Bed wetting and diaper use

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Bed wetting is one of the most widespread and chronic childhood disorders and may have a significant negative impact on the child.

Parents are concerned with the adverse social and emotional impact of bed wetting on their child. In an attempt to cope with bed wetting, many parents adopt methods that include waking the child during the night or taking him or her to the toilets during sleep to void.

Another coping method is wearing night diapers or napkins. However, many clinicians claim that this method can have an adverse impact on the child’s motivation to develop nocturnal bladder control and on self-esteem. However, there are no evidence-based studies supporting these claims.

A previous study in 2007 explored whether bladder voiding led to arousals in sleeping infants. They simulated voiding by administering water into diapers. This procedure did not cause an awakening nor induced body movements in sleeping infants.  Another study did not reveal an association between the type of diaper babies wear and the frequency of night waking of three months old infants.

In another study it was found that naturalistic sleep of children with bed wetting was significantly more impaired compared to sleep of non bed wetting children. A key finding was that this phenomenon was associated with the occurrence of bed wetting episodes and attempts to keep the child dry during the night.

 

Recently, it was shown that in comparison to children without bed wetting, children with bed wetting who did not sleep with night diapers had poorer sleep quality. and sleep of children using night diapers is similar to those of healthy children
One possible explanation is that sleeping with night diapers may reduce the implementation of adverse parental coping strategies and maintain children’s sleep. Another possible explanation is that night diapers prevent discomfort or awakenings related to wetting itself. These current study’s results may serve as evidence countering various possible claims suggesting that sleeping with night diapers at older ages may have a negative impact on children with enuresis and may perpetuate night wetting. It is also possible that using such strategy will contribute to reduction of parental stress and children’s feelings of shame due to being blamed by their parents for the burden of daily cleaning and washing of bedclothes related to enuresis. It may also lower the negative impact of enuresis on the child’s well-being and psychological functioning. Thus, clinicians and health care providers should consider recommending sleeping with night diapers for untreated children with enuresis, based on its positive impact on sleep.

 

Conclusions about Bed wetting and diaper use

Sleep of children with bed wetting who do not sleep with night diapers is impaired. In contrast, the sleep patterns of children with bed wetting who sleep with night diapers resemble to those of healthy children. Possible explanations for this phenomenon are that sleeping with night diapers may reduce the use of other common parental coping strategies, such as parent-initiated night-wakings, or can prevent discomfort or awakenings that can have potential negative effects on sleep. Thus, it is suggested that clinicians and health care providers consider recommending sleeping with night diapers for untreated children with bed wetting, based on its positive impact on sleep quality.