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6歳以上のおねしょ「夜尿症」の原因と対策

幼児

おねしょをすることを「布団に地図を描く」とか言ったりします。個人差はありますが、乳幼児ならたいしておねしょは珍しいことではありません。しかし6歳を過ぎても続くようなら病院に相談した方が良いようです。学校でも宿泊行事なども困りますよね。

こちらでは、夜尿症の原因と対策をご紹介します。

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問題の解消方法・実践方法など

夜尿症とは


夜尿症とは生まれたときから続く夜間寝ている間のおねしょのことです。幼児期の夜尿をおねしょといい、6~7歳(小学校入学後)以後の夜尿を夜尿症というのが一般的です。一般的には1週間に1回以上のおねしょが続いていれば「夜尿症がある」としています。

夜尿症の原因

夜尿症の原因は下記のようなことが考えられています。夜尿症の多くは、これらの原因が複数みられることが一般的です。

抗利尿ホルモンの夜間分泌不足
夜間の尿量をコントロールするのに重要なのが、抗利尿ホルモンです。これは、脳から分泌されるホルモンで、昼間少なく、夜になると多く出ます。そのため、夜につくられる尿量は昼間につくられる尿量よりも少なくなります。抗利尿ホルモンの分泌のリズムは、通常、成長とともに整ってきますが、夜尿症の子どもの中には、夜だけ抗利尿ホルモンの出方が悪いため、夜間の尿量が多くなっていることがあります。

不安定膀胱
夜間の膀胱機能は子どもの成長とともに発達していき、夜間は昼間の1回の尿量の1.5~2.0倍はためられるようになります。しかし、夜尿症の子どもの中には、膀胱の機能が未発達で、膀胱のためが小さいことがあります。また、寝る前に排尿しても全部出せずに残尿が残る場合もあります。

心理的ストレス
下垂体のすぐ上に視床下部というところがあり自律神経と深くかかわっているため、強いストレスがかかると、自律神経の働きが不調となり、これが夜尿の原因につながることがあります。

膀胱や腎臓の異常
膀胱や腎臓に器質的な異常が原因であることがあります。昼間もパンツが濡れること(昼間遺尿症)がある場合は可能性が高いです。

夜尿症のタイプ

夜尿症にもタイプがあります。検査によってどのタイプか見分ける事が対策に役立ちます。

  • 1. 多尿型(抗利尿ホルモンの夜間分泌不足)
  • 2. 膀胱型(不安定膀胱)
  • 3. 混合型

夜尿症の対策

夜尿症の子供の2割~3割は生活習慣を見直すことで改善します。

自宅での夜尿症の対策方法

規則正しい生活
早寝早起きしましょう。さらに夕食終了後から就寝まで最低2時間30分あけることが大事です。また睡眠も十分とることが必要です。

水分制限
夕食時の水分摂取量は原則コップ軽く1杯。 夕食終了時から就寝までの水分摂取を禁じましょう。 夕食後は2時間30分の間隔をあけ、必ず排尿してから就寝させるのが大事です。

塩分制限と牛乳制限
夕食の味付けは薄味に、夕食のお味噌汁・お吸い物・スープは基本的にやめましょう。またスナック菓子も禁止です。夕方以降の牛乳の摂取はやめましょう。

夜起こさない
例えば,毎晩夜中の1時に起こしてトイレに連れて行く習慣があったとすると、起こすのを止めた場合、今度は1時に無意識に寝具の中で排尿するようになる可能性があります。また夜間中途覚醒によって睡眠リズムを狂わすことになり、結局抗利尿ホルモンの分泌に対してマイナスに影響を及ぼすことになります。

夜尿を叱らない
さらに悪い緊張感が生じストレスを与えることになり、夜尿の増悪につながります。

焦らない
夜尿症は非常に経過の長い病気で平均治療期間は1年6ヶ月です。医師が指導したことをじっくり焦らず実行することが、治療の最短距離なのです。

.寒さ対策をする
就寝前に風呂に入り、じっくり身体を温めることが大事です。また子どもはもともと寝相が悪く毛布や掛け布団を蹴飛ばして、いつの間にか身体がヒンヤリしていることが多いでしょう。これを防止するために工夫をすべきです。

おむつはしない
おむつをしていると万一失敗しても誰も困りませんから、本人に『がんばって治そう』という積極性が出て来ません。夜尿症の改善にはいい意味での緊張感が必要です。

試してみたい民間療法

ギンナン
夜尿症には、昔からギンナンが効果的だといわれています。これはギンナンに含まれるカリウムなどの成分が腎臓に働きかけて、排尿を調節するためだと考えられます。ただし、食べすぎると中毒を起こすので、1日8~10粒を目安に与えるようにしてください。

少量の塩
寝る前に少量の塩をなめさせても効果があります。血液中の塩分濃度が上がると、細胞内の水分が吸収されて尿量が減るからです。神経の興奮を鎮める作用もあります。

おモチ
モチ米には温熱作用、利尿抑制作用があるので、寝る前に焼きたてのおモチを食べさせるのもよいそう。

ヤマノイモ
ヤマノイモを薄く切って乾燥させたものを漢方薬山薬といい、これを用いたスープもよく効きます。

新 おねしょなんかこわくない―子どもから大人まで最新の治療法
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小学館
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まとめ:夜尿症の原因と対策を知ろう

6~7歳以後のおねしょを夜尿症といいます。原因はいくつかあるようです。おさらいしておきましょう。

原因

  • 抗利尿ホルモンの夜間分泌不足
  • 不安定膀胱
  • 心理的ストレス
  • 膀胱や腎臓の異常

対策方法

  • 規則正しい生活
  • 水分制限
  • 塩分・牛乳の制限
  • 起こさない・叱らない・焦らない
  • 寒さ対策
  • おむつはしない

布団やシーツの洗濯物など、ママは本当に大変です。でも焦らず待ってみてくださいね。

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