|
How long will treatment
take?
Typically
treatment is 6 to 8 weeks, but with treatment of
any condition there is a great deal of
variability. If you are familiar with the normal
distribution graph, then this describes the
treatment time parameter, e.g., some children will
respond and be finished with treatment within a
week, a larger group take 3-8 weeks, and a small
group takes longer. While it is quite normal for
some children to take longer, if you become
concerned about the time, just contact us at info@DRI-Sleeper.com.
My child sleeps very deeply so
how will the DRI
Sleeper™ help?
All
children who wet the bed sleep very deeply, but
research indicates that all young children sleep
more heavily than adults, because they spend more
time in the deep sleep phases. Therefore there is
no consistent evidence that children who wet the
bed actually sleep more heavily than children who
do not. Nonetheless parents will usually agree
that their bedwetter sleeps more heavily that
their other children. So we have designed the
DRI
Sleeper™ alarm to
be maximally alerting for heavy sleepers, firstly
because of its loudness and position on the
shoulder, and secondly because the frequency is
particularly alerting.
An alarm clock does not wake my
child and so how will the DRI
Sleeper™?
There are
several reasons why the DRI
Sleeper™ is more
likely to wake your child.
| (i) |
The alarm unit of the DRI
Sleeper™ is
placed on a Velcro patch on the shoulder of the
child, and so is much closer than an alarm
clock, and therefore, while the alarm clock may
appear to be quite loud, it is not as loud as
the DRI
Sleeper™
. |
| (ii) |
The DRI
Sleeper™ is
triggered as the child starts to pass urine, and
this is likely to be when the stage of sleep is
closer to waking, and so there is a higher
chance of the child waking to the
sound. |
| (iii) |
An alarm clock being set to go off at a
particular time will have no relationship to the
child experiencing the urge to urinate, and so
not only is the alarm clock not as loud as the
DRI
Sleeper™ , but
it is going off without there being the
important relationship between the sound and the
urge to empty the bladder, and the child being
in a lighter state of sleep.
|
What if the DRI
Sleeper™ does not
wake my child?
Surprisingly these are the children for
whom the use of an alarm is very important. Take a
look at what well-known pediatrician Dr
Green says. He explains that the children who
initially do not wake to the alarm are very
suitable for alarm treatment.
With
these children the strategy is that you hear the
alarm, go into the room, put on the light, say
your child’s name, and if no waking is happening,
wipe your child's face with a cool damp cloth.
Leave the alarm beeping.
Then have
your child get up (by themselves) and go to the
bathroom with the alarm still sounding, and ONLY
then should you unplug the alarm.
The
reason for this is so that waking is happening
with the alarm sounding, and a link between waking
and the sound of the alarm can be formed in your
child’s brain.
It is
very important that in the morning that your
child remembers the alarm sounding and going to
the bathroom, because only if your child remembers
will learning happen effectively.
However,
for these children there is this extra step in the
treatment program and so expect it to take
longer.
But what if even that doesn’t
work?
When
there is still no progress (and I guess it’s no
comfort to you that not many children are in this
category), a part of the learning to wake to the
alarm is practised during the day.
Have the
alarm box already attached to a favourite pyjama
top, or maybe a T shirt that you have bought
especially for this treatment (anything that makes
the process special will help).
Check the
alarm is working correctly by plugging in the
detector and touching the sensing surface with a
damp finger and noting that it beeps.
Before
you follow this routine, make sure you know it
well. Explain it to your child, and make sure your
child understands that this practise is teaching
the brain to be ready to wake to the buzzer, and,
that with practise your child's brain will get
fast enough to beat the buzzer. Then he or she
will have dry beds.
| 1. |
From dinner time on, have your child
drink extra liquids. This may sound strange, but
we are wanting to get plenty of practise at the
routine of responding to the
alarm. |
| 2. |
Have your child tell you when he or she
needs to go to the bathroom (you could call it
having a “bladder signal” or any other term you
like, as long as it is one that you have agreed
on and you continue to use that
term). |
| 3. |
Immediately go with your child to the
bedroom, have him or her put on the pyjama top
with the alarm box attached, lie on the bed, and
pretend to be sleeping. Plug on the detector,
but you hold on to it. |
| 4. |
When he or she is relaxed, you make the
alarm "beep" by touching the detector sensing
surface with your damp finger. Then your child
is to get up and you both run right along to the
bathroom, with the alarm still
beeping. |
| 5. |
Have him or her unplug the detector from
the alarm box, just as would happen if this were
during the night. |
| 6. |
When possible, another parent or sibling
may also help, by going to the parents’ room and
when the alarm starts beeping, "race" the child
into the bathroom. Children of this age tend to
like this kind of competitive involvement. It
also encourages the sense of urgency to react to
the alarm beeping. |
| 7. |
Have your child splash his or her face
vigorously five times in a row with cold water.
