title: α(1)-adrenoceptor blocker naftopidil improves sleep disturbance with reduction in nocturnal urine volume.
abstract: OBJECTIVE
  To examine the mechanism underlying improvements in nocturia by α(1)-blockers, we investigated whether the α(1)-blocker naftopidil acts on nocturia with sleep disturbance using a frequency/volume chart (FVC).
  
  
  METHODS
  A total of 56 male patients with lower urinary tract symptoms were enrolled. The inclusion criteria were as follows: eight or more points on the I-PSS; three or more points on the I-PSS score for nocturia; and prostate volume larger than 20 ml. Patients received 50 mg of naftopidil once daily for 4 weeks, and non-responders received 75 mg for another 4 weeks. All patients were examined, and their data entered into FVC for 2 days before and after administration of naftopidil. Quality of sleep was also evaluated using modified Pittsburgh sleep quality index (PSQI).
  
  
  RESULTS
  Patients with sleep quality scores of three or four were assigned to sleep disturbance group (n = 33), while those with scores of less than three were assigned to non-disturbance group (n = 23). After administration of naftopidil, total I-PSS decreased and nocturia score decreased from 3.5 to 2.6 (P < 0.01). Total mean score of modified PSQI in sleep disturbance group became significantly lower after administration of naftopidil (from 16.9 to 14.0; P < 0.01). Naftopidil significantly decreased nocturnal urine volume, resulting in a decrease in the nocturnal polyuria index in both sleep disturbance and non-disturbance groups.
  
  
  CONCLUSIONS
  These results suggest that α(1)-blockers have the ability to normalize sleep disorders. Naftopidil improved nocturnal polyuria regardless of the presence of sleep disturbance, meaning that it might directly reduce nocturnal urine production.
authors.affiliation: Department of Urology, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji, Fukui, 910-1193, Japan. oyoko@u-fukui.ac.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokoyama
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Aoki
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujimura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Takao
authors.forename: Mikio
authors.initials: M
authors.lastname: Namiki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okuyama
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use*; D053158:Nocturia / Q000150:complications / Q000188:drug therapy*; D010879:Piperazines / Q000627:therapeutic use*; D015995:Prevalence; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D009281:Naphthalenes; D010879:Piperazines; C064357:naftopidil
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