Bed-Wetting with acupuncture and acupressure

Introduction

Bed-wetting, also known as nocturnal enuresis, is a common condition in children and can cause significant emotional distress for both the child and the family. It is defined as involuntary urination during sleep in children who are five years of age or older. 

While bed-wetting is a self-limiting condition that usually resolves on its own, it can cause significant social and psychological problems for children, such as low self-esteem and social isolation. Traditional Chinese medicine (TCM), including acupuncture and acupressure, has been used as a treatment for bed-wetting for centuries. 

This essay will discuss the causes and symptoms of bed-wetting, the conventional treatment options available, and the use of acupuncture and acupressure as alternative treatment methods for bed-wetting. It will also explore the commonly used acupressure points for the treatment of bed-wetting.

Causes and Symptoms of Bed-wetting

Causes

The exact cause of bed-wetting is unknown, but it is thought to be due to a combination of genetic, developmental, and environmental factors. It is believed that bed-wetting is caused by the inability of the child's bladder to hold urine during sleep. The bladder may be too small, the bladder muscles may not be strong enough to hold urine, or the child may produce too much urine during the night. Other factors that may contribute to bed-wetting include constipation, sleep apnea, and psychological factors such as stress and anxiety.

Symptoms 

The symptoms of bed-wetting are straightforward: the child wets the bed during sleep. Bed-wetting can occur sporadically or be a persistent problem, and it can cause embarrassment, shame, and anxiety for the child. In some cases, bed-wetting can also be a sign of an underlying medical condition, such as a urinary tract infection or diabetes.

Conventional Treatment Options

The conventional treatment options for bed-wetting include behavioral interventions, medications, and bed-wetting alarms. Behavioral interventions include limiting fluid intake before bed, encouraging regular toilet breaks during the day, and using positive reinforcement techniques to encourage the child to wake up and use the toilet at night. 

• Medications such as desmopressin and imipramine can also be used to reduce the production of urine and increase bladder capacity. 

• Bed-wetting alarms are devices that emit a sound or vibration when the child wets the bed, which can help train the child to wake up and use the toilet.

• While these treatments can be effective for some children, they are not always successful, and they can have side effects. 

• Behavioral interventions can be challenging to implement, and they may not be suitable for children who have underlying medical conditions. 

Medications can have side effects such as nausea, headaches, and constipation. Bed-wetting alarms can be disruptive to sleep and may not be effective for deep sleepers or children who sleep through the alarm.

Acupuncture and Acupressure for Bed-wetting

TCM has been used to treat bed-wetting for centuries, and acupuncture and acupressure are two of the most commonly used modalities. Acupuncture involves the insertion of fine needles into specific points on the body, while acupressure involves the application of pressure to the same points using fingers, thumbs, or specialized tools. 

Both acupuncture and acupressure aim to balance the flow of energy, or qi, in the body, and they can help to address the underlying imbalances that contribute to bed-wetting.

Acupuncture and acupressure for bed-wetting typically involve a series of treatments over several weeks or months. The specific points used will vary depending on the individual and the underlying imbalances that are contributing to the bed-wetting. 

In general, points on the bladder, kidney, and spleen meridians are commonly used, as these meridians are believed to be involved in the regulation of urine production and bladder function.

Acupressure Points for Bed-wetting

Here are some of the commonly used acupressure points for the treatment of bed-wetting:

• Shenshu BL23: This point is located on the lower back, approximately 1.5 CUN from the spine, at the level of the waist. It is believed to tonify the kidney qi and regulate urinary function.

• Pangguangshu BL28: This point is located on the lower back, approximately 1.5 CUN from the spine, at the level of the sacrum. It is believed to tonify the bladder and regulate urinary function.

• Taixi KI3: This point is located on the inside of the ankle, in the depression between the ankle bone and the Achilles tendon. It is believed to tonify the kidney qi and regulate urinary function.

• Sanyinjiao SP6: This point is located on the inside of the leg, four finger widths above the ankle bone. It is believed to tonify the spleen and regulate urinary function.

• Zhongji CV3: This point is located on the midline of the lower abdomen, approximately 4 CUN below the navel. It is believed to tonify the bladder and regulate urinary function.

• Neiguan PC6: This point is located on the inside of the wrist, two finger widths from the wrist crease, between the two tendons. It is believed to regulate the heart and calm the mind, which can help to address the emotional factors that may contribute to bed-wetting.

Conclusion

Bed-wetting is a common condition in children that can cause significant emotional distress for both the child and the family. 

While conventional treatment options such as behavioral interventions, medications, and bed-wetting alarms can be effective for some children, they are not always successful, and they can have side effects. 

Acupuncture and acupressure are two alternative treatment methods that have been used for centuries to treat bed-wetting. These modalities aim to balance the flow of energy in the body and address the underlying imbalances that contribute to bed-wetting. 

The specific acupressure points used will vary depending on the individual and the underlying imbalances. 

The acupressure points commonly used for bed-wetting include BL23, BL28, KI3, SP6, CV3, and PC6. 

While more research is needed to fully understand the effectiveness of acupuncture and acupressure for bed-wetting, they can be a safe and non-invasive treatment option for children who are struggling with this condition. 

As with any medical condition, it is important to consult with a qualified healthcare provider before beginning any new treatment.

REFERENCES

• Chen, Q. (2012). Acupuncture treatment for primary nocturnal enuresis: a systematic review of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine, 2012. This systematic review analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be a safe and effective treatment option for bed-wetting.

• Lee, Y. T., Wu, Y. C., & Huang, T. P. (2019). Acupuncture for children with nocturnal enuresis: A systematic review and meta-analysis. European Journal of Pediatrics, 178(3), 375-383. This systematic review and meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be an effective treatment option for bed-wetting.

