Efficacy of combination therapy with tamsulosin and zolpidem on nocturia in patients with benign prostatic hyperplasia

摘要

Introduction. We examined the efficacy of combinationtherapy with α1-blocker tamsulosin and hypnoticzolpidem in patients who had suffered from sleep disturbanceassociated with nocturia.Material and methods. A total of 35 patients diagnosedwith nocturia with lower urinary tract symptoms(LUTS) suggestive of benign prostatic hyperplasia (BPH)were studied. After treatment with tamsulosin for 4weeks, 16 patients dissatisfied with nocturia (nocturiaqualityof life index ≥4) and suspected to have sleep disturbance(Athens Insomnia Scale ≥6) received additionaltreatment with tamsulosin and zolpidem for 2 weeks.Outcomes were evaluated by the International ProstateSymptom Score (IPSS) and quality of life index (QOL),Athens Insomnia Scale (AIS) and nocturia-quality of lifeindex (nocturia-QOL).Results. After monotherapy with tamsulosin, significantreductions in IPSS (18.9 ±3.8 to 9.9 ±3.0, p <0.001), QOL(4.5 ±0.9 to 3.2 ±0.9, p <0.001) and nocturia episodes(3.4 ±0.7 to 2.6 ±1.0, p <0.001) were observed. However20 patients were dissatisfied with nocturia (nocturia-QOL ≥4). Among 20 patients, 16 patients were suspectedto have sleep disturbances (AIS ≥6). In these patients,additional therapy with tamsulosin and zolpidem significantlyreduced nocturia episodes (3.3 ±0.8 to 1.9 ±0.7,p <0.001), AIS (10.6 ±2.9 to 6.8 ±25, p <0.001) and nocturia– QOL (5.6 ±0.5 to 3.6 ±1.1, p <0.001) comparedwith patients after treatment with tamsulosin only.Conclusions. Combination therapy with tamsulosin andzolpidem may be useful for patients with BPH dissatisfiedwith nocturia and suspected to have sleep disturbance