Has anyone had sleep issues taking Flomax (Tamsulosin) or Trospium (Sanctura)?

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I have had a number of recent posts here about sleep issues for the past couple of years, that weren't solved by a recent TURP. Urologist says my bladder is sensitive due to radiation cystitis from prostate cancer treatment in 2014. While that may be so, I was wondering if anyone else on this forum has had sleep issues taking Flomax or Trospium? I take both. Sleep issues aren't mentioned as a side effect of Flomax, but are mentioned for Trospium. The longest stretch I can sleep is about 1.5 hrs before waking up to go to the bathroom, then 5-10 min later try to get back to sleep once my bladder feels empty. This goes on all night long - gets even worse closer to morning. I am up and down at least 6-10x per night, and sometimes more. This is no longer a retention issue after the TURP. Maybe my brain is trained to wake up frequently. I would happily go off all these drugs if I could just get a good night's sleep. I have started taking a bit of Benadryl and melatonin and they help a bit, but not much and I feel drugged when I take them.

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  • Posted

    I just thought I would mention caffeine as it can irritate the bladder But if you have already cut it out then that isnt the answer. We try to avoid it in the eves.

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  • Posted

    More recently trained urologists are aware of the fact that the root cause may be a sleep disorder waking the patient, and not the bladder. In such a case, the patient wakes first, and then assumes that it's the bladder waking him. So ask your doctor about having a sleep study done. I have a friend who fortunately had a younger urologist who recommended a sleep study, which led to a solution to his nocturia.

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    • Posted

      What was the solution?

      I sometimes try a very low dose of Xanax (.125 mg) at bedtime, and think it may reduce nighttime voids by 1. I don't think it's a good solution, though, because one could build up a tolerance to benzos, need more, and then become dependent on them to go to sleep.

      What I notice with my own nocturia is that it has 2 phases. During the first 4 hours of sleep, a normal amount of urine comes out. During the second 4 hours I have the same amount of bladder signaling but often little urine comes out. So I pee a little -- sometimes a very little -- my bladder seems satisfied and the urge stops, and I go back to sleep.

      I'm on 10 mg of alfuzosin at 7:00 o'clock so the bladder relaxation should be the same in both cases.

      Does the prostate swell during the night? Could it be that during the second 4 hours it's swollen more and tricks the bladder into believing I have to pee?

      It would be a great help if I could eliminate peeing during the second 4 hours, when I really don't have to pee. To that end, I've tried taking 200 or 400 mg of ibuprofen at the beginning of the 2nd half of sleeping. I can't say conclusively whether it did or did not help. I know you're not supposed to take NSAIDs on a regular basis. If it helps at all it would most likely be because of an analgesic effect and not anti-inflammatory, which takes weeks to work. Analgesic would be okay if it masks bladder signaling. I think I'll try a high dose of Tylenol, which would be safer long-term than ibuprofen, and see if it helps.

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    • Posted

      I think Alfuzosin counteracts the natural narrowing of the urethra as we sleep and especially if we take certain drugs like Benadryl and I think also benzodiazepines. So I've always taken my Alfuzosin just as I go to sleep - not at 7pm. Try it and good luck.

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    • Posted

      Maybe this image will be allowed by the moderator:


      If not, https : // www . accessdata . fda . gov / drugsatfda_docs / label / 2008 / 021287s011lbl.pdf is the link.

      It shows: "Mean (SEM) Alfuzosin Plasma Concentration-Time Profiles after a

      Single Administration of UROXATRAL 10 mg tablets to 8 Healthy Middle-Aged Male

      Volunteers in Fed and Fasted States"

      Food causes the level of alfuzosin to go way up. The peak is reached at 10 hours after eating , so if I take it after a meal at 7:00 the peak will be at 5 am.If you take it at 11, after eating, which always causes the concentration to be greater, it won't peak until after you get up.

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    • Posted

      Good post, Doug. This is the chart I use as well to decide when I take alfuzosin. Just wanted to mention that, as shown on the chart, the peak for the "fed" condition is pretty much 7.5 to 10 hours after alfuzosin is taken and is still pretty high even 12 hours afterwards.

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