Deep sleep and the unresponsive bedwetter
Posted by Karen Radford on | 0 comments
You're probably reading this at midnight having been woken by the bedwetting alarm which failed to rouse your child. This is not an uncommon problem in around 10% of bedwetters who would sleep through the Charge of the Light Brigade were it to be re-enacted in their bedroom! However, knowing you are not the only parent with this problem is not very comforting when you need your child to respond to the alarm so they can start making the bladder/brain connection in their sleep to help them conquer their bedwetting.
So, what to do?
Night time toilet training, like many learning experiences, is a process. A good place to start is understanding your child's usual bedwetting rhythm:
- what time your child wets;
- how many times a night your child wets;
- is your child unresponsive to the alarm at a particular bedwetting time and remember nothing about being woken the next morning;
- does your child become extremely agitated or distressed at being woken at a particular bedwetting time;
- are there times when your child is more responsive to the alarm or being woken.
One of the most important things experience has taught us is when you start using the alarm you should practice what your child needs to do when it triggers, so their prospective memory (something the brain has to remember in the future) is activated. This is called Priming.
Before your child settles down to sleep have him or her lie in bed pretending to be asleep. Take the alarm and trigger it by putting something metal (a stainless steel knife) across the sensor. Ask your child to get up, de-activate the alarm and pretend to go to the toilet. When your child returns to bed get them to re-activate the alarm. Practice this three or four times a night over the first few nights so they are more ready to respond when they hear the alarm.
Many children experience a phase of deep non-REM sleep within 90 minutes of falling asleep and often this is when the first bedwetting event occurs. Being roused from this state can be difficult and result in disoriented or even extremely agitated behaviour. They will usually feel very groggy and it can take up to 30 minutes to attain normal mental performance (known as sleep inertia). As a result, they probably won't remember being woken the next morning.
If your child has this sort of reaction but is easier to rouse during subsequent bedwetting incidents it may pay to leave alarm training for the subsequent incidents. In this case you would wake your child 15-20 minutes before they wet the bed the first time, so the alarm doesn't disturb them during the very deep sleep phase, and take them to the toilet. Then, when they wet the bed later in the night, you can follow the normal alarm training procedure
It is important your child remembers getting up in the night when the alarm triggers as recall is a vital step in activating the connection between the bladder and the brain. If your child has no memory of waking when the alarm triggers we suggest the following strategy:
Give your child a code word when you wake them in response to the alarm (a different one each night). Ask them to remember it and the next morning get them to repeat it to you. This makes your child focus and start recognising the feeling of a full bladder when they are woken.
Not all children go from starting to use the alarm to being dry straight away; it usually happens in stages.
Reward Programmes are a great way of engaging your child in the process and a simple reward system, such as a sticker chart, may be all that is needed. You can also offer other tangible rewards when milestones are reached e.g. when your deep sleeper remembers the code word you gave them several mornings in a row.
If you set achievable goals your child is less likely to become disheartened if things don't go perfectly to plan. Here are some milestones you may consider rewarding:
- consecutive wet nights when you woke your child and they got up straight away and went to the toilet;
- remembering the code word you gave them several mornings in a row;
- wet nights when your child woke to the sound of the alarm on their own;
- wet nights when your child woke to the alarm and got up and went straight to the toilet;
- wet nights when your child helped with the clean-up and was back in bed asap;
- dry nights;
- 14 Consecutive dry nights - becoming a DRI Sleeper!
Finally, make sure you give yourself a reward for all your efforts. You're worth it!