Bedwetting (enuresis) in children with sickle cell disease (SCD)

This leaflet offers more information about bedwetting in children with sickle cell disease (SCD), including why it is common in children with SCD and what you can do to help. If you have any more concerns and questions do contact us.

What is bedwetting?

Bedwetting is a term for accidentally wetting the bed during the night and is a common problem. Although most children are able to stay dry through the night by the time they are four years old, some children take much longer before they are dry at night. In the UK approximately half a million children aged between 5 and 16 years old wet the bed, but the percentage of children who do this decreases with age.

The medical name for bedwetting at night is nocturnal enuresis. It is considered to be a problem when children over the age of five years wet the bed three or more times a week.

Does my child’s bedwetting have anything to do with their sickle cell disease (SCD)?

Children with SCD do appear more likely to have problems with bedwetting. This is mainly because the kidneys of people with SCD are less able to concentrate their urine and therefore make large amounts of dilute urine. This more dilute urine fills up the bladder quickly and results in children and young people needing to urinate more often during the night. When the children are asleep they may not notice that their bladder is full. Some children may also have a small bladder which will also mean that their bladder fills quickly and they are unable to get through the night without passing urine.

How can bedwetting affect my child?

Bedwetting often has a negative effect on a child’s self-esteem and can make them upset and sad. Bedwetting can also interfere with the child’s social development as they may not want to attend sleepovers or overnight school trips, or visit relatives. Having a child that is wet at night can also impact on the family since parents are often up in the night changing sheets. Parents may feel tired and frustrated due to lack of sleep, increased laundry and being unable to help their child. It is important to remember that the child can’t help this and shouldn’t be told off or punished.

What if the bedwetting continues?

If the bedwetting continues we can refer you and your child to an enuresis clinic. Following evaluation your child may be offered a number of treatment options:

Bedwetting alarm

This is an alarm attached to a sensor pad that is placed in your child’s underwear or under the sheet of the bed. When the child starts to urinate the alarm will sound and wake up your child, alerting them to get up and go to the toilet. With time your child will get quicker at waking, until they learn to wake before actually passing urine with a full bladder.

Medication

Medication for the treatment of bedwetting may be used when other methods haven’t worked.

Desmopressin can be used for the treatment of bedwetting. It works by helping to make the urine more concentrated, so there is less urine. However, when desmopressin is discontinued the bedwetting may start again.

Other drugs may also be considered including imipramine and oxybutynin.

Imipramine may be used if desmopressin does not work and oxybutynin can be used to improve bladder capacity. These will be discussed with you should they be considered in the enuresis clinic.

Almost all children will stop wetting the bed eventually. Only a few may continue into adulthood.

Further support available

The Sickle Cell Society (opens in a new tab)

Tel: 020 8961 7795

UK Thalassaemia Society (opens in a new tab)

Raises awareness in health education and provides counselling services to children with thalassaemia and their families.

ERIC (opens in a new tab)

Education and resources for improving childhood continence. This charity provides support and help through their website and freephone helpline (0808 1699 949).

Contact us

If you have any concerns or questions about bedwetting, please contact:

• the sickle cell team via the paediatric day unit (01223 257157) or
• the paediatric clinical nurse specialist (01223 216692)