Causes of Nocturnal Enuresis in Adults
Nocturnal enuresis, commonly known as nighttime incontinence or bedwetting, refers to the involuntary urination that occurs during sleep after a person has reached an age where they can usually control urination. Various underlying factors can contribute to this condition in adults, including:
Genetic Factors
Genetics play a significant role in the development of nocturnal enuresis in adults. It is possible for environmental, psychological, social, and physical factors to also contribute. Research published in the Journal of Urology in 2001 indicates that the likelihood of developing this type of incontinence is hereditary, with an estimated autosomal dominant inheritance pattern of around 90%, despite the precise genes responsible for this disorder not yet being identified.
Hormonal Disorders
Certain hormonal imbalances may contribute to nocturnal enuresis in adults. For instance, insufficient production of the antidiuretic hormone (ADH) can lead to increased urine production at night. Additionally, the body may not respond appropriately to ADH, further compounding the issue. The antidiuretic hormone is crucial for reducing kidney urine production during sleep. If combined with bladder dysfunction or sleep disturbances, a lack of adequate hormone regulation can result in nighttime incontinence.
Small Bladder Capacity
A small bladder capacity can lead to increased urgency to urinate both during the day and at night, as those with smaller bladders may not be able to hold as much urine as their counterparts. This can create challenges in controlling urination during the night, thus resulting in nocturnal enuresis.
Overactive Bladder Muscles
An overactive bladder (OAB) occurs when the detrusor muscles contract involuntarily. This can happen due to abnormal nerve signals between the brain and bladder, or from the irritants found in substances such as alcohol and caffeine. These irritants can destabilize bladder muscles, leading to frequent urges to urinate. Under normal circumstances, the bladder muscles relax to allow for urine collection and contract when the body is ready to urinate; however, with OAB, these muscles can contract at inappropriate times, leading to an inability to control urination.
Medications
Certain medications can exacerbate nocturnal enuresis as a side effect, making it essential to consult healthcare providers regarding prescribed drugs and their possible implications. Some examples include:
- Medications for anxiety.
- Medications for insomnia.
- Drugs for managing hypertension and cardiovascular issues.
- Hypnotic medications.
- Psychiatric medications such as:
- Clozapine.
- Risperidone.
- Thioridazine.
Dietary Influences
Diet can also play a significant role in triggering nighttime incontinence, including:
- Alcohol: Alcohol intake can irritate the bladder muscles, leading to diminished awareness of the need to urinate, especially if the individual becomes unconscious due to intoxication.
- Caffeine: Caffeine can stimulate bladder muscle contractions, prompting the urge to urinate before the bladder is full, ultimately reducing the ability to hold urine over time.
Other Potential Causes
Additional reasons for nocturnal enuresis in adults include:
- Urinary Tract Infections (UTIs): These infections can lead to increased urgency and control issues.
- Neurological Disorders: Conditions like Parkinson’s disease, seizures, and multiple sclerosis may trigger involuntary urination.
- Sleep Disorders: Certain sleep disturbances can lead to increased production of atrial natriuretic peptide, affecting urine output.
- Stress and Anxiety: Emotional distress can manifest physically as nocturnal enuresis.
- Uncontrolled Diabetes: Elevated blood sugar levels can lead to excessive urination, increasing the likelihood of bedwetting at night.
- Tumors and Cancers: Tumors may obstruct the urinary tract, impacting the ability to control urination, particularly at night.
- Other Causes: Such as pelvic organ prolapse, constipation, prostate enlargement, urinary stones, urethral obstruction, or bladder deformities.
When to See a Doctor
If experiencing frequent nocturnal enuresis, it is advisable to consult a healthcare professional. This condition may indicate an underlying disorder that requires appropriate diagnosis and treatment. A healthcare provider may conduct several diagnostic tests and review other symptoms or medical history to determine the most suitable treatment plan.
Video on Nocturnal Enuresis in Adults
For additional information regarding nighttime incontinence in adults, please watch the following video: