Hi Allison, It must be incredibly frustrating and disheartening when you feel like you have tried it all and still your son continues to wet at night. With respect to the alarm – the time it takes for children to achieve dryness when using conditioning alarms can be anything from a few weeks to a few months with about 10-15% of children experiencing some relapse – when this happens you need to reintroduce the alarm treatment although you will find that he becomes dry much quicker the second time around. For some children it can take up to 3 cycles of treatment so it is important not to give up if it at first it does not seem to work. It may be helpful to get your son to practice setting the alarm off during the day (with a drop of water) so that way he will become familiar to the sound of the alarm. Some alarms have different settings that allow you to vary the sound – sometimes a louder alarm will raise a particularly deep sleeper. Others include a vibration option, which your son may respond to more easily. It would also be worthwhile speaking with a continence advisor before re-introducing the alarm as the more support and guidance you receive the greater the chance of a successful outcome. The nasal spray medication is like a synthetic version of ADH (antidiuretic hormone), which is designed to inhibit the amount of urine produced by the kidneys overnight. This is not always a successful treatment option – particularly in instances where low ADH levels are not a contributing factor. While some children do stop wetting the bed after its use, a common problem with this form of treatment is that once children stop the medication the bedwetting often resumes. This form of treatment has met with more success when used in conjunction with a bedwetting alarm so that may be a better way to go. There are some more alternative methods that have met with different degrees of success. Please keep in mind however that these have not received the same level of research support as conditioning alarms or medications. Hypnotherapy has been successfully used to help individuals either hold their urine overnight or wake up and go to the toilet. This can be used on its own or in combination with the conditioning alarm. Your best point of contact for hypnotherapy is the Australian Hypnotherapists’ Association http://www.ahahypnotherapy.org.au/, which has branches in each state. They also have a free advisory line: 1800 067 557. Another alternative form of treatment that has met with some success is chiropractic manipulation. This appears to be more relevant for individuals whose bedwetting is the result of a poorly aligned spine. If this sounds like a suitable option you should first contact the Chiropractic Association of Australia http://chiropractors.asn.au (1800 075 003) who will be able to recommend someone in your area that has experience in treating bedwetting.

Regards,
Dr Cathrine

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