14.
Don't Talk About Bedwetting
on Rice turned 8 years
old last week, and he's
having a party. Not
just any party. It's a
sleepover with four of
his school friends, cake
and a Ninja movie.
Typical plans for 8-year-olds,
true. But not so for Jon, who was
a bedwetter before receiving help
from a local treatment center this
winter.
Last year this time, Jon woke
up wet and cold every morning.
Bedwetting prevented him from
spending the night at
friends' homes — much less
inviting them over for a
slumber party at his house.
Jon isn't alone. Millions
of youngsters chronically
wet the bed. Teen-agers and
adults suffer from "enure-
sis," too, but privately. Much
of society considers the
problem embarrassing, dis-
gusting, even deviant. Psy-
choanalyst Otto Feneschel
once attributed it to unre-
solved feelings of anger and
lust for one's mother.
"Bedwetting looks like a
psychological problem. Very
often it is treated as a psy-
chological problem. But it
isn't a psychological prob-
lem," said local clinical psychol-
ogist Dr. Lyle Danuloff.
"Bedwetting is the result of a
sleep disorder, though it can lead
to significant psychological prob-
lems."
"Bedwetters often live in fail-
ure, shame and the terrible fear
of discovery," he said. "Let's say
a little girl's class is spending a
few days at Camp Tamarack.
Everyone is excited. But she's
afraid. Afraid she'll wet the bed."
Dr. Danuloff runs a private
practice in Farmington Hills
where he also counsels bedwet-
ters and their families at the
Enuresis Treatment Center, one
of few in the world.
People who suffer from enure-
sis exhibit abnormal sleep pat-
terns. Healthy sleepers drift
gradually through four stages of
sleep (see diagram). Bedwetters,
however, crash into deep sleep
and stay there. They rarely drift
into "R.E.M." sleep, the stage in
which dreaming occurs.
During sleep, the bladder
11
Shame and fear
still surround
a problem
specialists
attribute to
deep,
deep sleep.
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LU
CD
CC
F-
LU
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36
sends signals to the brain that it
is full and needs emptying. Dur-
ing a typical sleep, the brain in-
terprets the signals and responds
by telling the bladder to close its
"sphincter" muscle, which retains
urine. If sufficient pressure de-
velops on the bladder, the indi-
vidual will wake up to use the
bathroom.
For bedwetters, however, the
brain is in such a deep stage of
sleep, it cannot interpret the
bladder's signals. The individual
keeps sleeping and the sphinc-
RUTH LITTMANN STAFF WRITER
ter muscle does not close when
the bladder fills up. The sleeper,
therefore, wets the bed.
Boys are three times more
likely than girls to suffer from
enuresis (The same gender ratio
pertains to learning disabilities).
Researchers have not explained
the discrepancy.
"Nobody knows why, to my
knowledge," Dr. Danuloff said.
There are two types of enure-
sis, primary and secondary, both
of which are thought to be ge-
netic. Primary bedwetters have
experienced the problem all their
lives. In secondary bedwetters,
however, enuresis is generally
caused by some sort of trauma:
the first day of kindergarten,
camp, divorce of the parents and
so on.
"What happens is that the
stress triggers the capacity for
deep sleep," Dr. Danuloff said.
"You would think that if the
stress were taken away, the deep
sleep would go away too — but
it doesn't. Once it's there, it
stays."
Parents of bedwetters
are often told not to wor-
Dr. Lyle
ry because youngsters
Danuloff
outgrow the disorder. This isn't
necessarily true, said Barbara
Moore, director and founder of the
Enuresis Treatment Center.
The Center services 300 to 400
patients at any one time. Many
are teen-agers who never "grew
out of it." Some are adults, up to
67 years old, who never "outgrew
it," either. At the Center, patients
and family members work with
nurses, social workers and psy-
chologists to learn about their
sleep disorders and the relation-
ship between the brain and blad-
der.
Most enuretics have small, un-
derdeveloped bladders. The ob-
jective of treatment is to expand
the bladder while creating new
sleep patterns. Contrary to the
layperson's logic, patients are en-
couraged to drink a lot before
they go to bed. Though this tac-
tic might not stop bedwetting
right off the bat, it strengthens
the sphincter muscle in the long
run, Ms. Moore said.
To help their child stop wet-
ting the bed, parents must take
it upon themselves to record how
much their child drinks, when
BEDWETTING page 38
SLEEP CHART
CONSCIOUSNESS A
STAGE 1
STAGE 2
STAGE 3
STAGE 4
20 TO 90 SECONDS
90 MINUTES