Bedwetting, also known as nocturnal enuresis, is a common challenge that many children naturally outgrow as they get older. However, for some, it persists beyond the age of five or six. In these cases, the issue may be linked to a variety of factors—both medical and non-medical.
While common causes like poor brain-bladder communication, constipation, and a weakened pelvic floor often contribute, underlying medical issues such as enlarged tonsils and adenoids can also play a role. Understanding these factors is crucial for parents when making informed decisions about their child’s health and well-being.
Tonsils, located at the back of the throat, are small lumps of tissue that play a role in the lymphatic system, helping the body fight infections.
When a child frequently has sore throats or infections, the tonsils can become enlarged. This swelling can block the airway, especially during sleep, leading to breathing problems such as snoring or sleep apnea. These breathing issues during sleep can interfere with a child’s ability to control bladder function, potentially leading to bedwetting.
Adenoids, similar to tonsils, are located higher up behind the nose and play a role in trapping germs that enter through the nasal passages as part of the body’s immune defense.
However, adenoids can become enlarged due to chronic infections or allergies. Swollen adenoids can block the nasal passages, causing mouth breathing during sleep, which disrupts sleep and may contribute to bedwetting. For more information on how allergies can contribute to bedwetting, see my post on allergies and bedwetting.
Chronic ear infections caused by enlarged adenoids may also lead to fluid buildup in the ears, affecting sleep quality. In some cases, grommets—small tubes inserted into the eardrum—are used to drain fluid and prevent ear infections, which may help reduce sleep disruptions and, in turn, decrease the likelihood of bedwetting.
For some children, removing enlarged tonsils or adenoids, or inserting grommets, may help reduce bedwetting, though results can vary. Here’s how:
Improved Sleep Quality: Enlarged tonsils and adenoids can cause obstructive sleep apnea (OSA), leading to snoring and poor sleep quality. By removing these tissues, the airway can be cleared, potentially leading to better sleep and fewer wet nights.
Experts often highlight the connection between sleep apnea and bedwetting, particularly in children. Dr. Dennis Kitsko, an otolaryngologist at the Children’s Hospital of Pittsburgh, notes that children with sleep apnea my struggle to stay dry at night:
“Children with sleep apnea can be difficult to rouse, which may cause the bedwetting. But not every child with sleep apnea will wet the bed, and not every bedwetter will have sleep apnea.”
Reduced Mouth Breathing: Addressing enlarged tonsils or adenoids can help eliminate mouth breathing, which often leads to poor sleep.
Better Ear Health: Inserting grommets helps alleviate ear infections and fluid buildup, potentially reducing sleep disturbances and improving bladder control at night.
While removing tonsils, adenoids, and inserting grommets can provide benefits for some children, it’s not a guaranteed solution for bedwetting. I’ve seen cases where these procedures didn’t lead to an improvement, as well as instances where children experienced positive changes.
If your child is showing several of the following symptoms, consider consulting an ENT (Ear, Nose, and Throat) specialist:
Snoring: Persistent snoring or loud breathing during sleep can be a sign of airway obstruction, often caused by enlarged tonsils or adenoids. According to Dr. Linda Dahl, an ear, nose, and throat doctor at Lenox Hill Hospital in New York City:
“Snoring in children is abnormal. Children snore because their tonsils and adenoids are enlarged, and they end up getting other behaviors that go along with sleep apnea, including bedwetting.”
Waking Up Tired: If your child frequently wakes up feeling tired or lethargic, it may indicate disrupted sleep due to breathing difficulties or issues like enlarged tonsils.
Mouth Breathing: Habitual mouth breathing can lead to dry mouths and sleep disturbances. This may suggest enlarged tonsils, adenoids, or other respiratory concerns.
Frequent Runny Nose or Colds: Chronic nasal congestion or recurrent colds may point to enlarged adenoids or tonsils, which could be contributing to sleep problems and possibly bedwetting.
Recurrent Ear Infections: Frequent ear infections can disrupt a child’s sleep quality. Inserting grommets can help relieve this issue, promoting better sleep patterns.
Bedwetting: All of the above factors can contribute to bedwetting. If it persists beyond the typical age range or becomes more frequent, it may be worth exploring potential medical causes.
Many other factors can contribute to bedwetting, including medical issues such as diabetes, hormonal imbalances, and urinary tract infections (UTIs). Additionally, lifestyle elements like poor brain-bladder communication, constipation, bladder irritants, emotional stress, sleep quality, and fluid intake also play significant roles.
These diverse causes highlight the importance of considering both medical and lifestyle factors when seeking solutions. Given this range of potential contributors, starting with non-invasive treatments is often a helpful first step.
