α1-adrenoceptor blockade improves nocturia and sleep quality

Treatment with an α1-adrenoceptor antagonist drug is associated with significant improvements in nocturia, sleep quality and lower urinary tract symptoms (LUTS) in women with voiding symptoms, study findings show.

Writing in Urology Journal, the researchers say their findings support further assessment of the safety and efficacy of α1-blockade in these patients.

A team led by Sun-Ouck Kim (Chonnam National University Hospital, Gwangju, South Korea) recruited 324 women with moderate-to-severe LUTS for the study. All had an International Prostate Symptom Score (IPSS) of 8 or higher, nocturia (defined as at least one void per night) and a maximal flow rate (Qmax) of 15 mL/s or less.

Treatment with an α1-adrenoceptor blocker was given for 4 weeks. Twenty-eight women discontinued therapy for personal reasons or lack of efficacy.

Among the 296 women who completed treatment, there were seven reports of mild dizziness or fatigue and three cases of incontinence. There were no significant treatment-related complications, however.

In terms of treatment efficacy, mean Qmax improved from 13.3 mL/s at baseline to 20.4 mL/s at 4 weeks and mean postvoid residual urine declined from 75.3 mL to 54.8 mL; both changes were statistically significant.

α1-blocker therapy was also associated with significant improvements in IPSS total score, IPSS voiding, storage and bother subscores, nocturnal voiding frequency and sleep quality.

On the Medical Outcome Sleep scale, there were significant improvements in the domains of sleep disturbance, somnolence and sleep adequacy, but no change in hours of sleep, shortness of breath or snoring.

The researchers note that while the efficacy of α1-blockers in relieving symptoms associated with bladder outlet obstruction is well established, less is known about how these agents affect nocturia and sleep quality in these patients.

This study demonstrates that α1-blockade significantly improved both voiding and storage symptoms in women with low Qmax and postvoid residual urine, they say, as well as reducing nocturia and improving sleep quality.

“Therefore therapy could be an initial treatment option for the patients with LUTS associated with low Qmax who do not have other distinct factors causing [bladder outlet obstruction]”, the researchers conclude.

α1-adrenoceptor blockade improves nocturia and sleep quality

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