Bed-wetting in US children: Epidemiology and related behavior problems

Objective. To better understand the epidemiology and behavioral correlates of bed-wetting in a nationally representative sample of children. Methods. Bivariate and multivariate logistic regression analyses of cross- sectional data regarding 10960 children aged 5 through 17 years from the 1981 Child Health Supplement to the National Health Interview Survey. Behavior problems were determined by extreme scores on a 32-item Behavior Problem Index (BPI, >90th percentile). Results. Bed-wetting was reported in 33% of 5- , 18% of 8-, 7% of 11-, and 0.7% of 17-year-olds. At all ages, infrequent bed-wetting (fewer than six episodes per year) accounted for half of all reported bed-wetting. Lower age, male gender, and extreme scores on the BPI all were independently associated with both infrequent and frequent bed- wetting. Extreme scores on the BPI were more common among children with bed- wetting than those who did not wet the bed, and the risk for this was similar among children with infrequent and frequent bed-wetting (adjusted odds ratios, 1.8 and 1.7, respectively). Parents' perceived need for help with emotional and behavioral problems, however, was increased only among children with frequent bed-wetting. Conclusions. Bed-wetting in children aged 5 years and older, irrespective of its frequency, is associated with increased rates of behavior problems. Thus, although infrequent bed-wetting may not warrant medical intervention, this condition should prompt health care providers to explore behavioral issues in greater depth.