Is There Any Objective Improvement of Nocturia by Combination Treatment of Zolpidem and Alpha-Blocker Therapy for Unresponsive to Alpha-Blocker Monotherapy in Men with Lower Urinary Tract Symptoms?

Abstract

Objectives: The aim of the present study was to determine whether administration of zolpidem, a nonbenzodiazepine sedative-hypnotic agent, at night would improve the nocturia unresponsive to alpha-blocker monotherapy in men with lower urinary tract symptoms (LUTS). Methods: This was a prospective observational study comprised of 39 men aged 50 years and older. The study inclusion criteria were age more than 50 years, and nocturia twice or more per night after taking alpha-blockers for more than 8 weeks. A total of 39 patients met the criteria and constituted the study cohort. Pittsburgh Sleep Quality Index (PSQI), International Prostate Symptom Score (IPSS), frequency volume chart (FVCs) and uroflowmetry were recorded. Patients were given 10 mg alfuzosin and 10 mg zolpidem once at night for the 8 weeks. Results: There were no serious side-effects in any patient. Nocturia decreased from a baseline (3.1 +/- 0.1) to 8 weeks (1.6 +/- 0.2) (P = 0.001). After treatment, global PSQI scores and severe sleep disorders improved. Storage and voiding symptoms including total IPSS scores and quality of life index improved. Nocturnal urine volume and functional bladder capacity improved. Maximum flow rate, voided volume increased and residual urine volume decreased. Conclusion: Combined zolpidem and alpha-blocker therapy resulted in a subjective and objective reduction in nocturia episodes when given to men with nocturia unresponsive to alpha-blocker monotherapy.