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bedwetting alarms

by Diane K. Newman, RNC, MSN, CRNP, FAAN

Moisture-sensing/bedwetting alarms can be very helpful. All of these devices work on the principal of conditioned response. The child attaches a moisture sensor to their 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 wetting episode so that over time he learns to awaken 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 better during sleep. With reported success rates of 70-80 percent, alarms like NiteTrain-r® are considered the safest and most effective method for curing bedwetting, with a much lower relapse rate than medication.

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 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.

References

1. Berry, AK. Helping Children with Nocturnal Enuresis. AJN. 2006;106(8):58-65.

Posted August 2006

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