Bedwetting Alarms

This leaflet just discusses treating bedwetting (nocturnal enuresis) with bedwetting alarms. Another leaflet discusses bedwetting in more detail. There are also other leaflets about medicines 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. Bedwetting alarms are usually only used for children aged seven or over.

There are various types of alarm. 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 the child.

The sensors are usually so sensitive that the alarm goes off as soon as the child starts to wet (pass urine). This wakes the child who then stops passing urine. The child should then get up and finish off in the toilet. This 'conditions' the 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, the 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 the 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 the child, and get up with them as it might be frightening when the alarm goes off. However, when the child gets used to the alarm, he or she should take responsibility for getting up when the alarm goes off. In time, the child should also be given responsibility for re-setting the alarm after getting up, and for changing any wet sheets or bedding.

• Sometimes the child just turns off the alarm and goes back to sleep. With some alarms you can place the alarm out of reach so the child needs to get out of bed to switch it off.
• Beware of batteries running low.
• False alarms sometimes occur if the child sweats a lot at night. A double or thicker sheet over the pad may help.
• Sometimes everyone else in the home wakes up, but not the child! This is unusual. If it happens, the child should be woken so that they switch off the alarm themselves.

How successful are bedwetting alarms?

In children who are old enough to understand (usually aged seven and above) and who are happy to do this treatment, up to 8 in 10 will be 'cured' of bedwetting. 'Cured' means that they have more than 14 continuous dry nights within 3-5 months of starting to use the alarm. However, some children do not finish the 3-5 month course for one reason or another. (For example, they may not like the alarm, or do not co-operate.)

In up to half of cases, the bedwetting returns (relapses) at some point after a successful treatment. Do not despair. A second course of alarm treatment will usually work.

Success is more likely in well motivated children. Motivation is helped by giving the child responsibility for the system, and being praised for signs of progress.

Complete dry nights do not usually occur straight away. It takes time to gradually 'condition' the 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.
• a dry night.

Do not punish a child if there is no success. See your continence advisor or GP if there has 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 program can be discussed.

The chance of a relapse (return to bedwetting) after successful treatment may be reduced by a technique called 'overlearning' of the bladder. Your doctor or continence advisor may advise on this. Briefly, to do this, when the child has been dry for 14 consecutive nights, encourage him or her to then drink extra fluids during the day and evening. This expands the bladder even more than usual at night-time which aims to 'over-condition' the bladder. This may at first cause some wet nights after the success of the initial treatment which may discourage the child. However, continue using the alarm until there have been 7-14 consecutive dry nights during this 'overlearning' phase. Then, go back to drinking normally.

ERIC - Education and Resources for Improving Childhood Continence
34 Old School House, Britannia Road, Kingswood, Bristol, BS15 8DB
Tel: 0117 960 3060    Web: www.eric.org.uk    Website for teenagers www.trusteric.org
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.

© EMIS and PIP 2005   Updated: November 2005   PRODIGY Validated