ADHD and bedwetting may occur together. This may be due to delays in the development of the central nervous system, which affects bladder control and recognizing the need to go to the bathroom.
People with ADHD may display certain behavior patterns, including difficulty focusing, hyperactivity, and impulsive actions. Symptoms can vary but can include:
- difficulty concentrating or following instructions
- difficulty staying organized
- interrupting others
- excessive movement or talking
Bedwetting can frequently occur in children with ADHD. The medical term for bedwetting is enuresis.
This article looks at the link between ADHD and bedwetting and tips for managing it.
Learn more about the early signs of ADHD here.
A 2020 study looked at the prevalence of ADHD in children with enuresis.
The study included 100 children aged 6–12 years diagnosed with enuresis. The study divided these two groups into those who also met the criteria for ADHD and compared them to an additional group of 40 children without an ADHD diagnosis.
Researchers found that in most cases, children with both enuresis and ADHD had abnormal brain waves in the left side of the brain. This type of brain wave links to epilepsy. In children without epilepsy, it may suggest brain dysfunction that could be a predictor of co-occurring enuresis and ADHD.
A delay in the typical development of the central nervous system (CNS) in ADHD may also play a role in bedwetting. As children develop, the CNS begins recognizing when the bladder is full, and bladder control improves. In children with ADHD, this development of the CNS may not happen until they are older.
- male biological sex
- lower educational level in parents
- having sepsis as a newborn
- low birth weight
- a family history of bedwetting
- cesarean delivery
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Research has found that bedwetting may harm a child’s self-esteem. A child may feel shame or embarrassment over bedwetting and fear other people finding out. This could lead to distress or shyness in social situations such as sleepovers.
It is important to reassure children that bedwetting is not their fault, to explain why it may happen, and remain calm and patient while managing it.
The American Urological Association recommends the following ways to manage bedwetting:
- Encourage children to drink enough fluids throughout the day, but limit drinks for at least 2 hours before bedtime.
- Reduce or eliminate caffeinated and carbonated drinks, as well as artificial colorings, as these can stimulate the bladder.
- Develop a schedule for using the bathroom 5–6 times throughout the day and twice before bedtime, even if the child says they do not need to go.
- If a child is not having at least one bowel movement a day, ask a doctor about constipation treatments, such as increasing fiber intake.
- Use a bedwetting alarm, a sensor that triggers an alarm when it identifies wetness and can help children wake up when they need the bathroom.
- Use a mattress protector and training pants for sleeping.
- After bedwetting, wash a child and use petroleum jelly to help stop the skin from chafing and becoming sore.
- Use a calendar to keep track of progress and monitor how well treatments are working.
If a child is comfortable sleeping in absorbent pants, it may help reduce stress or embarrassment. Using incontinence products does not delay the development of bladder control or toilet training.
According to a 2022 review article, certain medications to treat ADHD may also have beneficial effects on treating bedwetting, including:
- stimulants, such as methylphenidate
- alpha-2 agonists, such as clonidine
- serotonin-norepinephrine reuptake inhibitors (SNRIs)
- tricyclic antidepressants (TCAs)
Treatments may help to resolve bedwetting in children with ADHD. Behavioral therapies, such as bedwetting alarms, require time and consistency to implement but can be a successful treatment option.
With proper use over 1–2 months, alarms have a success rate of around 75% and low rates of bedwetting reoccurring once people stop using the alarm.
Research suggests that certain medications for behavioral disorders such as ADHD may also have beneficial effects on bedwetting, including stimulants, alpha 2 agonists, and SNRIs.
Bedwetting will stop in most children over time.
Treatments such as psychotherapy, education and behavioral therapies, and medications
It is common for children with ADHD to experience bedwetting. This may be due to a delay in the development of the CNS, which helps to control and regulate urination.
As children develop, bladder control and recognizing the need to use the bathroom improves. Evidence also shows that genetics may play a role in both conditions.
Bedwetting may adversely affect a child’s self-esteem, so it is important to reassure them it is not their fault; explain that it is a medical condition and that treatments can help.
Ways to manage bedwetting may include bedwetting alarms, limiting drinks before bedtime, and developing positive toilet habits. Using incontinence products and mattress protectors may make it easier to clean up after bedwetting.
In some cases, medications that can help manage ADHD may also have beneficial effects on bedwetting.