This study is based on 2,421 children’s data, aged between 6-12 and suffering from bedwetting issues. Persistent bedwetting (functional nocturnal enuresis) often becomes a problem once a child has reached 6 years of age and continues to wet the bed at least twice a week over three consecutive months. This common problem affects 12% of all 6-12-year-olds and can be both frustrating and embarrassing to children and parents [1]. Bedwetting is about twice as common in boys than girls [1]. Root causes that can lead to nocturnal enuresis include stress, genotype, hormonal imbalances or a large nightly urine production prompted by delayed cognitive and physical development. Being able to recognize the feeling of a full bladder is a learnt skill for children to become aware of. For some children this milestone can take longer than customary guidelines, causing them to involuntarily urinate in bed whilst asleep at night [1]. 

One solution to tackle functional nocturnal enuresis is a bedwetting alarm. This product helps train the child’s brain to recognize the body signals when the bladder is full and stay dry at night [2]. Based on this concept we developed an innovative non-invasive eHealth bedwetting alarm called Oopsie Heroes, including a tiny bedwetting sensor and simple mobile device application. The Oopsie Heroes bedwetting sensor is different because it makes use of a safe, child-friendly and frequency-based sound emission signal (instead of harmful Bluetooth or other radio wireless signals) to communicate with the Oopsie Heroes application which functions as the alarm module. The Oopsie Heroes bedwetting sensor is very small, thin (25x35x5mm) and comfortable. It does not require any special underwear and can be easily attached to all underwear or pyjama trousers using a sticker. 

The aim of this study is to demonstrate the effectiveness of using the Oopsie Heroes Bedwetting Alarm system to record data about bedwetting. It is based on data collected through an anonymous database that helps record events such as when the alarm gently wakes a child up after a bedwetting event occurs at night.

The hypothesis of this study is that the Oopsie Heroes bedwetting alarm can record accurate user data about bedwetting. These insights may help provide a better understanding of the bedwetting issues and eventually cure children from bedwetting sooner.

Data from 2,421 children, aged between 6-12 (M=8,3, SD=1,9) and suffering from bedwetting issues was included. The children’s parents noted the child’s age and gender in the Oopsie Heroes device application. In this study, data of bedwetting events that took place between 06:00AM and 5:59PM was excluded as the intended use of the system is at night-time. 

The sensor was attached to the underwear or pyjama trousers of the child (user) using a double-sided adhesive sticker. The application was activated, and the mobile device placed in the room where the child slept. In case of a bedwetting event, the Oopsie Heroes bedwetting sensor detected urine in the underwear using a sensitive impedance measurement and emitted a pulsating frequency sound which the application on the mobile device detected. As a result of a bedwetting event, the mobile emitted within less then 5 seconds an interval alarm sound that woke up the child. The mobile alarm sound could be for example a pre-recorded parents voice which has been proven to be the fastest and most effective way to wake the child up during his night-time sleep [3].

Alongside, for the analysis of the app’s “night-mode activation” and “sensor activation” (bedwetting) events detailed data of night-mode activation and bedwetting events times and dates from 16.6% (n=403) of the users was collected over a period of maximum three months from the date the user installed the Oopsie Heroes application. The data collection period depended upon how soon the child woke up dry for a consecutive period of two weeks. Data about the age, demographics and bedwetting events time and date were automatically collected by the application. Data was automatically uploaded to our database and stored anonymously.

The average age of the 2,421 users was 8,3 years (SD=1,9). The division in gender was 62% boys (n=1492) and 38% girls (n=929). See figure 1.

The average time the users (n=403) activated the night mode of the application was 9:54 PM (SD=2:42 hours) and the average time of the sensor activation events was 11:18 PM (SD=3:18 hours). See figure 2.

The global data indicates that the average age at which users try a bedwetting alarm is approximately 8 years old, and there is an almost equal divide amongst of 6, 7 and 8-year-olds using the bedwetting alarm system Oopsie Heroes. The gender division of (62% boys, 38% girls) correlates with research indicating a 2/3 vs. 1/3 division between boys and girls [1]. However, at an older age the division gap becomes smaller.

According to the data collected the average bedtime (night-mode activation) for 6-12-year-olds is 9:54 PM. The data also indicates that the sensor is activated (when a bedwetting event occurs) at 11:18 PM, approximately one and a half hours after the night mode of the application has been activated. Additionally, the data indicates that during the bedwetting training period the child wets the bed on average once every 4 nights. However, we should also take into account that after the sensor has been activated and the application has responded to wake the child up, the night-mode could have been activated for a second time for the remaining of the night and thus the bedwetting frequency could be higher than once every 4 nights. 

Alongside, based on collected user feedback we see that after using the Oopsie Heroes application and device children’s bedwetting frequency events plummet. From this we conclude that children using a bedwetting alarm can learn to control their bladder at night. This is in keeping with the current research [2].

The Oopsie Heroes bedwetting alarm demonstrates it is an effective system to 1. Discreetly collect bedwetting event data 2. Provide an overview of events to parents/carers 3. Help children wake up on time after a bedwetting event takes place. This system can especially be of value to healthcare professionals and parents interested in understanding their patients/child’s bedwetting pattern.

Doleys, D. M. (1977). Behavioral treatments for nocturnal enuresis in children: a review of the recent literature. Psychological Bulletin, 84(1), 30.
Baker, H. (2001). Practical solutions to help parents deal with childhood bedwetting. Professional nurse (London, England), 17(2), 133-136.
Smith, G. A., Chounthirath, T., & Splaingard, M. (2019). Effectiveness of a Voice Smoke Alarm Using the Child’s Name for Sleeping Children: A Randomized Trial. The Journal of Pediatrics, 205, 250–256.e1. https://doi.org/10.1016/j.jpeds.2018.09.027.