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Let’s Talk About Autism and Bedwetting

January 5, 2025

Let's Talk About Autism and Bedwetting

There are parents of autistic children who wonder if there is a connection between autism and bedwetting. They have probably noticed that their children have some sleep problems, like:

  • falling asleep and staying asleep
  • sleep apnea
  • night terrors
  • nighttime incontinence
  • nighttime bowel control
  • trouble waking up in the morning

These and other nighttime issues can cause anxiety in both parents and children. This article is going to discuss whether there is a connection between autism spectrum disorders and bedwetting, what the cause of the bedwetting could be, and what parents can do to help their child.

Is there a connection between bedwetting and autism spectrum disorders?

There would be different reasons that typically developing children wet the bed, some of those reasons include:

  • potty training difficulties
  • underlying medical condition (like urinary tract infection)
  • sleep problems

Children with autism have some other reasons they experience nocturnal enuresis, which, according to kidshealth.org, is “involuntary urination that happens at night while sleeping, after the age when a person should be able to control his or her bladder.

Some reasons autistic children may experience enuresis starts with, but is not limited to:

  • anxiety or anxiousness before bed
  • potty training difficulties
  • difficulty with daytime bladder control
  • some underlying psychological symptoms and other disorders
  • underlying physical medical conditions (like urinary tract infection)
  • sleep disorders (like sleep apnea)
  • difficulty controlling urgency and the ability to control their bladder
  • night terrors or nightmares
  • lying awake and inability to sleep
  • being a deep sleeper

It would seem that there could be connections between children with autism spectrum disorder and nocturnal enuresis, or bed wetting. It would seem that this doesn’t include all autistic children, or even all children with autism that wet the bed.

There are other factors that need to be considered. It is always a good idea to talk to your child’s doctor about anything that you may be concerned about. 

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  • Why is my child wetting the bed?

    There could be many different reasons why a child with autism is wetting the bed. Although there have been reasons that have been discussed above, there are night and daytime habits that could be causing the child’s bedwetting behavior.

    There are times when the child is able to fall asleep, they either experience restless sleep or deep sleep. Both of these can be problematic as the child who is experiencing restless sleep may be undergoing a particularly stressful and/or anxiety-filled time and cannot relax.

    On the other hand, there are autistic children who are in a deep sleep making it difficult to wake up when they have the urgency to urinate while they are sleeping. They may not realize until after they have wet the bed and have the uncomfortable feeling of wet underwear.

    There are also behavioral reasons that can cause bedwetting. If a parent feels that their child is exhibiting behaviors that are making toilet training difficult, leading to the child wetting their bed, they should discuss this with their child’s doctor to get ideas, help, and support for themselves and their child.

    How can I help my child have a dry bed?

    There are different things that parents can try that can help their autistic children get a better night’s sleep, as well as wake up to a dry bed. These include, but are not limited to:

    • practicing good sleep hygiene:
      a.) reducing screen time before bed
      b.) creating and implementing a good bedtime routine (with a visual chart if needed)
      c.) creating a comfortable sleep area
      d.) using a weighted blanket or other nighttime comfort item
      e.) keeping sensory aversions in mind with pjs, blankets, etc.
    • using a mattress pad and mattress protector on the child’s bed
    • using a bedwetting alarm that helps to alert parents and children when a bedtime accident is happening

    Although there is no one size fits all guide to eliminating bedwetting, parents can talk to their child’s doctor to get ideas of how to help their children with autism. If the doctor is unable to answer their questions, they can refer parents to a pediatric psychology professional that could determine if the bedwetting is a behavior that could benefit from different types of behavioral intervention.

    If the underlying problem is physical, then a pediatric urologist could determine underlying bladder, kidney, or other ailments. If treatments, medications, or behavioral interventions are needed, they can then be implemented and monitored to figure out if they are successful in helping with sleep problems and/or wetting the bed.

    Final thoughts

    Overall, there could be a connection between autistic children and wetting the bed. Whether the reasons are physical or behavioral, that is a conversation that a parent can have with their child’s doctor.

    That conversation is important so that the correct course, that is the most beneficial for the child, can be taken. If the doctor is unable to help the child, they are able to refer the child and parents to specialists that can help.

    Please keep in mind if there are any other symptoms like sleep apnea, constant urinary tract infections, chronic constipation, or other gastrointestinal discomfort, it is suggested to get medical attention right away. There is no real way to determine if there are any underlying conditions that could be medical or behavioral without a medical professional because they are able to test and check symptoms.

    Other articles you may be interested in:

    References

    Doman, M. (2022). A Closer Look at Sleep Disorders with Autism. https://www.autismparentingmagazine.com/sleep-disorders-autism/

    Escoto, M. (2018). Bedwetting (Nocturnal Enuresis). https://kidshealth.org/en/teens/enuresis.html

    Equit, M., Gontard, A., Niemczyk, J., & Pirrung, M. (2015). Incontinence in children with autism spectrum disorder. https://pubmed.ncbi.nlm.nih.gov/26052001

    Hobbs, K. (2021). How Does Autism Affect Sleep In Some Children?https://www.autismparentingmagazine.com/autism-and-sleep/

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