Examining the Connection Between Gout and Sleep Apnea

by Martin Reed Patient Advocate

Gout is a form of inflammatory arthritis that occurs when an excessive amount of uric acid crystallizes in the joints. Symptoms include the sudden onset of pain, redness and swelling — particularly in a single joint such as the big toe.

Research suggests gout may be linked to sleep apnea

A 2013 study published in the journal BMC Musculoskeletal Disorders set out to examine the link between gout and sleep apnea.

Researchers analyzed British databases that contained patient consultation and prescription data from 13 doctors' offices in the UK. A total of 1,689 individuals consulted their primary care doctors about gout. Their data was compared to data from 6,756 patients without gout.

The study revealed that those with sleep apnea were twice as likely to have gout compared to those without sleep apnea. Even after adjusting for medications and other medical conditions that may have influenced results, those with sleep apnea were still found to be almost one-and-a-half times more likely to have gout.

The authors of the study concluded that obstructive sleep apnea appeared to be a risk factor for gout and that CPAP therapy may lower uric acid levels and help control gout symptoms.

What gout and sleep apnea have in common

In a separate 2013 study, 1,042 individuals underwent a sleep study to determine whether they had sleep apnea. They also had their blood tested and their blood pressure taken. Researchers found that individuals with obstructive sleep apnea had higher levels of uric acid in the blood.

The study found that lower oxygen saturation in the blood (common in those with sleep apnea) was a significant predictor of uric acid levels.

Research published by the American College of Rheumatology found that those with sleep apnea were at a higher risk of gout compared to those without the sleep disorder. The authors pointed out that treating the hypoxia associated with sleep apnea can considerably aid gout management.

Since as many as 90 percent of individuals with obstructive sleep apnea are undiagnosed, could this sleep disorder be the cause of your gout?

Do you have sleep apnea?

If you suffer from gout and recognize any of the following symptoms of sleep apnea, consider speaking with your doctor:

  • Snoring or loud breathing

  • Excessive daytime sleepiness

  • Dry mouth, irritability or mood swings

  • Frequent nighttime trips to the bathroom

How to reduce uric acid levels

Uric acid is a byproduct of natural cell breakdown and the purines that come from what we eat and drink. If you have been diagnosed with gout or sleep apnea, you may be able to reduce uric acid levels by adjusting your diet.

The U.K. Gout Society recommends avoiding high purine foods such as:

  • Beer

  • Crab

  • Liver

  • Shrimp

  • Mussels

  • Venison

  • Oily fish

Moderate purine foods should be eaten in moderation and include:

  • Beef

  • Pork

  • Lamb

  • Chicken

  • Mushrooms

  • Whole grains

  • Dried peas, beans and legumes

Cherries have been found to reduce levels of uric acid and may help combat the inflammatory properties of urate crystals.

The benefits of a Mediterranean diet

A study published in 2012 found that adhering to a Mediterranean-type diet was associated with lower uric acid levels and a lower likelihood of hyperuricemia. The study also found that:

  • Beer and liquor consumption was associated with increased uric acid but moderate wine consumption appeared to have no effect.

  • Vitamin C intake was associated with lower risk for gout and lower uric acid levels.

  • Higher levels of uric acid were found in those who consumed more meat, legumes and soft drinks.

If you are suffering from gout and recognize any of the symptoms of sleep apnea, speak with your doctor. You may be referred to a sleep clinic to undergo a sleep study that will help determine whether your gout is a symptom of sleep apnea.

Make sure you also discuss with your doctor in advance any changes you plan to make to your diet.

Martin Reed
Meet Our Writer
Martin Reed

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.