A 2015 study published in the journal Arthritis Rheumatology found the risk of gout attacks during the night and early morning was 2.4 times higher than in the daytime. Unsurprisingly, the swelling and unpleasant sensations of a painful gout flare can make it hard to fall asleep and stay asleep.
Fortunately, there are some steps you can take to help improve your sleep when gout threatens to interrupt your night.
Why does gout strike in the night?
As pointed out by the authors of the 2015 study, there are many theories as to why gout attacks tend to occur at night. These include:
A lower body temperature in the early morning (this can lead to a higher risk of uric acid crystallization)
Low cortisol levels (this can increase inflammation)
Sleep apnea (this can lead to an increase in uric acid)
How to sleep during a gout flare
Unfortunately, it is probably going to be very difficult to sleep during a gout attack. With that being said, you may find that icing for 20 to 30 minutes will help to relieve discomfort. Having a couple of extra pillows handy can also be helpful — if you experience a gout flare during the night, try putting a pillow or two under your feet and raise them above chest level.
Preventing nighttime gout attacks
Prevention is likely the best route to take if you want to improve your sleep when living with gout.
Our sleep is influenced by the food we eat. Gout flares might be, too. Try to avoid foods that increase uric acid levels such as red meat, seafood, and sugary foods and drinks. Foods such as cheese, yogurt, and beans may help protect against gout. Cherries may even help reduce uric acid levels.
During the day, drink plenty of fluids. The Institute of Medicine recommends that men drink around 13 cups of liquids (water and other beverages) each day, while women should drink roughly nine cups each day. To reduce the risk of having to wake during the night to use the bathroom, I suggest restricting the amount of liquid you drink to one cup in the four-hour period before bed.
Alcohol should be avoided. Although alcohol may make it easier to fall asleep, it actually disrupts sleep. The process of breaking down the alcohol can also increase levels of uric acid, making a gout flare more likely.
Just as regular exercise can help improve sleep, being active may also help reduce the frequency of gout attacks. If you are not regularly active, or are overweight, you may want to discuss an exercise plan with your doctor.
Treating nighttime gout flares with drugs
Avoid the temptation to take aspirin during any gout flares since this drug can actually increase uric acid levels.
Regular gout attacks can be treated with anti-inflammatory steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) — so talk to your doctor if you are struggling. Early treatment is better than late treatment, and it’s often more effective.