Deep Sleep

Children with healthy bladders simply do not need to pee overnight. Because human beings typically do not eat or drink overnight, we do not produce enough urine to need to pee. A

healthy bladder has the capacity and stability to hold the urine we do produce. When a person — child or adult — needs to pee overnight, it is because his or her bladder is overactive; in other words, the bladder spasms when it is not full, often with little warning. In children, virtually all bladder overactivity is directly caused by constipation; the stool-stuffed rectum squishes the bladder, shrinking bladder capacity and irritating the spinal nerves that supply the bladder. There can also be is a delayed communication between the bladder and brain or “underdeveloped bladder” where an overactive bladder spasm too quickly for the child to react. It is like a hiccup: You cannot stop it. Even when fully awake, many chronically constipated kids cannot make it to the toilet in time to avoid an accident. So, if a child sleeps when the bladder hiccups, what chance does this child have of jolting awake and sprinting to the toilet? None! The theory that deep sleep causes bedwetting conveniently overlooks the proven connection between bedwetting and daytime accidents. Children, by contrast, experience dynamic, abrupt bladder spasms. So, boom: wet sheets.

If a toilet-trained child is wetting the bed, it is a sign of an overactive bladder and/or low

bladder capacity. But the bladder is small because the clogged rectum is squishing it not because the bladder is “underdeveloped.”