A bedwetting alarm is an option to treat children who are wetting the bed at night. Using an alarm reduces bedwetting in about two thirds of children during treatment, and about half the children remain dry after stopping using the alarm. This leaflet just discusses treating bedwetting (nocturnal enuresis) with bedwetting alarms. Another separate leaflet called 'Bedwetting (Nocturnal Enuresis)' discusses bedwetting in more detail. There are also other leaflets about a medicine called desmopressin to treat bedwetting and reward systems to treat bedwetting.
What is a bedwetting alarm?
A bedwetting alarm is a device that wakes a child who begins to wet the bed. There are various types. For example, the mini or body-worn alarm has a sensor which is worn in the pyjamas or pants. The sensor is linked to an alarm (bell or vibration alarm). If the sensor gets wet, it immediately activates the alarm. The pad and bell is similar but the the sensor pad is put under your child.
How do bedwetting alarms work?
The sensors are usually so sensitive that the alarm goes off as soon as your child starts to wet (pass urine). This wakes your child who then stops passing urine. Your child should then get up and finish off in the toilet. This conditions your child to wake up and go to the toilet if he or she starts to wet the bed, or is about to start. In time, your child is conditioned to wake when their bladder is full before they begin wetting, or learns to sleep through the night without wetting the bed.
Where can I get an alarm?
Your local continence advisor will be able to lend you a device. (There may be a waiting list in some areas.) They will also give instructions on how to use it. Ask your doctor or practice nurse how to contact your local continence advisor. Alternatively, you may wish to buy one. The organisation listed below (ERIC) has details of devices available.
How is the alarm used?
Make sure you know exactly how the alarm works. Use it every night until your child has had at least 14 consecutive dry nights. On average, 3-5 months is needed for this.
At first it may be best for an adult to sleep in the same room as your child, and get up with them, as it might be frightening when the alarm goes off. However, when your child gets used to the alarm, he or she should take responsibility for getting up when the alarm goes off. In time, your child should also be given responsibility for re-setting the alarm after getting up, and for changing any wet sheets or bedding.
Some possible problems when using bedwetting alarms
- Sometimes your child just turns off the alarm and goes back to sleep. With some alarms you can place the alarm out of reach so your child needs to get out of bed to switch it off.
- Beware of batteries running low.
- False alarms sometimes occur if your child sweats a lot at night.
- Sometimes everyone else in the home wakes up, but not your child! This is unusual. If it happens, wake your child so that they switch off the alarm themselves.
How successful are bedwetting alarms?
In children who are old enough to understand (from aged around five and above) and who are happy to do this treatment, there is a good chance of a cure. (Alarms are not usually used in children aged under five.) Cured means more than 14 continuous dry nights within 3-5 months of starting to use the alarm.
Following an initial successful treatment, the bedwetting may return (relapse) at some point after treatment stops. If this occurs, a second course of alarm treatment will often work.
Tips for success
Success is more likely in well-motivated children. Motivation is helped by giving your child responsibility for the system, and praising your child for signs of progress.
Complete dry nights do not usually occur straight away. It takes time to gradually condition your child and their bladder. Signs of progress may include: waking and getting up to the alarm; smaller wet patches; the alarm going off later in the night or less frequently; a dry night.
You should not punish your child if there is no success. If there has been no response with the alarm after four weeks then it is unlikely to work for your child. You should see your continence advisor or GP if there have been no signs of progress after a few weeks or so. It is important to keep up contact with the advisor or GP every few weeks during the treatment period. Any problems or adjustments to the treatment programme can be discussed.
The alarms are usually used until your child has 14 dry nights and then they can be stopped. If your child relapses in the future then it may be worthwhile starting again with the alarm.
Alarms can be used with other treatments - for example, the medication desmopressin or with rewards. They can also be used when these other treatments do not work.
ERIC - Education and Resources for Improving Childhood Continence
34 Old School House, Britannia Road, Kingswood, Bristol, BS15 8DB
Tel (helpline): 0845 370 8008 Tel (admin): 0117 960 3060 Web: www.eric.org.uk Provides support and information (including booklets, CD-ROM, DVD, and video), and sells a range of products, including alarms, mattress and bedding covers, waterproof duvets, etc.
Further reading & references
- Nocturnal enuresis - the management of bedwetting in children and young people, NICE Clinical Guideline (October 2010)
- Bedwetting (enuresis), Clinical Knowledge Summaries (January 2011)
- Guidelines on Paediatric Urology, European Society of Urology (2008)
- Kwak KW, Lee YS, Park KH, et al; Efficacy of desmopressin and enuresis alarm as first and second line treatment J Urol. 2010 Dec;184(6):2521-6. Epub 2010 Oct 18.
- Kwak KW, Park KH, Baek M; The efficacy of enuresis alarm treatment in pharmacotherapy-resistant nocturnal Urology. 2011 Jan;77(1):200-4. Epub 2010 Oct 13.
- Glazener CM, Evans JH, Peto RE; Alarm interventions for nocturnal enuresis in children.; Cochrane Database Syst Rev. 2005 Apr 18;(2):CD002911.
- Ozden C, Ozdal OL, Aktas BK, et al; The efficacy of the addition of short-term desmopressin to alarm therapy in the Int Urol Nephrol. 2008;40(3):583-6. Epub 2008 Mar 5.
|Original Author: Dr Tim Kenny||Current Version: Dr Louise Newson|
|Last Checked: 25/03/2011||Document ID: 4205 Version: 39||© EMIS|
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