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It's not because they’re lazy brats who aren't trying hard enough to stay dry.  Nor are bedwetting children necessarily acting out their stress or anxiety.   The most recent research suggests that bedwetting, or nocturnal enuresis, is genetic; a bed wetter is likely to have a parent, aunt, uncle or grandparents who wet the bed as a young child.    Child health expert Martin Scharf argues in his book  "Waking Up Dry: How to End Bedwetting Forever” that for most kids, bedwetting is physiological rather than psychological,  “a maturational lag” resulting from the small size of the child’s bladder or the byproduct of different rates of development in different muscles.   The bladder muscles that release the urine may simply be stronger than the sphincter muscles that hold it in.

Enuresis can also be caused by medical conditions such as diabetes, urinary tract infection, or sleep apnea, or by psychiatric disorders.   If bedwetting is due to these conditions, a combination of behavior modification alarm devices, and medications can help address the problem.  

Former bed wetters who have learned to control their bladders may relapse into their earlier habits when they are feeling stress or anxiety and start wetting again.   However, a child who has never wet the bed is extremely unlikely to start having nocturnal accidents simply because of stress.    

Dr. Anthony Atala, who heads the urology department at the Wake Forest University School of Medicine, has studied the issue and found  “no major association between anxiety, stress, and bedwetting. ”   Rather, stress is associated with other behaviors, such as eating a high-salt diet, forgetting to use the bathroom at night before bedtime, or drinking fluids right until bedtime, that might in turn cause bedwetting in children whose weak or small bladders make them already predisposed to accidents.  

Atala points out that kids, like adults, find it comforting to eat salty snacks such as chips or crackers.  When they are stressed, they might well eat more of these comfort foods, and as a result, they retain more fluids in their bodies.  Greater fluid retention, in turn, increases the likelihood of a small-bladdered child wetting the bed at night.    Anxious kids might also drink more water at night, or forget to use the potty before going to bed.   If they have small or weak bladders, they are more likely to wet the bed as a result of these behaviors, which in turn are indications of the children's high level of stress.  

Children may also react to stress with bouts of insomnia followed by periods of deep, dreamless sleep.   Events at school, fights with friends, or conflict at home cause them to toss, turn and worry one night, and crumble from exhaustion the next.  During these nights of deep sleep, they are more likely to wet the bed because their bladder and sphincter muscles are too relaxed to wake them up when they need to use the bathroom.    

Childhood bedwetting is quite common.  5 million U.S. children over the age of 6 wet the bed, and the stress they experience is more the result of bedwetting than the cause.  Their friends tease them, they cannot go on sleepovers or to sleep away camps, and they may feel low self-esteem because they think bedwetting is for babies.   

Bedwetting is not the end of the world, however.   Parents can help their kids gain control over their bladders.  For example, they can make sure their child uses the bathroom before going to sleep and stops drinking fluids a few hours before bed.   The child can use alarms to wake up at night to go to the bathroom.  Dr Atala and other experts at the American Academy of Family Physicians made the following suggestions to parents who read WebMD:  

• They can support their children emotionally, by reassuring them that bedwetting is not their fault, by not punishing them for it, and by reminding them that bedwetting runs in families.   They can encourage the children to engage in the same activities as all their friends, such as camps or sleepovers.  
• They can put night-lights in the child's bedroom so that it becomes less scary to use the bathroom at night.  
• The children can get rewards for following the treatment plan that will help stop bedwetting -- night time bathroom trips, holding back on fluids, setting alarms and so forth. Should children have a bedwetting accident, parents can praise them for doing their best to stay dry, and encourage them to help change their beds and do laundry after the accident.  If the children help clean up, they may feel that they are helping to solve the problem and feel proud of their contributions.  

Bedwetting ends gradually, Dr. Atala explains.   A child may have accidents every night, “then maybe five nights a week, then maybe only three or four…. It’s a transition.”   Once the bedwetting ends, there is a good chance that it won't come back.   On the rare occasions where there is a recurrence, it may be the result of changes in diet and behavior that make bedwetting more likely; parents can help their child address the problem by returning to habits that helped them stay dry.   However, Atala wants parents to know that with bedwetting, “the rule is that they just outgrow it.”

 *This article is based on information provided at WebMD