Then pretend to use the toilet for a few seconds
as if to urinate, and have your child say, "I
have a bladder signal (or whatever is the term
you have agreed on), but I can wait to urinate."
|
Return to
the bedroom and repeat steps 3 to 7 above four
more times. If your child cannot hold off
urinating, then let him or her urinate and then
continue until you have practiced steps 3 to 7
five times in total.
If after
a week your child is still not waking to the alarm
at night, then increase the number of repetitions
to 10 times per evening. For more difficult cases
go to 20 repetitions in the 3rd week.
If even
this is not successful (and that’s very rare) then
leave it for a few months to allow more brain
maturing and then start again.
General Bed
Wetting Questions
My child is a bed wetter. Is that
unusual?
20% of 5-year-olds and 10% of
7-year-olds wet the bed at night. By the age of
10, that figure is closer to 5%, and even at the
age of 18 it is still 1-2%. In short, bedwetting
is quite common.
Does it mean that there is something
wrong with my child's
bladder?
Bedwetting is hardly ever
caused by abnormalities in the bladder. But if
your child is previously "dry" and then starts to
wet the bed at night or during the day, then it is
important to see a doctor to check out if there is
any medical reason for that. A few children may
have a rather small bladder, but that usually
shows up by a child needing to go to the bathroom
frequently during the day, and passing only a
small amount of urine. Again, if you suspect that
this is the case, have you child checked out by
your doctor, and bladder stretching exercises may
be necessary before starting any treatment for
night-time bedwetting.
Does this mean my child sleeps too
deeply?
All children who wet the bed
sleep very deeply, but research indicates that all
young children sleep more heavily than adults,
because they spend more time in the deep sleep
phases. Therefore there is no consistent evidence
that children who wet the bed actually sleep more
heavily than children who do not. Nonetheless
parents will usually agree that their bedwetter
sleeps more heavily that their other
children.
I used to wet the bed myself when I
was young. Could I have passed this on to my
child?
Yes, that is very likely,
because it has been found that if both mother and
father were bedwetters that there is around a 70%
chance that the pattern will be repeated in one of
their children. If only one parent was a bedwetter
there is a 50% chance of a child being a
bed wetter.
Are there different kinds of
bedwetting?
Yes there are. Never having
been dry at night since coming out of diapers is
what is called "primary" bedwetting (primary
nocturnal enuresis), and that's
the most common problem, and is the one which is
passed on in the genes.
When a child has been dry
(for a period of at least six months, and
starts to wet the bed, perhaps in the daytime too,
that is called "secondary" bedwetting (secondary
nocturnal enuresis), because it
is secondary to some other problem. It is most
likely to be caused by a medical condition or
perhaps an emotional upset of some kind. This secondary type
is the one that needs to be checked out by a
doctor. However, it is fairly uncommon, perhaps
around 1-2% of cases.
What actually causes
bedwetting?
There is no definite answer
but I will sum up what is known so far.
| 1. |
Primary bedwetting runs in
families and is a genetic condition. There is a
pattern of heavy sleeping, and producing high
amounts of urine while asleep. |
| 2. |
Secondary bedwetting might
be due to a physical or emotional problem, but
as I said, it is quite
uncommon. |
| 3. |
Recent research suggests
that some children who wet the bed may suffer
obstructed breathing while they sleep. These
children may have problems with their tonsils,
and some of them have been found to have a
rather narrow ''V'' shaped palate. These
children are inclined to snore. If your child
snores at night, and in particular you notice
that breathing stops for a period, or your child
suffers from infected tonsils, then it is
important to have this checked out by your
doctor. |
What should I do
now?
First of all decide whether
your child's bedwetting is the primary kind, the
primary kind is when your child has mostly not
been dry at night since coming out of diapers (a
rule of thumb is that your child is at least five
years old, and bedwetting is happening at least
two times a week). This type of bedwetting is the
case with 98% of bedwetting.
If your child has been dry at
night for two or three years, and then begins to
start bedwetting, then this is likely to be the
secondary kind and needs to be investigated by
your doctor.
If your child suffers throat
infections, or snores at night and in particular
appears to stop breathing at times, then this also
needs to be investigated by your
doctor.
My child
has never been dry at night and so it's the
primary kind of bedwetting. What's the best way of
curing this problem?
