Peds

Bed-Wetting Alarm

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Bed-Wetting Alarm, Bed Alarm Therapy, Enuresis Alarm, Nocturnal Bladder Warning System

  • Indications
  1. Nocturnal Enuresis (Bed wetting) at least 1-2 times weekly typically in a child age 6 years and older
  • Preparations
  • Devices
  1. Bell, light, vibrator, or buzzer and Pad (Alarm)
  2. Alarms when device becomes wet
    1. Acoustic devices emit a loud sound
  3. Bed alarms that wake the child (instead of the parent) are most effective
  4. Children prefer body-worn bed alarms over bed pads
  5. Do not use electric shock alarms!
  • Efficacy
  1. Higher success rate (75%) than medications
  2. Least relapse rate after therapy is stopped (41%)
  3. Most effective in children age >6 years with frequent Nocturnal Enuresis (at least weekly) and in highly motivated families
  • Advantages
  1. Best efficacy of any method in Nocturnal Enuresis (better than Desmopressin and Imipramine)
  2. Low initial cost ($100) compared with medications
  3. Alarm may be covered by insurance
  4. Vibratory alarms are available for Hearing impaired
  • Disadvantages
  1. Requires use often for up to 15 weeks for full effect
    1. Reevaluate at 2-3 weeks after starting
    2. Consider other therapy if no effect by 6 weeks (consider re-trial every 2 years despite failed prior trial)
    3. May discontinue after 2 weeks of consecutive dry nights (restart if relapse)
  2. High drop-out rate (10-30%)
  3. Bed wetting should be at least 1-2 nights weekly to be warranted
  4. Parents and children must be motivated for success
    1. Parents often need to sleep in same room with child initially to assist awakening to the alarm
    2. Child may need to be awakened and carried to bathroom to finish voiding
  • References
  1. Baird (2014) Am Fam Physician 90(8): 560-8 [PubMed]
  2. French (2002) Am Fam Physician 65(9):1798-99 [PubMed]
  3. Jensen (1999) Scand J Urol Nephrol Suppl 202:73-5 [PubMed]
  4. Thiedke (2003) Am Fam Physician 67:1499-506 [PubMed]