Bedwetting children are often normal emotionally and physically, although<unk>  can be caused by other health conditions. Primary nocturnal<unk>  can have multiple causes, which can make approaching a course of treatment more difficult.<unk>  can be caused by one or more of the following: Caffeine consumption Caffeine is a diuretic, which means that it increases urine production. Reports from those who have failed<unk>  treatment say that they were not recommended to limit caffeine and that they mostly consume 2 to 4 mg/kg/day. Pattern and volume of fluid intake A pediatric day can be categorized into 3 periods: 7 AM to 12 PM, 12 PM to 5 PM, and after 5 PM. Children with<unk>  are usually dehydrated and drink the most after 5 PM. This can be remedied by having the child drink 40% of daily fluid requirement before noon, 40% from noon to 4:30 PM, and 20% in the evening. Lower functional bladder capacity Children with<unk>  have lower functional bladder capacity than healthy children. This means that their bladders hold less urine, often over 50% less. Dysfunctional voiding Both bladder voiding and storage problems may be present with dysfunctional voiding and may be present at any age. It is characterized by an obstruction of the bladder as a result of a non-neurogenic cause, which is due to the muscles controlling urine flow that do not completely relax. Symptoms may include daytime wetting, night wetting, urgency, a feeling that the bladder is always full, and straining to urinate. Urinary tract infection It is uncommon for nocturnal<unk> , in the absence of other symptoms, to be caused by an infection. Although uncommon in America, pinworm is linked with sudden onset<unk>  in young girls. Delay in maturation and development Mastering urinary control during sleep time is a normal part of childhood development and may be delayed by stress and social pressures. The risk for<unk>  increases threefold for children who experience stress, demonstrated by the higher prevalence of<unk>  in lower socioeconomic groups. Anxiety experienced by a child between ages 2 to 4 also increases the risk for<unk>  because this particular time period is sensitive for the development of nighttime bladder control. Nocturnal<unk>  has been found to be more common in those with developmental delay, physical or intellectual disabilities, and psychological or behavioral disorders. Bladder instability Urodynamic sleep studies show that enuretic children have high pressure bladder contractions more frequently while they are asleep when compared to healthy children. Nocturnal polyuria and antidiuretic hormone secretion Nocturnal polyuria is defined as having more than 130% of the expected bladder capacity, which is specific for each age. Many children with nocturnal<unk>  have altered nighttime secretion levels of antidiuretic hormone, which controls water retention in the body. This results in low antidiuretic hormone levels and excessive amounts of urine produced during sleep time. Sleep disorders The inability to wake from sleep has been understood as one cause of nocturnal<unk> , however studies focused on the importance of the time of night in which<unk>  episodes occur have shown inconsistent results. Parents often report that their bedwetting children are very difficult to awaken from sleep, therefore research regarding<unk>  has also aimed to elucidate why children with<unk>  do not awaken from the sensation of a full bladder. Some studies have led to hypotheses that children who suffer from<unk>  have altered hemodynamics during sleep (in terms of measurements of blood pressure and heart rate), sleep-disordered breathing, and altered hypothalamus function leading to a lack of bladder control during sleep. Genetics<unk>  is also theorized to be a hereditary condition based on epidemiological and genetic studies. Although several genes are considered of interest in relation to<unk> , lack of a single gene that may cause<unk>  means that individuals of a family may have differing genetic mechanisms resulting in the condition.
Enuresis
Diuresis
Natriuresis
Kaliuresis
Paruresis
Antidiuretic
Diuretic
Antipyretic