BETTER BEDWETTING TREATMENT THAN MEDICATION
By Becky Ham, Science Writer
Health Behavior News Service
Release Date: May 2, 2005
Alarms that buzz, ring or light up when a child wets the bed are more
effective at stopping bedwetting than medications like the drug commonly
used to prevent urination, according to a new review of recent studies.
Among the 2,345 children enrolled in the studies, two-thirds of those
who used an alarm stopped bedwetting for 14 straight days. About half
of those children (55 percent) relapsed into bedwetting after quitting
the alarm treatment, compared with 99 percent of children who received
no bedwetting treatments.
“ On average, there were three fewer wet nights per week using
the standard alarm,” compared with no alarm, conclude Dr. Cathryn
Glazener of the University of Aberdeen in Scotland and colleagues in
the drug desmopressin stopped bedwetting faster than those using
system, but “there is no reliable evidence
that the drugs are effective after treatment has stopped,” says
Only 18 percent of children taking the drug stayed dry in the weeks
after the therapy, compared with 67 percent of children using alarms,
the researchers found.
Glazener and colleagues found some evidence that alarms are also better
at treating bedwetting than tricyclic drugs, a group of antidepressant
medications, but say more studies are needed to confirm this finding.
The review appears in the most recent issue of The Cochrane Library,
a publication of The Cochrane Collaboration, an international organization
that evaluates medical research. Systematic reviews draw evidence-based
conclusions about medical practice after considering both the content
and quality of existing medical trials on a topic.
Nighttime bedwetting, or enuresis, affects 15 percent to 20 percent
of 5-year-olds and 1 percent to 3 percent of teens, according to a
2003 report by the American Academy of Family Physicians.
not physically harmful, but it can cause “stigma,
stress and inconvenience” and increase the risk of emotional
and physical abuse by disapproving parents, say the Cochrane reviewers.
There are a variety of treatments for bedwetting, although most cases
of enuresis eventually resolve themselves, Glazener explains.
“ Without treatment, about 15 percent bedwetting children become
dry each year. However, it is not possible to predict which children
will become dry spontaneously,” she says.
Glazener and colleagues
analyzed 55 trials comparing the effectiveness of bedwetting alarms
to several other therapies. In general, the studies
were small, involving an average of 57 children, and “the quality
of many trials was poor,” Glazener says.
Most of the alarms used in the studies made a buzzing or ringing noise,
but alarms used in a 1964 study gave children small electric shocks.
Some of the children were burned by the shocks, many were frightened
of them and several parents refused to allow them to be used, say the
Glazener and colleagues found some, but insufficient, evidence to
suggest that an immediate alarm was better than a delayed alarm or
than one which woke the parents rather than the child.
They say that there is not enough evidence to determine whether alarms
are a better therapy than other interventions like waking up a child
during the night to use the toilet or using a reward system to encourage
The Cochrane reviewers
also examined studies of complementary or alternative treatments
including hypnosis, chiropractic methods,
acupuncture, psychotherapy and special diets. The complementary therapy
studies were small, single trials of “dubious” quality,
the reviewers found.
“ People often use complementary methods to treat their children,
but the review of trials did not provide good evidence to support this,” Glazener
C.M.A. Glazener et al. Alarm interventions for nocturnal enuresis
in children (Review). The Cochrane Database of Systematic Reviews 2005,
C.M.A. Glazener et al. Complementary and miscellaneous interventions
for nocturnal enuresis in children (Review). The Cochrane Database
of Systematic Reviews 2005, Issue 2
The Cochrane Collaboration is an international nonprofit, independent
organization that produces and disseminates systematic reviews of health
care interventions and promotes the search for evidence in the form
of clinical trials and other studies of interventions. Visit http://www.cochrane.org
for more information.
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