Bedwetting and Sleep Disorders
It is estimated that between seven and eight million children suffer from some type of sleep disorder. These include snoring, sleepwalking, insomnia, night terrors, teeth grinding and – the most common sleep disorder – enuresis (bedwetting). These conditions can be a cause of embarrassment, self-esteem issues and even fear. Add in the factor of a disability, disease or disorder, and the issue can be increased exponentially.
Sleep Disorders in Special Needs Children
Statistics from both the National Sleep Foundation and Children's Memorial Hospital in Chicago state that children with special needs often suffer from numerous other sleep disorders as a result of their special needs.
"Children with special needs tend to have at least one sleep disorder," says Dr. Stephen Sheldon, director of the sleep medicine center at Children's Memorial Hospital in Chicago, Ill. "Special needs children may have – and often do have – bladder or bowel control issues either due to their condition, disease or perhaps their mobility. These facts are what can lead to sleep disorders such as snoring, sleepwalking, sleep apnea, teeth grinding, night terrors, bedwetting and/or insomnia."
Sleep disorders are hard on the entire family, as it is not only the child's sleep patterns that are disrupted and according to Dr. Sheldon, it's a problem that tends to affect special needs children more than others. "When a child wakes up and cannot go back to sleep, wakes up wet or wakes up crying or screaming, it is the parent who comes to their aid," says Dr. Sheldon. "Children see this and can sense if their parent is upset or angry because they have been woken up, have to change the sheets or have to lose sleep to tend to the child. Children fear that their parents will become angry with them, will be upset or will be disappointed in them. And because special needs children can be more emotional, sensitive and fragile than others, the effects of their parents' reactions last for hours, days or even weeks."
Connecting Sleep Disorders and Bedwetting
The presence of one sleep disorder often leads to another. For example, night terrors may lead to insomnia or snoring to sleep apnea. Dr. Sheldon states that this is not only possible, but is often the reason for the presence of bedwetting in special needs children. "Children with special needs often suffer from numerous other sleep disorders," he says. "This initial sleep disorder may lead to or cause bedwetting. Whether it is snoring, sleep apnea, sleep walking or night terrors, these sleep disorders can and do lead to enuresis. One example is that a child may wake up from a nightmare, not cry out from fear of upsetting his/her parents and may wet the bed. Or, a child may not be able to get to the bathroom alone, but wanting to be independent and not 'bother' Mom or Dad, try to hold it until morning and end up wetting the bed instead."
Not a "Special" Problem
While it is common for special needs children to suffer from bedwetting, it is not a problem that is solely theirs. "Enuresis is not unique to or seen only in children with special needs," says Dr. Sheldon. "In the U.S. alone, millions of children – both those with special needs and those without – suffer from bedwetting."
According to Dr. Sheldon, all children, including special needs children, may in fact be genetically predisposed to the condition of bedwetting. "The condition of bedwetting is often seen to run in families," he says. "A child who has one parent who also suffered from enuresis has an increased risk of the condition as well – about a 40 to 45 percent chance. If both a child's parents were bedwetters, the child's chance of suffering from enuresis is approximately 75 percent."
"My daughter started wetting the bed when she was about 2 years," says Yvette, a mother in Phoenix, Ariz. "I talked to her doctor and while he is unworried, he did explain to me how it may be a genetic problem. My daughter's father wet the bed until he was 12."
There are many available treatments – both medical and at home – for bedwetting, but the treatments do not differentiate between a special needs child and one without special needs. "Treatments for bedwetting are created and designed for children period," says Dr. Sheldon. "There is not one set of treatments for children with special needs and another set for those who do not have special needs. The problem may be caused by different circumstances and manifest for different reasons, but the condition is the same."
One of the first steps many parents take when dealing with enuresis is to use disposable absorbent underpants while working on the problem. Absorbent underpants often help kids' self-esteem by alleviating the embarrassment of waking to cold, wet sheets. In addition, they allow kids to enjoy activities such as sleepovers with non-bedwetting friends.
When assisting a child in overcoming bedwetting, Dr. Sheldon says it is important to treat the accompanying sleeping disorder. In addition, he advises parents to remember two things: patience and understanding. "A special needs child is just that – a special needs child," he says. "This means not only do they have a special need in a physical or mental capacity, but also in an emotional one as well. You can't separate the two conditions. One may lead to, cause or exacerbate the other. Don't assume that your child is never going to learn or is never going to overcome their sleeping disorders and bedwetting. With your understanding, encouragement and patience, he/she will – in their own time and at their own pace – overcome it just as any other child would."
Special needs children strive for and struggle with the same things as other children. "These children have the same issues and concerns as other children," says Dr. Sheldon. "They want to be liked, loved, accepted, to become independent and yet be the same as other kids. But, in addition, they have the added effects of their condition or illness, too. This fact often turns a situation that would or should not be an issue into a major one. This is where a parent's job truly is."
Special needs children already know they are different and the presence of a sleeping disorder can make them feel that their differences are even more apparent. "Sleeping disorders are not normal, but they are common," says Dr. Sheldon. "Letting your child know that their sleeping disorder – even bedwetting – happens to literally millions of other children every day may help them in dealing with, and eventually overcoming, bedwetting and/or other sleeping disorders."
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