How ADHD and Sensory Processing Disorder (SPD) Contribute to Bedwetting: Causes and Solutions

Bedwetting (nocturnal enuresis) is a common concern for many parents. While occasional bedwetting is a normal part of childhood development, children with ADHD or Sensory Processing Disorder (SPD) often experience it more frequently and for a longer duration. Understanding the connection between these conditions and night-time accidents can help caregivers provide the right support and reassurance.

Why Do Children with ADHD and SPD Struggle with Bedwetting?

Both ADHD and SPD can impact a child’s ability to recognise, respond to, and control their bladder signals. Here’s how these conditions play a role:

The Link Between ADHD, SPD, and Bedwetting

Children with ADHD are more likely to experience bedwetting due to:

• Delayed Bladder Maturation – Some children with ADHD have slower bladder development, making it harder for them to control urination at night.

• Deep Sleep Patterns – Many children with ADHD sleep very deeply, making it difficult for them to wake up when their bladder is full.

• Executive Function Challenges – ADHD affects impulse control, body awareness, and the ability to recognize bodily signals, which can impact nighttime bladder control.

• Daytime Inattention to Body Signals – Children with ADHD may be so focused on activities that they ignore the urge to use the bathroom, leading to bladder overfilling at night.

Children with SPD process sensory information differently, which can affect their ability to wake up and respond to bladder signals. Some key reasons include:

• Interoception Difficulties – Interoception is the body’s ability to recognize internal signals like hunger, thirst, or the need to urinate. If a child struggles with interoception, they may not recognize when their bladder is full.

• Sensory Overload During the Day – Some children with SPD suppress their need to go to the bathroom during the day because they dislike the sensations of using the toilet (such as the sound of flushing, cold bathroom tiles, or the feeling of wiping). This can lead to nighttime accidents.

• Sleep Disruptions – Many children with SPD have irregular sleep patterns and struggle to wake up when their body needs them to. Some may also be overly sensitive to the feeling of wetness, while others may not notice it at all.

 Practical Strategies for Managing Bedwetting

While bedwetting can be stressful, it’s important to approach it with patience and understanding, so step one is to take the time to calm yourself.  A brief moment of mindfulness or breathing before tackling it can pay dividends.

8 Effective Strategies to Manage Bedwetting in Children with ADHD and SPD

1. Create a Predictable Bathroom Routine

Encourage regular bathroom breaks throughout the day and right before bedtime. A consistent schedule can help train the bladder and reinforce the habit of emptying it before sleep.  It can help to also have regularly timed drink and snack breaks around an hour before the bathroom break (adjust times according to your child)

2. Support Sensory Needs

If your child has sensory sensitivities, consider what you might be able to do to make the bathroom experience more comfortable:

• Use soft lighting and minimise noise.

• Provide a comfortable toilet seat if they dislike hard surfaces.

• Allow them to use a warm wipe or moist flushable toilet wipe instead of cold toilet paper if they struggle with texture sensitivity.

• Decor that is either minimal for those who are easily overwhelmed, or has a fun picture, mat or shower curtain where they

3. Use a Waterproof Mattress Cover

A waterproof mattress protector can reduce the stress of night-time accidents and make cleanup easier. Some parents also use absorbent bed pads or special night-time underwear designed for older children.

To reduce wakefulness it can be worth layering sheets and mattress protectors so you can easily remove one wet layer without having to remake the whole bed as a fresh set is already underneath.

4. Try a Bedwetting Alarm

For some children, a bedwetting alarm can help train the brain to wake up when the bladder is full. These alarms detect moisture and sound an alert, reinforcing the connection between urination and waking up.  Be sure to also have back up of whatever you need to encourage your child back to sleep afterwards.

5. Encourage Hydration but Limit Evening Fluids

Ensure your child stays hydrated during the day but limit fluids from an hour before bedtime to reduce the chances of night-time accidents.

6. Offer Gentle Wake-Ups for Bathroom Breaks

Some parents find success in waking their child once or twice a night for a quick trip to the bathroom. This can help train their body to recognise the need to wake up and urinate.  The ideal time for this can be worked out once you know what approximate times they are wetting.

7. Provide Positive Reinforcement

Avoid punishments or frustration over bedwetting, as it is not often possible for children to be consistently dry so is not intentional, and anxiety will not help. Instead, offer encouragement for small steps towards success and small rewards for dry nights to help build confidence.

8. Rule Out Medical Causes

If bedwetting persists past age 7, suddenly worsens, or is accompanied by other symptoms (such as increased thirst or painful urination), consult your GP/ Doctor to rule out underlying medical issues.

Managing bedwetting in children with ADHD and SPD can be challenging, but with understanding and the right strategies, most children will eventually overcome this hurdle. With patience, consistency, and a supportive environment, you can help your child navigate this phase with confidence.