Dr. Greene’s Answer:
Star charts prove very beneficial to some children, used either alone or with a bed-wetting alarm. As you know from experience, you wake up more easily when the day holds promise and excitement. On holiday mornings it is easier to get out of bed; on dreary mornings it is easier to hit the snooze-alarm. Star charts use this to advantage. A child is offered a star on the calendar for each dry night. When the child collects a predetermined number of stars (usually 3-7), he is given a small reward. When he collects 21 in a row, he gets a larger, looked-forward-to, prize. This puts the reticular activating system of the brain in a more heightened state of readiness to wake up when the bladder signals that it is full. For some children, this is enough to make them responsive to nighttime bladder fullness. If no improvement occurs within 2 weeks, however, it should not continue to be used without an alarm or some other therapy.
Hypnotherapy and guided imagery are other techniques available to help deep sleepers gain nighttime bladder control. Hypnotherapy requires a trained therapist, but guided imagery can be employed by anyone. Have your son relax, close his eyes, and listen to what you say. Tell him that his kidneys are a pee factory, making urine day and night. His bladder is a storage tank where the pee is kept until he is ready to put it in the toilet. There is a gate or muscle that holds the pee in the bladder until he is ready. During the day, he is in control of the gate, but at night some of the pee has been sneaking out. When he sleeps, he is going to begin taking control. When the bladder starts to fill up, he will control the gate when he is asleep, just like when he is awake. He will pee in the toilet when he is ready. Messages like this help put his brain in a state of readiness to receive the bladder’s signals. As with star charts, this should not be continued as the only therapy for longer than 2 weeks with no noticeable improvement.