Sleep Enuresis Sleep Enuresis Sleep enuresis is characterized by recurrent involuntary micturition that occurs during sleep. Persistent bed-wetting after age five in the absence of urologic, medical, or mental pathology is considered a primary enuretic disorder. Typically, the child has never achieved continuous dry nights. In secondary enuresis, the child has had at least three to six months of dryness. Enuretic episodes occur throughout all sleep stages, as well as during nocturnal awakenings.
Most episodes occur in the first third of the night.
Bladder control during the daytime can be normal. Primary enuresis is continuous from infancy, with children wetting from once or twice a week to nightly and often several times a night. Small functional bladder capacity and an irritable bladder are associated with multiple wettings at night and also with increased frequency of voiding and urgency during the day. In some enuretics, toilet training is not encouraged or achieved early in childhood. This finding may account for the increased prevalence of enuresis in lower socio-economic groups, where parenting skills or expectations may be less developed.