The Stay Dry at Night program equips parents with valuable insights and helps children build better brain-bladder communication, increase sensation awareness, and develop effective bladder control. By addressing these varied aspects, this approach offers a comprehensive strategy that may help your child achieve dry nights.
For some children, removing enlarged tonsils, adenoids, or inserting grommets can improve bedwetting, especially when sleep disruptions are a contributing factor. However, it’s important to approach this issue with a holistic mindset, recognizing that multiple factors may be at play. If your child displays symptoms such as snoring, mouth breathing, or persistent ear infections, consulting with an ENT specialist can help determine whether these issues are affecting their sleep and bladder control.
It’s crucial to remember that every child is different, and what works for one may not work for another. A comprehensive approach, considering both medical and lifestyle factors, is often the most effective way to address bedwetting.
HealthDay. “Tonsil Removal Might Cure Bedwetting in Some Kids With Sleep Apnea.” Retrieved from https://www.healthday.com/health-news/child-health/tonsil-removal-might-cure-bedwetting-in-some-kids-with-sleep-apnea-653003.html
MedlinePlus. “Adenoids.” Retrieved from https://medlineplus.gov/adenoids.html
Abdollohi-Fakhim S, Talebi A, Naghavi-Behzad M, Piri R, Nazari MS. “Effects of adenotonsillar hypertrophy corrective surgery on nocturnal enuresis of children.” Niger Med J. 2016 Jan-Feb;57(1):69-73. doi: 10.4103/0300-1652.180558. PMID: 27185983; PMCID: PMC4859118. https://www.researchgate.net/publication/301330480_Effects_of_adenotonsillar_hypertrophy_corrective_surgery_on_nocturnal_enuresis_of_children
InformedHealth.org. “Overview: Enlarged tonsils and adenoids.” Institute for Quality and Efficiency in Health Care (IQWiG). Available from: https://www.ncbi.nlm.nih.gov/books/NBK536881/
InformedHealth.org. “Enlarged tonsils and adenoids: Learn More – Surgery for enlarged tonsils or adenoids.” Institute for Quality and Efficiency in Health Care (IQWiG). Available from: https://www.ncbi.nlm.nih.gov/books/NBK536875/
Kidney.org. “Snoring and Bedwetting.” Retrieved from https://www.kidney.org/snoring-and-bed-wetting
Mayo Clinic. “Bedwetting (Nocturnal Enuresis) Symptoms and Causes.” Retrieved from https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685#:~=Sometimes%20bed%2Dwetting%20is%20a,being%20sleepy%20during%20the%20day
Dr. Sanu. “Adenotonsillectomy Can Improve Bedwetting in Children with Obstructive Sleep Apnoea.” Retrieved from https://drsanu.com/blog/adenotonsillectomy-can-improve-bedwetting-children-obstructive-sleep-apnoea/
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Somuk BT, Bozkurt H, Göktaş G, Demir O, Gürbüzler L, Eyibilen A. Impact of adenotonsillectomy on ADHD and nocturnal enuresis in children with chronic adenotonsillar hypertrophy. Am J Otolaryngol. 2016 Jan-Feb;37(1):27-30. doi: 10.1016/j.amjoto.2015.08.003. Epub 2015 Aug 23. PMID: 26700255. https://pubmed.ncbi.nlm.nih.gov/26700255/
Kovacevic L, Wolfe-Christensen C, Lu H, Lulgjuraj M, Abdulhamid I, Thottam PJ, Madgy DN, Lakshmanan Y. Adenotonsillectomy improves quality of life in children with sleep-disordered breathing regardless of nocturnal enuresis outcome. J Pediatr Urol. 2015 Oct;11(5):269.e1-5. doi: 10.1016/j.jpurol.2015.03.021. Epub 2015 Jun 9. PMID: 26116409. https://pubmed.ncbi.nlm.nih.gov/26116409/
Ginny Laver BA (Hons), MSc, NLP, Dip. THP is a Clinical Hypnotherapist and Neuro Linguistic Programming (NLP) practitioner who specialises in helping children learn how to stop bedwetting naturally.
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Have you or someone you know experienced changes in bedwetting after having enlarged tonsils or adenoids removed or after inserting grommets? Whether it led to success or didn’t go as planned, your story could help other families going through the same journey.
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Removing enlarged tonsils, adenoids, and inserting grommets can sometimes help with bedwetting, particularly if sleep quality is affected. While this isn’t a common cause of bedwetting, it’s worth considering if other treatments haven’t been effective. Read this blog to find out more about how these procedures may help.
Explore how bladder irritants like caffeine, citrus, and certain medications can contribute to bedwetting in children. Learn how to identify and manage triggers to help your child achieve more dry nights.
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