Bedwetting and Sleep Cycles.

Bedwetting occurs at different times of the night for different children.   Some children will wet the bed early on in the night, whilst others may wet the bed early morning, and many chronic bedwetters wet the bed more than once a night.  

If your child is getting to bed at a regular time every night (including weekends) and getting sufficient sleep, then s/he will most likely have fairly regular sleep cycles.  Understanding these cycles can be very helpful for children and adults, because the nature of your sleep and ability to wake up from it, are different in each of the stages within a sleep cycle.

As you begin to fall asleep you start to enter stage one of sleep.  Your breathing slows down and you become lightly asleep.  This stage typically lasts for about one to seven minutes and you can easily be woken up from this sleep.1  In fact, if you were woken up, you may not think you had been asleep.2  It is at this stage of sleep when we sometimes experience the hypnagogic startle, a sudden jerk of your whole body that wakes you momentarily, and that is quite normal.  Of course, this doesn’t happen every time you go to sleep.
   
Then you enter stage two of sleep.  You are still in a ‘light sleep’ and it can be quite easy to wake you up depending on how far into stage two you are.   More time is spent in stage two of sleep throughout the night, than in any other single stage.3 

One example of a night's sleep in an adult, tracked using the App 'Sleep Cycle'.

This is followed by stage three which is now a ‘deep sleep’ (formerly divided into stages three and four).  Your brain waves slow down and it becomes more difficult to wake up.  In fact, someone calling your name would not necessarily wake you up.  Apparently, even in your deepest sleep, your brain still has an element of awareness.  You can wake up from this sleep if there is an element of urgency, but it may be difficult to become alert and fully awake quickly.  This is the most restful and restorative sleep.  Energy is restored and growth hormones are released.4  If you take your child to the toilet in this sleep stage, he or she may stay in a semi-sleep state and fall straight back to sleep with no recollection of going to the toilet in the morning.5  According to Dr Ferber, author of Solve Your Child’s Sleep Problems, young children tend to spend more time in deep sleep during the first few hours of the night.  And early morning, children typically have a period of very deep sleep before awakening.

Finally, you go into REM (Rapid Eye Movement) sleep.  Your eyes move rapidly during this stage and most of your dreams occur in REM sleep.  Your breathing and heart rate become irregular.  Your muscles are relaxed and you don’t move your body, in fact, much of your body is effectively paralysed.6  You can wake up easily or with difficulty, and you can become alert quickly.  The first period of REM sleep may only last one to five minutes and typically gets longer throughout the night.7

​Then the cycle starts all over again.  Each cycle lasts approximately 90 minutes in adults and around 50 minutes in children.8  There is often a brief awakening at the start of the cycle, when you may become aware of your environment, adjust your position, you might check the time, reach for the blankets, or become consciously aware that you need to go to the toilet. 

When a child can understand that they naturally come out of their deep sleep at least a few times a night, it opens up the possibility that they can check in with their bladder at these times to see if they need to go, and getting out of bed will be easier at that stage in the sleep cycle.  Whilst this may not be a bed wetting solution on it's own, it can help build confidence that dry nights are possible.

Stay Dry at Night is the gentle and effective bed wetting program that includes recordings that your child listens to whilst going to sleep at night.  The aim of the program is to build on the brain and bladder connection so that your child wakes up to go to the toilet at night, or wakes up dry in the morning.  For more information click here.

1. Natural Patterns of Sleep, A resource from the Division of Sleep Medicine at 
Harvard Medical School, Accessed 2016,  http://healthysleep.med.harvard.edu/healthy/science/what/sleep-patterns-rem-nrem
2. Dr Richard Ferber, Solve Your Child’s Sleep Problems, Vermilion London, 2006
3. Health Boosters by Withings, Accessed 2016,  http://blog.withings.com/2015/03/17/the-4-different-stages-of-sleep/
4. National Sleep Foundation, Accessed 2016, https://sleepfoundation.org/how-sleep-works/what-happens-when-you-sleep
5. Dr Richard Ferber, op.cit
6. Dr Richard Ferber, op.cit.
7. Natural Patterns of Sleep, loc.cit.
8. Natural Patterns of Sleep, Accessed 2016, http://healthysleep.med.harvard.edu/healthy/science/variations/changes-in-sleep-with-age

Author

Ginny Laver is a Neuro-Linguistic Practitioner who specialises in helping children and adults to stop bedwetting.