• Leung, T. W., & Chan, K. W. (2016). Acupuncture for nocturnal enuresis in children: a systematic review and network meta-analysis. BMC Complementary and Alternative Medicine, 16(1), 248. This systematic review and network meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be an effective treatment option for bed-wetting. 

• Li, C., & Lu, L. (2021). Acupuncture for nocturnal enuresis in children: a systematic review and meta-analysis. Acupuncture in Medicine, 39(1), 3-12. This systematic review and meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be an effective treatment option for bed-wetting.

• Liao, X., Yang, J., & Zhang, X. (2017). Acupuncture for children with nocturnal enuresis: a systematic review and meta-analysis of randomized controlled trials. Journal of Traditional Chinese Medicine, 37(2), 182-190. This systematic review and meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be an effective treatment option for bed-wetting.

• Ma, X., Lin, X., & Chen, Z. (2018). Acupuncture for nocturnal enuresis in children: A systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine, 37, 143-153. This systematic review and meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be an effective treatment option for bed-wetting.

• Qiu, Y., Liu, X., Cheng, M., Xu, X., & Zhang, X. (2017). Acupuncture and acupressure for nocturnal enuresis in children: a systematic review and meta-analysis. Evidence-based Complementary and Alternative Medicine, 2017, 1-16. This systematic review and meta-analysis analyzed 12 studies that investigated the use of acupuncture or acupressure therapy for nocturnal enuresis in children. The review found that both acupuncture and acupressure therapy were effective in treating nocturnal enuresis, and that acupressure therapy was associated with fewer adverse effects compared to acupuncture therapy.

• Shu, X. Y., & Li, X. (2015). Acupuncture for nocturnal enuresis in children: A systematic review and meta-analysis. Journal of Acupuncture and Tuina Science, 13(6), 376-383. This systematic review and meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be an effective treatment option for bed-wetting.

• Tam, L. S., & Leung, C. W. (2002). Acupuncture and nocturnal enuresis in children: a randomized controlled trial. Hong Kong Medical Journal, 8(5), 306-310. This study investigated the effectiveness of acupuncture in treating bed-wetting in children. The results showed that acupuncture was effective in reducing the frequency of bed-wetting in children.

• Wang, W., & Wu, J. (2017). Acupuncture treatment for primary nocturnal enuresis: A meta-analysis of randomized controlled trials. Medicine, 96(49). This meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The meta-analysis concluded that acupuncture can be an effective treatment option for bed-wetting.

• Xiong, Q., Huang, Y., & Li, Y. (2020). Acupressure for the treatment of nocturnal enuresis in children: A systematic review and meta-analysis. Journal of Traditional Chinese Medicine, 40(6), 954-963. This systematic review and meta-analysis analyzed the results of studies investigating the effectiveness of acupressure in treating bed-wetting in children. The review concluded that acupressure can be an effective treatment option for bed-wetting.

• Yan, X., Zhang, Y., & Liu, Z. (2020). Acupuncture combined with desmopressin for the treatment of nocturnal enuresis in children: a systematic review and meta-analysis. BMC Complementary Medicine and Therapies, 20(1), 100. This systematic review and meta-analysis analyzed the results of studies investigating the effectiveness of acupuncture combined with desmopressin (a medication commonly used to treat bed-wetting) in treating bed-wetting in children. The review concluded that this combination treatment can be an effective treatment option for bed-wetting.

• Yang, J., Liao, X., & Zhu, X. (2017). Acupuncture for nocturnal enuresis in children: a systematic review and network meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2017. This systematic review and network meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be an effective treatment option for bed-wetting. 

• Yu, Y., Sun, R., & Chen, Z. (2020). Acupuncture for the treatment of primary nocturnal enuresis in children: A protocol for systematic review and meta-analysis. Medicine, 99(45), e23129. This systematic review protocol aims to analyze the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children.

• Yu, Z., Chen, R., & Zhao, Y. (2019). Acupuncture for nocturnal enuresis in children: a systematic review and meta-analysis. Complementary Therapies in Medicine, 47, 102202. This systematic review and meta-analysis analyzed the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children. The review concluded that acupuncture can be an effective treatment option for bed-wetting.

• Zhang, G., Hu, H., Liu, M., Wang, L., Zhang, H., & Yan, J. (2015). Acupressure for nocturnal enuresis: a randomized controlled trial. Journal of Traditional Chinese Medicine, 35(1), 32-36. This randomized controlled trial studied the effects of acupressure therapy on 52 children with nocturnal enuresis. The children were randomly assigned to an acupressure group or a control group, and the acupressure group received acupressure therapy at the CV3 and SP6 points for 20 minutes each day for 8 weeks. The study found that the acupressure group had a significantly higher rate of cure and improvement compared to the control group.

• Zhang, J., Lu, Y., Li, S., Ma, Y., Wu, H., & Gu, Y. (2020). Acupressure therapy for bed-wetting in children: a systematic review and meta-analysis. Evidence-based Complementary and Alternative Medicine, 2020, 1-10. This systematic review and meta-analysis analyzed 12 studies that investigated the use of acupressure therapy for bed-wetting in children. The review found that acupressure therapy was effective in reducing the frequency of bed-wetting, and that it was a safe and non-invasive treatment option. The study also noted that further research is needed to explore the optimal acupressure points and treatment protocols for bed-wetting.

• Zhang, T., Yang, Z., & Wu, H. (2019). Acupuncture for nocturnal enuresis in children: A protocol for systematic review and meta-analysis. Medicine, 98(51), e18223. This systematic review protocol aims to analyze the results of randomized controlled trials investigating the effectiveness of acupuncture in treating bed-wetting in children.

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Nocturnal Enuresis (Wetting the Bed)