Wednesday, 13 May 2015

Why simple strategies are not enough for bedwetting - Continued from last week

Continued from last week 

The new report was published recently in The Cochrane Library. For the review, Caldwell’s team reviewed 16 published studies involving more than 1,600 children, with about half trying simple interventions. Among them were fluid retention, rewards for dry nights (such as stars on chart), and lifting children and taking them to the bathroom after they have been asleep. 

No one simple strategy worked better than another, the researchers found. When they compared alarm training with the simple strategies, the alarm training was more effective. And treatment with medication alone was better than the simple interventions. However, the researcher noted that “the findings from this review should be interpreted cautiously due to the poor quality and small sizes of the trials.” The findings suggest that parents may want to start with simple treatments, Caldwell said, “then move to alarm training or medication if simple treatments do not work after trying for six months.” “Younger children generally take longer to respond to treatment,” she said. “Don’t get annoyed with the child, because bedwetting is usually out of their control.” 

While the alarm system, which sounds an alarm when drops of urine are detected, is effective, it is difficult to do, Caldwell said. Another downside she has sometimes seen is when children become dry on alarm training then develop sleepwalking or night terrors. “Bedwetting and night terrors and sleepwalking are all parasomnias (sleep disorders) and are known to be associated,” she said. The new findings mirror what U.S. expert Resnick has seen in his patients. “I’d say behavioural therapies work about 50 percent of the time,” said Resnick, who was not involved in the study. If simple treatments do not work, Resnick said he may consider medications, but he only prescribes them on an as-needed basis, since the medications have side effects.


This story was published in Newswatch Times on May 9,  2015.

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