Key result
Adding zolpidem to tamsulosin is linked to ~42% fewer nocturia episodes in BPH.
Why the study?
Does combination therapy with tamsulosin and zolpidem improve nocturia and sleep disturbance in patients with BPH?
Does combination therapy with tamsulosin and zolpidem improve nocturia and sleep disturbance in patients with BPH?
Absolute Event Rate: 1.9% vs 3.3%
p-value: p=<0.001
Combination therapy with tamsulosin and zolpidem improves nocturia and sleep quality in BPH patients with residual sleep disturbance on tamsulosin monotherapy.
May support zolpidem addition for residual nocturia in BPH; hypothesis-generating and requires RCT confirmation before practice change.
INTRODUCTION: We examined the efficacy of combination therapy with α1-blocker tamsulosin and hypnotic zolpidem in patients who had suffered from sleep disturbance associated with nocturia. MATERIAL AND METHODS: A total of 35 patients diagnosed with nocturia with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) were studied. After treatment with tamsulosin for 4 weeks, 16 patients dissatisfied with nocturia (nocturiaquality of life index ≥4) and suspected to have sleep disturbance (Athens Insomnia Scale ≥6) received additional treatment with tamsulosin and zolpidem for 2 weeks. Outcomes were evaluated by the International Prostate Symptom Score (IPSS) and quality of life index (QOL), Athens Insomnia Scale (AIS) and nocturia-quality of life index (nocturia-QOL). RESULTS: After monotherapy with tamsulosin, significant reductions 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. However 20 patients were dissatisfied with nocturia (nocturia- QOL ≥4). Among 20 patients, 16 patients were suspected to have sleep disturbances (AIS ≥6). In these patients, additional therapy with tamsulosin and zolpidem significantly reduced 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) compared with patients after treatment with tamsulosin only. CONCLUSIONS: Combination therapy with tamsulosin and zolpidem may be useful for patients with BPH dissatisfied with nocturia and suspected to have sleep disturbance.
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Miwa et al. (2011) studied Benign prostatic hyperplasia (BPH) with nocturia (n=35). Tamsulosin and zolpidem combination therapy vs. Tamsulosin monotherapy was evaluated on Nocturia episodes (p=<0.001). In BPH patients with persistent nocturia and sleep disturbance on tamsulosin, adding zolpidem significantly reduced nocturia episodes from 3.3 to 1.9 (p<0.001).
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