Bed-wetting blues: Millions of adults suffer, too

Some people wet the bed. Cynthia MacGregor wet her boyfriend.

“I was in bed with my then-boyfriend, one leg over his leg and I woke up and found myself peeing on him,” says 65-year-old MacGregor, a freelance writer and editor from Palm Springs, Fla. “He was a good sport about it, but I was embarrassed as all bloody hell.”

MacGregor’s episode with nocturnal enuresis — involuntary bed-wetting — took place 30 years ago, after the radiation treatment she received for her cervical cancer left her with temporary urinary incontinence. A talk with her urologist and a few months of medication helped her beat the bed-wetting — and the urgency and frequency issues that went with it — but others haven’t been as fortunate, primarily because they haven't been as forthcoming.

About 26 million American adults are currently affected by urinary incontinence, according to the Simon Foundation for Continence. Of those, an estimated 1 to 2 percent experience bed-wetting, either as an issue that’s carried over from childhood (i.e., primary enuresis) or a secondary condition that’s developed in adulthood due to a neurological disorder, prostate obstruction, diabetes, overactive bladder, complications from childbirth or other medical issues.

But some believe that number is low.

“I think bed-wetting is underestimated,” says Dr. Jennifer Anger, assistant professor of urology at UCLA. “It’s a don’t ask, don’t tell situation. Physicians don’t inquire about it and if they don’t inquire, it’s often not discussed. It’s very underreported.”

Many adults are loath to bring up the “b” word with anyone — even a doctor — and hide their night-time incontinence, “managing” their condition by limiting their life. They refuse to travel, to spend the night on a buddy’s couch and put off becoming intimate with those they’ve grown to love for fear their nocturnal nemesis will rear its head and cause them to lose friends or significant others. Some end relationships rather than spill the beans about their bladder trouble; others simply avoid them altogether.

More on this topic Auanet.org: The American Urological Association Nafc.org: The National Association of Continence, a nonprofit dedicated to improving the quality of life of people with incontinence NationalIncontinence.com: An online store for people of all ages with bladder control problems (kids’ products are available at Bedwettingstore.com) Nobedwetting.com: The Enuresis Treatment Center (for both kids and adults) focuses on deep sleep as a cause for bedwetting. Simonfoundation.org: A nonprofit whose mission is to bring the topic of incontinence out of the closet, remove the stigma surrounding it, and provide help and hope for people with incontinence, their families, and the health professionals who provide their care.

“Bed-wetting can affect partnerships, it can affect sleep, and it can be a financial burden, as well, if you factor in the cost of bedding, protective sheets, mattress covers, et cetera,” says Anger, who has been treating patients for 10 years. “It can have a significant impact on the quality of life.”

According to the National Association for Continence, two-thirds of men and women age 30 to 70 have never discussed bladder health with their doctor, and only one in eight Americans who’ve experienced loss of bladder control have actually been diagnosed. Women, who are between four and five times more likely than men to suffer urinary incontinence problems because of the trauma of pregnancy and childbirth, wait an average of six-and-a-half years from the first time they experienced symptoms until they obtain a diagnoses for bladder control problems. Men are even less likely to be diagnosed than women.

But the underreportage isn't just because doctors don't ask about bladder health, Anger says.

“When patients — especially older patients — are asked if they wet the bed, they almost always say no,” she says. “But when asked if they wear a pad or diaper at night and if they wet that, they’ll say yes. If the bed itself is not getting wet, they don’t feel they’re wetting the bed.”

Childhood burdens
The hedging and hair-splitting are part of a larger problem: the shame adults feel about owning up to a behavior that’s usually thought of as a bad childhood habit.

Connie, a 42-year-old Rome, Ga., housewife who’s dealt with wetting the bed on and off her entire life, says she has yet to discuss the issue with a doctor.

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“It’s just extremely embarrassing to talk about,” says Connie, who asked that her last name not be used. “It’s hard to come out and say, ‘I’m 42 years old and I wet the bed sometimes.’ I still remember my parents saying it was ridiculous that I would wet the bed, that I was just lazy. I was shamed about it as a kid.”

Many people perceive wetting the bed as being infantile behavior, says Dr. Elaine Ducharme, a Glastonbury, Conn., clinical psychologist who’s worked with several patients with enuresis. “When you’re a child, you’re spanked for wetting the bed. It’s considered naughty. And grown-ups aren’t supposed to do that. If you’re routinely wetting the bed, there’s a sense that you’re don’t have control of your body and that’s a big issue. Adults are supposed to have control of their bodies.”

Unfortunately, bodies can go haywire — sometimes in socially awkward ways — and people suffering with nocturnal enuresis are left to reconcile a mix of conflicting emotions: fear, shame, embarrassment, anger, denial.

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