Bedwetting can be primary or secondary. A child with primary bedwetting has never regularly stayed dry during sleep for six straight months. A child or adult with secondary bedwetting had earlier stayed dry for at least six straight months. Then he or she began bedwetting at least twice a week for a period of at least three months. Some people may also urinate by accident when they are awake. This tends to be related to a physical problem. Social or mental stress is rarely the cause of primary bedwetting. But it does occur more often in children with attention-deficit/hyperactivity disorder and/or children living in disorganized families. There appears to be a genetic link to primary bedwetting. Children are more likely to have it if their parents and/or siblings had it as children. Bedwetting is reported of older adults in assisted-living homes. It is more common among women than men.
Secondary bedwetting occurs more often in children who have recently faced a strong social or mental stress. This includes parental divorce, physical or sexual abuse, or neglect. Secondary bedwetting can occur at any age.
Secondary bedwetting may be caused by or related to the following:
- An inability to concentrate urine, as in sickle cell disease or some forms of diabetes
- An increase in urine production caused by the use of caffeine, diuretics, or other substances
- A urinary tract problem, such as urinary tract infections or an irritable bladder
- Chronic constipation and involuntary soiling of the pants
- A neurologic problem, such as seizures and epilepsy
- Obstructive sleep apnea (OSA)
- Social or psychological stress
Secondary bedwetting among older adults may be related to symptoms of the following:
- Congestive heart failure
- Obstructive sleep apnea (OSA)
- Depression
- Dementia