Nocturial enuresis

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Overview

Nyctalopia refers to night blindness or difficulty of the eye in visualizing under dim light or at night. Daytime vision, however, is unimpaired. Nyctalopia is due to the eye's inability to adapt quickly from lightness to darkness. The principle cell-type associated with Nyctalopia is rod cells. Rods are a type of photoreceptor cell present in the retina that transmits low-light vision and is most responsible for the neural transmission of nighttime sight. Rods have a singular photopigment, rhodopsin, which utilizes the protein scotopsin and the Vitamin A-derived cofactor, retinol. This cascade is essential for the body's ability to regulate the pupillary light reflex. The pupillary light reflex allows unilateral afferent detection of changes in light energy entering the eye, and efferent adjustments in the pupillary sphincter and dilator pupillae muscles to initiate consensual constriction and dilation of the eyes. Pupil dilation is an adaptive response to changes in lightness and darkness. Night blindness is the physical manifestation of impaired functioning of these processes.

Symptoms

Bed-wetting — also called nighttime incontinence or nocturnal enuresis — is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected. Soggy sheets and pajamas — and an embarrassed child — are a familiar scene in many homes.

Causes

Physical and psychological conditions can lead to some people having bedwetting. Common causes of children and adults having bedwetting include:

small bladder size

urinary tract infection (UTI)

stress, fear, or insecurity

neurological disorders, such as being post-stroke

prostate gland enlargement

sleep apnea, or abnormal pauses in breathing during sleep

constipation

Hormonal imbalances can also cause some people to experience bedwetting. Everyone’s body makes antidiuretic hormone (ADH). ADH tells your body to slow down the production of urine overnight. The lower volume of urine helps a normal bladder hold urine overnight.

People whose bodies don’t make sufficient levels of ADH may experience nocturnal enuresis because their bladders can’t hold higher volumes of urine.

Diabetes is another disorder that can cause bedwetting. If you have diabetes, your body doesn’t process glucose, or sugar, properly and may produce larger amounts of urine. The increase in urine production can cause children and adults who normally stay dry overnight to wet the bed.

Risk factors

Gender and genetics are among the main risk factors for developing bedwetting in childhood. Both boys and girls may experience episodes of nocturnal enuresis during early childhood, usually between ages 3 and 5. But boys are more likely to continue to wet the bed as they get older.

Family history plays a role, too. A child is more likely to wet the bed if a parent, sibling, or other family member has had the same issue. The chances are 70 percent if both parents had bedwetting as children.

Bedwetting is also more common among children diagnosed with attention deficit hyperactivity disorder (ADHD). Researchers don’t yet fully understand the relationship between bedwetting and ADHD.


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Complications

Although frustrating, bed-wetting without a physical cause doesn't pose any health risks. However, bed-wetting can create some issues for your child, including:


Guilt and embarrassment, which can lead to low self-esteem

Loss of opportunities for social activities, such as sleepovers and camp

Rashes on the child's bottom and genital area — especially if your child sleeps in wet underwear

Prevention

Reduce evening fluid intake. ...

Have your child go to the bathroom before getting into bed.

Set a goal for your child of getting up at night to use the toilet. ...

Make sure the child has easy access to the toilet. ...

Reward your child for remaining dry. ...

Consider using absorbent pants at night.