Bedwetting is quite common in children diagnosed with Down syndrome, yet many parents and guardians are surprised to learn that there may be a connection. However, it’s not as black-and-white as you might expect.
Down syndrome doesn’t “cause” incontinence at night, but rather influences the timeline in which children may learn to manage their bladders both during the day and at night.
Once you know a bit more about the connection between Down syndrome and bedwetting, you’ll be better equipped to seek the help your child needs, including potentially accessing overnight supplies that can reduce the impact.
Plus, October is Down Syndrome Awareness Month, so it’s a great time to explore how to help those with Down syndrome journey through each stage of life successfully.
Is Bedwetting Normal with Down Syndrome?
It is. In fact, bedwetting is common in all children, not just those diagnosed with Down syndrome. The National Kidney Foundation says around 20% of all children have some bedwetting at age 5, and up to 10% still do at age 7.
Children with Down syndrome often finish daytime potty training at a later age, so it makes sense that night potty training would follow a similar pattern.
A study of 77 children with Down syndrome and 78 without found that those with Down syndrome finished toilet training at an average age of 5.5 years, compared to age 2.2 for those without.
Even among children with Down syndrome, the age at which day and nighttime potty training wraps up can vary significantly.
A later timeline is common, and it says nothing about your child’s potential. It may just take a bit longer than expected, and that’s completely normal!
What Makes Dry Nights Come Last for Children?
When potty training, daytime bladder control often comes first, with nighttime control following along after.
There are three factors involved in just how long that period between daytime dryness and consistent nighttime dryness is:
- A child’s bladder may be too small to hold a full night’s urine
- A child’s kidneys may make extra urine overnight
- The brain may not wake a child up to a full bladder consistently
Mayo Clinic research has found that bladder nerves can also be slow to mature in many children.
There’s also evidence that genetics plays a role: a study by the National Kidney Foundation has found that a child has a 40% chance of bedwetting if one parent wet the bed, and up to a 70% chance if both parents did.
But there’s an important caveat here: research has found that Down syndrome is not the reason for bedwetting in children.
The reality is that many children with Down syndrome develop on a later timeline, and nights come last. Similar to bedwetting and autism, a developmental timeline may simply be a bit more delayed compared to other kids.
Could Sleep Apnea Play a Part in Nighttime Bedwetting?
Research has found that sleep apnea may play a role in whether or not a child can make it through the night without an accident.
Some studies suggest 53% to 76% of children with Down syndrome have obstructive sleep apnea, compared with about 2% to 6% of children without it.
The American Academy of Pediatrics also says that issues such as frequent snoring, breathing trouble at night, daytime sleepiness, and trouble paying attention could be among the signs of a child struggling with sleep apnea, and even names Down syndrome as a higher risk.
But why the connection? One proposed reason is that it may trigger a hormone that makes the kidneys produce extra urine during sleep, which can then lead to nighttime bedwetting.
The Mayo Clinic also lists sleep apnea as a possible cause of bedwetting. Your child’s doctor can tell you whether a sleep study makes sense.
What Can Help at Night?
When it comes to helping children with Down syndrome manage bedwetting, it’s helpful to focus on small routines during the day that can make nights easier. For instance, many clinicians suggest:
- Creating a daily routine for when water-based drinks are offered and how often
- Trips to the bathroom right before bed
- Development of a consistent and calming bedtime routine that includes checking whether or not a child feels the need to go potty
In all your efforts, approach the process with calm and patience. Avoid punishment as well as rewards, as a child may not truly have control over their bladder at night.
If you’ve built a schedule and routine and nighttime bedwetting continues, your child’s doctor may be able to offer insights on other options such as bladder training, bathroom alarms, or potentially medication.
In the meantime, overnight protection can work as a comfort bridge. Supplies are designed to protect both sleep and the skin, and they can help your child feel confident both during the day and at night.
When accidents do occur (as they likely will!), the key is to manage them calmly. Our tips for managing overnight accidents can help with those moments.
When Is It Time to Ask for Help?
Most children with Down syndrome do get there, but nights often take longer. Use this list as a guide for when to check in with your child’s doctor.
| When this happens | Why it is worth asking |
| Your child is 5 or older, dry by day, and still wetting at night | Help should be offered at this age, including for children with Down syndrome |
| Wetting starts again after months of dry nights | A new pattern can point to something that needs a look, such as an infection |
| Pain or burning when peeing, or cloudy or discolored urine | These can be signs of a urinary tract infection |
| Unusual thirst | Mayo lists it as a reason to see a doctor |
| Loud snoring, restless sleep, breathing pauses, or daytime sleepiness | May point to sleep apnea, which is common with Down syndrome. NDSS recommends a sleep study by age 4 |
| Fewer than 3 to 4 bowel movements a week, or fewer than one every 3 days | A full bowel can press on the bladder, so constipation is one of the first things to check |
| Any ongoing day or night wetting | Your child’s doctor can check for constipation and talk through options such as bladder training, a bedwetting alarm, or medication |
Do Overnight Incontinence Supplies Qualify for Coverage?
For families managing nighttime incontinence, having the right supplies can make a huge difference.
For older children, especially those with Down syndrome, supplies such as overnight diapers and pull-ups are a great option. And in many cases, they may be covered under Medicaid rules.
Supplies and eligibility will vary by state, and supplies may come at little to no cost for families who qualify.
Supply coverage depends on a few factors, including your state’s Medicaid program and a qualifying diagnosis such as autism or ADHD. A bit of research ahead of time can help answer many of your questions and connect you with the right partner in the process.
Our guide to getting diapers for a child with special needs walks through the steps, and our insurance-covered supplies guide goes even deeper into which supplies may or may not be covered.
Get Overnight Support With UroStat
Wet nights are common for children, and children with Down syndrome deserve the support and encouragement needed to transition from wet to dry nights.
You don’t have to manage this journey alone. UroStat Healthcare helps families of children with special needs access much-needed, insurance-covered incontinence supplies and have them delivered to their door.
Want to learn more? Call 888-845-8698 or check your eligibility online to see if your child may qualify. You care for them. We’ll take care of the rest.