The Connection Between Sleep Apnea and Gout

By , Category : Pain

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Marchione_261015Sleep apnea and gout are two serious medical conditions—but did you know that there is a connection between the two?

Sleep apnea is a disorder where one’s breathing frequently stops and starts during sleeping. The muscles lining the airway relax enough to allow it to close until the brain signals them with a jolt to reopen. As a result, oxygen is reduced in the bloodstream causing the cells in the body to undergo disintegration, leading to the generation of too much uric acid. Once uric acid is formed it cannot be reversed, even when breathing resumes. With every incident, more uric acid flows into the bloodstream—much faster than the kidneys can get rid of it. The increased ratio of oxygen to carbon dioxide in the bloodstream makes the blood more acidic. This reduces its ability to hold uric acid in solution and leads to excess uric acid. Uric acid builds up and forms sharp urate crystals in a joint that can cause inflammation, swelling and pain.

Gout is a complex form of arthritis that occurs when urate crystals gather in the joints, leading to intense discomfort, swelling and inflammation. It is characterized by severe attacks of pain, redness and tenderness in the joints.

Evidence Connects Gout and Sleep Apnea

In a 2012 report that looked at the association between high serum uric acid levels and sleep variables, researchers examined data obtained from the 2005-2008 National Health and Nutrition Examination survey. They analyzed sleep variables (i.e. snoring, snorting, daytime sleepiness, and sleep duration) and high serum uric acid levels in 6,491 participants aged 20 and older.

Study results were surprising. Daytime sleepiness and snoring more than five nights per week were linked with high serum uric acid levels, even when adjusting for lifestyle risk factors. Researchers concluded that there was a positive relationship between sleep variables (i.e. snoring and daytime sleepiness) and high serum uric acid levels. As we already know, high levels of uric acid are associated with gout.

Another study conducted in the U.K. also examined the relationship between gout and sleep apnea, and arrived to a similar conclusion.

For this study, data was taken from a database of general practice records from nine practices in the U.K. between 2001 and 2008. Patients consulting for gout were identified and matched with four controls: gender, practice, year of consultation, and age. Confounding diseases, sleep problems and medications were also identified.

To assess the association between gout and sleep disorders, researchers used a logistic regression model and adjusted for hypertension, diabetes mellitus, ischemic heart disease, and diuretic use. They identified 1,689 individuals with gout—each individual was successfully matched to four controls. Among patients with gout, the occurrence of any sleep problem was 4.9% while it was 4.2% for sleep problems other than sleep apnea and 0.7% for sleep apnea, compared to 3.5%, 3.2% and 0.3% in controls.

Study researchers concluded that gout and sleep disorders appear to be associated and clinicians should be aware of their co-existence.

Sleeping Habits That Cause Gout

Poor sleeping habits are known contributors to gout. Sometimes what you need is a bedroom makeover to overcome some of the structural barriers to deep sleep. Take a closer look at your sleeping environment:

  • Do you have a peacefully quiet bedroom? Or are you struggling to shut out steady noises such as road traffic or the tick-tock sound of your nightstand clock?
  • Do you have a predictable bedroom? Are you awakened by sudden ambulance sirens or slamming doors?
  • Is your bedroom dark? The smallest amount of light can prevent deep sleep. Light also reduces the body’s ability to produce the sleep hormone melatonin.
  • Does your bedroom have a comfortable temperature? Does your mattress cause your body to overheat? Are you having differences over the temperature with your spouse? Cool temperatures are associated with better sleep.
  • Is your bedroom a calm sanctuary or is it filled with distracting things, such as a computer or a television?
  • Is your bed comfortable? Or do you find yourself tossing and turning to try and find a pain-free position?

Gout Killer Sleep Sanctuary

  • If the streetlight is interrupting your sleep, place black-out curtains over your windows.
  • Invest in a high-quality mattress that won’t cause your body to overheat.
  • Invest in silky organic sheets—they are comfortable and will make you crave getting into bed.
  • Cover or remove gadgets that emit light, or purchase an eye mask if needed.

Treat Sleep Apnea to Treat Gout

Here are a few natural ways you can treat sleep apnea:

  • Lose excess weight: Lose excess weight to help relieve constriction of your throat. Sleep apnea may go into remission when you return to a healthy weight. But, it is likely to come back if you return to an unhealthy weight.
  • Keep your nasal passages open during the night: Use a saline spray (a salt solution) to keep your nasal passages open. Most nasal decongestants and antihistamines are only supposed to be used for a short period of time, so speak to your doctor about using them first.
  • Avoid tranquilizers, sleeping pills and alcohol: Consuming these will relax the muscles in the back of your throat and obstruct breathing.
  • Don’t sleep on your back: Sleeping on your back may cause your tongue and soft palate (the back part of your mouth) to rest against the back of your throat, blocking your airway. Sleep on your side or abdomen instead.

Sources for Today’s Article:
“Sleep Apnea,” Mayo Clinic web site; August 25, 2015; http://www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/lifestyle-home-remedies/con-20020286.
“Gout,” Mayo Clinic web site; November 25, 2014; http://www.mayoclinic.org/diseases-conditions/gout/basics/causes/con-20019400.
Koulouris, S., “Gout and Sleep Apnea,” Gout and You web site, http://goutandyou.com/gout-and-sleep-apnea/, last accessed October 26, 2015.
Roddy, E., et al., “The association of gout with sleep disorders: a cross-sectional study in primary care,” BMC Musculoskeletal Disorders, 2013; 14:119, doi: 10.1186/1471-2474-14-119.
Wiener, R.C., et al., “Association between Serum Uric Acid Levels and Sleep Variables: Results from the National Health and Nutrition Survey 2005-2008,” International Journal of Inflammation, 2012; 363054, doi: 10.1155/2012/363054.
Abrams, B., “Gout and the Sleep Apnea Connection,” Beating Gout web site, last updated August 1, 2009; http://www.beatinggout.com/2009/04/gout-and-the-sleep-apnea-connection/, last accessed October 26, 2015.
“Sleep for Gout Prevention?” The Gout Killer web site, https://thegoutkiller.com/gout-treatment/prevention/sleep-for-gout-prevention/, last accessed October 26, 2015.




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Dr. Victor Marchione, MD

About the Author, Browse Victor's Articles

Victor Marchione, MD received his Bachelor of Science Degree in 1973 and his Medical Degree from the University of Messina in 1981. He has been licensed and practicing medicine in New York and New Jersey for over 20 years. Dr. Marchione is a respected leader in the field of smoking cessation and pulmonary medicine. He has been featured on ABC News and World Report, CBS Evening News and the NBC Today Show and is the editor of the popular The... Read Full Bio »