by Diane K. Newman, DNP, FAAN, BCB-PMD
Enuresis alarms can be a very useful solution to children's bedwetting. Bedwetting alarms for children condition the child to wake up and stop the flow of urine.
Bedwetting (nocturnal enuresis) can be difficult for both parents and children. Bedwetting causes social limitations for a child, especially about sleepovers with friends. Children commonly fear having their bedwetting discovered by others and they sense being different from other children. In fact, children who bed-wet are more likely to report being bullied by other children.
Parents often become frustrated and aggravated over the constant need to change bed linens and both children and parents may develop a sense of failure, which can be very painful for the child. As with incontinence in adults, bedwetting in children is surrounded with myths and misinformation.
Parents must understand that children eventually outgrow the problem. Only five to ten percent of children who suffer from enuresis are found to have a physical abnormality. Only one to three percent of adolescents over age sixteen are troubled by nocturnal enuresis. Controversy surrounds the various treatment options and most professionals feel that parents should postpone medical action, at least until puberty, since most children outgrow the problem by then. Bedwetting can be very upsetting for both children and parents but moisture-sensing/bedwetting alarms (enuresis alarms) can be very helpful.
All of these devices work on the principal of conditioned response. The child attaches a moisture sensor to his or her pajamas, or uses a pad with a built-in-sensor, which when activated by wetness causes an alarm to sound. The child becomes conditioned to wake up with each bedwetting episode so that over time he learns to wake up more quickly, and to eventually waken before he actually wets. It may also condition the child to contract the pelvic floor muscles when the bladder is about to release urine, so that the child eventually learns to hold urine better during sleep.
With reported success rates of 70-80 percent, bedwetting alarm systems like NiteTrain-r® are considered the safest and most effective method for curing bedwetting, with a much lower relapse rate than medication. The NiteTrain-r® will be greatly welcomed by parents of children who suffer from bedwetting. The device works by triggering an alarm when it senses the first few drops of urine, causing the child to wake up and stop the flow of urine. The alarm method along with parental help cures many children of bedwetting in just a few months.
The NiteTrain-r® consists of a small transistorized alarm and two, long-lasting moisture-sensing pads. It only takes one or two drops of urine to set off the alarm. This awakens the bed wetter so he/she can go to the bathroom normally. (There is no possibility of electric shock from the alarm system.)
Motivation on the part of the child and family, and commitment to using this device are critical to its success. Many parents feel that an alarm requires too much time, effort and motivation. Because the child may have difficulty awakening on his own, a family member must be an active participant in helping the child to awaken when the alarm sounds, particularly in the early weeks of use. It usually takes several weeks to see improvement, so the child may need encouragement to continue. The average duration of treatment is 3 to 4 months with consistent use. The child's sleeping arrangements and when the alarm is initiated (over summer or school break) are considerations.
Most experts recommend combining enuresis alarms with medications. Those who wet more than 1-2 times per night on a regular basis may benefit from using the alarm in combination with a medication. Children too young or not sufficiently motivated may have difficulty cooperating with the months long course of conditioning therapy.
Parents often report taking their child to the bathroom during the night, but express frustration that if a night is missed, or if the child is not lifted by a certain time, the bed will be wet. While lifting a child during the night may yield a dry bed, it is not helping the child learn to become dry, particularly when it is revealed that the child doesn't really awaken during the process.
An enuresis alarm can be a very effection solution to the problem of bedwetting.
References
1. Berry, AK. Helping Children with Nocturnal Enuresis. AJN. 2006;106(8):58-65.
Posted August 2006
Updated January 2009
