BedWetting (Nocturnal Enuresis) Explained

and Chiropractic’s Approach to the Problem

“It rained in my bed again last night,” were the very words a young lad wrote on a note to hand to his doctor. These words express the embarrassment and reluctance of a child to admit to the fact that he has wet the bed.

Many times parents actually blame their child for urinating in bed. They believe this is a behavior intended to get back at them for something. Nothing could be farther from the truth. No, children do not willfully wet their beds. This, in their words, is “gross.”

Oh, the anguish of the young child who wets the bed at night. He cannot go to camp, stay over night at his friend’s house, or go on trips without the constant fear of the wet bed in the morning. Psychologically the bed wetting child, bears a burden, but so does the mother. The constant changing of bed linen is certainly a chore she would like to put behind her.

Just what causes Nocturnal Enuresis (bed wetting) and is there any help for this problem? Yes, there is andto explain why children wet the bed we must understand a spinal reflex calledthe phrenic reflex. You see, when ababy sleeps, its respiration (breathing) gets slower and slower until a mothermight bend over the crib and exclaim, “My child’s not breathing!” Then suddenly the infant shudders, takes a deep breath, and the normalbreathing cycle resumes. With a sigh of relief, the mother returns to her activities.

This pattern of breathing goes on throughout the night. As the infant sleeps respiration continues to slow down untilthe carbon dioxide in the body gets high enough to trigger a breathing mechanismcalled the phrenic reflex. Thismechanism stimulates the large muscle of breathing, the diaphragm, to increasedactivity and the normal rhythm of breathing returns. If this mechanism is not working correctly, the carbon dioxide continuesto increase and when it gets too high, ‘smooth’ muscles begin to relax. Smooth muscles are the involuntary muscles of the body, those

thatfunction without our conscious control. Thevalve at the bottom of the urinary bladder is a smooth muscle, and when itrelaxes the bladder simply does not retain its fluid, you might say it leaksthroughout the night.

Now this is normal for infants as the phrenic reflex is not fullydeveloped at birth, but as the child grows, the reflex matures and soon mostchildren can sleep all night and retain their urine. This reflex develops moreslowly in boys, in the same way that boys mature sexually later than girls, andthus boys are more frequently bed wetters.

The bladder could be described as amuscular pouch that holds urine as it is discharged from the kidneys. The tubes from the kidneys are called ureters and the muscle that formsthe valve that holds back the urine is called the sphincter muscle.

The typical bedwetting child sleeps in a high state of carbon dioxideintoxication. This produces a deepsleep that appears almost comatose to the parents. It is very difficult to wake the child up to go to the bathroom. You almost have to manually lift the child up, lead him to the bathroom,command him to urinate, and lead him back to bed. Most commonly the bed is just as wet in the morning as it would have beenhad you not gotten the child up at all.

he sleeps.involuntarilywhile child does not voluntarily urinate in bed. The urine simply runs out ,the leaks throughout the night. Nothebladder the system. The bladder valve(sphincter) relaxes, and upin reflex allows too much carbon dioxide to build phrenic or immature ssluggish,child’. The slowrespiration and when at sleep, sleeping in a very deep slumber with toexhaustionA bed wetting child is typically a very active child, often playing


The Chiropractic Approach

Now in some children the phrenic reflex is simply slow to develop. In fact this slow development does at times run in families (hereditaryfactors), but in other children this reflex is disturbed by a vertebralmisalignment termed by chiropractors a “subluxation.’

The phrenic nerves come out from between the 3rd, 4thand 5th cervical (neck) vertebra. Subluxation of these vertebrae cancause nerve interference which can disturb the proper function of the phrenicreflex and cause bed wetting. Chiropractorscorrect vertebral subluxations, and thus influence the return of proper nervefunction.

Unfortunately, there is really no way to tell if a child is simply slowin the development of the phrenic reflex, or if a subluxation is the directcause of the problem. Chiropracticx-rays and examination can help pinpoint spinal problems, but the only real wayto see if chiropractic care will help Nocturnal Enuresis is to actually try it. A series of chiropractic adjustments will generally determine whether ornot chiropractic care will be of help. Somecases respond spontaneously with instant cessation of the bed wetting problem. In difficult cases it is sometimes wise to bring the child in for aseries of spinal adjustments and then wait a few months and bring the child backin again for care. Yourchiropractor can explain this to you. Hewill offer helpful suggestions which aid in controlling enuresis such asavoiding fluids before going to bed, preventing the child from excessiveexhaustion and fatigue, etc.; but be assured that chiropractic care does offer apositive approach to solving Nocturnal Enuresis. In many children it has completely solved the problem. If your child is suffering the anguish of bed wetting considerchiropractic care.

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