp. Chatting with
my mother-in-law the other day, I asked if her
kids had ever gone to overnight camp when they
"Sure," she said, "Margaret and
Debbie went. Bruce went." And she stopped
there. She didn't mention her other son, Jayme,
my successful, charming forty year old brother-in-law.
"How come Jayme didn't go?" I asked.
Was he adopted, I wondered? Did he have some crippling
disease as a young boy?
"He was a bed-wetter," she told me,
loosing this family secret on someone she should
have known would put it in every newspaper in
which he could get printed.
"Back then," my mother-in-law told
me, "the doctors just told us he was a heavy
sleeper and he'd grow out of it. But he didn't
grow out of it until he was in his teens. We rented
this thing they put under the sheet. As soon as
it got wet, a bell would ring. Well, it'd ring
and everybody would wake up. Everybody but Jay.
It was terrible for him. He didn't go to overnight
camp. And he didn't sleep over friend's houses.
It was embarrassing. Kids can be cruel."
The emotional trauma that Jayme grew up with
is not uncommon. Night-time bed-wetting, also
known as nocturnal enuresis, is a problem for
one out of every seven children between the ages
of 5 and 6 years old. A surprisingly large number
of children, nearly 10% over 8 years old, wet
the bed at night. Three and a half million kids
in the U.S. are bed-wetters. And boys are affected
nearly twice as often as girls.
Bed-wetting that occurs after toilet training
is not a disease in very young children. Accidents
are expected. Even early school age children have
occasional accidents. But everyone - parents and
peers - expects a child to be dry by the age of
eight or nine. After that age, nocturnal enuresis
can wreak havoc on a child's life, as well as
There are a lot explanations for bed-wetting.
Blame has been placed on emotional problems, developmental
delays, urinary tract abnormalities, allergies,
a hormone deficiency, and "deep sleep."
In individual cases, one or more of these factors
may be the cause. But I like my mother-in-law's
explanation of her son's problem the best.
"The little nerve in the head that says,
'Ding-ding! Wake up! You're bladder is full,'
After any clear anatomical or pathological problems
are ruled out, there are several treatment options.
Most doctors don't recommend treatment for 6 year
olds. But for 7 year olds, pajama moisture sensors
that awaken the child when he wets may be recommended.
This is a behavioral modification approach that
can take months to produce results. Quicker and
more effective are drug treatments. Tricyclic
antidepressants like imipramine have been reported
to have success rates up to 50%. How it works
isn't clear. Another drug, desmopressin, has an
even greater success rate. This drug works on
the theory that bed-wetters have a deficiency
of the hormone that the body secretes to save
water. This hormone is supposed to increase at
night to help the kidneys conserve urine and reduce
the filling of the bladder during sleep. Recent
medical studies have shown that levels of this
hormone fail to rise at night for many bed-wetters.
Adding this hormone, which can be prescribed as
a nasal spray, can alleviate the problem by correcting
Despite today's medical options, many parents
never seek help for their child's nocturnal enuresis.
Many attempt to correct the unacceptable behavior
of bed-wetting by a variety of methods that border
on psychological child abuse. Some use physical
punishment. Some shame and embarrass their children
by publicly displaying wet sheets or making the
child wash the dirty linens. More often than not,
a child's psychological problems are due to, and
not a cause of, bed-wetting.
Jayme turned out to be a great guy, though sadly
he never got to go to camp. But today, a child
with the same problem can pump a desmopressin
spray in his nose, stay dry all night, and just
be one of the guys in the bunk.