title: Efficacy of combination therapy with tamsulosin and zolpidem on nocturia in patients with benign prostatic hyperplasia.
abstract: BACKGROUND
  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.
  
  
  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.
authors.affiliation: Department of Urology, Gifu University School of Medicine, Gifu, Japan.
authors.forename: Kousei
authors.initials: K
authors.lastname: Miwa
authors.affiliation: Department of Urology, Gifu University School of Medicine, Gifu, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nishino
authors.affiliation: Department of Urology, Gifu University School of Medicine, Gifu, Japan.
authors.forename: Mina
authors.initials: M
authors.lastname: Kikuchi
authors.affiliation: Gifu Red-Cross Hospital, Gifu, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Masue
authors.affiliation: Department of Urology, Gifu University School of Medicine, Gifu, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Moriyama
authors.affiliation: Department of Urology, Gifu University School of Medicine, Gifu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Deguchi
keywords: benign prostatic hyperplasia; nocturia; tamsulosin; zolpidem