Professor Hjalmas, a world expert,
has said that the bedwetting alarm "… is the only
method proven to have cured the problem." (See The Report).
How does
a bedwetting alarm work?
The DRI
Sleeper™ has two
parts to it. It has the alarm unit which is
approximately half the size of a credit card in
its width and length, and only 5/8 of an inch (12
mm) thick (one of the smallest alarm units
available).
On the back of the alarm case
is a hook piece of Velcro, and we supply the loop
piece of Velcro which you can sew or pin to the
pajamas. The alarm case sits firmly in place on
the Velcro patch, and you can pull it off in the
morning.
The second part is that the
moisture detector (Flexitector), and this plugs into the alarm
unit which sits on the child's shoulder. The wire
runs inside the pajamas down into the
crotch of the underwear where the detector part
is positioned (see "how
does the detector stay in the underwear").
When the child starts to wet,
the urine hits the detector and triggers the alarm
and wakes the child.
What if
my child does not start waking to the alarm
straight away?
It may take a few days, and
in some cases a week or two, for some children to
begin to wake to the alarm, and until that happens
it is important that you wake your child, and make
sure your child is completely awake before
unplugging the detector to switch off the alarm.
The reason why it is very important to make sure
your child is completely awake (even using a cool
face cloth on the face to make sure) is so that
your child is aware of being awakened to the sound of
the alarm, and can remember the next day
having been awakened by it.
Remembering the occurrence
will assist in learning to recognize the sensation
of a full bladder.
What
happens when my child has started to wake to the
alarm?
Over the next few weeks the
child is learning to react more and more quickly
to the alarm, and then begins to "beat the buzzer"
by waking up before starting to pass urine. Now
the child is beginning to respond to the sensation
of the bladder filling, which is exactly to which the
treatment has been leading.
The process is then to keep
using the DRI
Sleeper™ every
night until there have been 14 nights in a row
with no triggering of the alarm, and no
bedwetting.
Does that
mean my child will always have to get up to go to
the bathroom during the night?
No. Here is
another aspect of bed wetting that is not
understood. As I mentioned before, children who
suffer primary bedwetting (never having been dry
at night since coming out of diapers) produce too
much urine during the night, as well as being
unable to wake themselves. However, a consistent
observation from my experience over 30 years, is
that after being successfully treated with the
DRI
Sleeper™ , within
a month or two (and often more quickly) the child
begins to sleep right through the night, and does
not wet the bed, but also does not need to get up
to go to the bathroom. This suggests that they are
now moving into the more adult pattern of
producing less urine while they are asleep and
therefore most often not needing to get up during
the night. However, this is a guess, and has not
been researched at this stage.
Are there any things I should not
do?
| 1. |
Don't limit drinks, it will
not help, and in fact may make things
worse. |
| 2. |
Don't expect that setting
an alarm clock or waking your child at a regular
time to empty the bladder will teach the child
to wake - it does not. |
| 3. |
Don't blame your child or
use punishment. It is not the child's fault. An
anxious child will be less able to cooperate
with you in the
treatment. |
Can drugs
help?
Some of the earliest drugs
used for treating bedwetting were antidepressants.
Specialist doctors agree that they should never be
used to treat bedwetting, because few children are
cured from bedwetting using these drugs, and they
can cause rashes, irritability and carry a risk of
poisoning.
An alternative drug
stimulates a reduction in urine (a DDAVP) and can
help for short term control, but most often
bedwetting starts again when the drug has stopped.
However, used for two years or more at a
maintenance level it is successful for some
children. But these drugs also have side-effects,
and in particular it is important to reduce water
intake for the next 10 hours after taking this
medication. Because the medication is reducing
urine output, drinking after having the medication
can result in a fluid build up and affect the
fluid balance of the brain, and cause mental
confusion, or even a convulsion (a fit). Doctors
recommend that a child taking this kind of drug
should be monitored by a doctor to make sure it is
being used correctly. This means that allowing a
child to take this medication while going to a
school camp, for example, is potentially dangerous
because there may not be close monitoring of the
taking of fluids after the medication.
My child
has a problem with wetting during the day, can the
DRI
Sleeper™
help?
Yes, parents have used the
DRI
Sleeper™
successfully during the day to teach
the child to tune into their bladder
signals.
My child
has special needs, can the DRI
Sleeper™ be used
to help with toilet training?
Yes, the DRI
Sleeper™ has been
used successfully for children with special needs
to assist them to become toilet trained so that
they can become mainstreamed at
school.
| 
