November 10, 2015

Sleep Apnea – Gout Flares, Tied

I have sleep apnea and use a type of CPAP machine when I sleep. I apparently am doing all the right things, as I have never had any problems with gout. However, this study says that sleep apnea may increase the risk of developing gout and experiencing flare-ups.

I know from friends that the pain can be intense and make walking very difficult. Gout causes swelling of a joint, normally in the big toe. Gout is caused by the accumulation of uric acid crystals in joints and tissue. Sleep apnea causes periods of oxygen deprivation during the night when people stop breathing, and this triggers the overproduction of uric acid in the blood stream. The study team states that little in known about the relationship between the two conditions.

The study, in Arthritis and Rheumatology, states that in 2007-2008, almost six percent of men and two percent of women in the U.S. Experienced gout, according to the Centers for Disease Control and Prevention. Sleep apnea, which is more common and if untreated can increase the risk of high blood pressure, heart attack, stroke, and heart failure.

Lead author, Yuqing Zhang of Boston University Clinical Epidemiology Research and Training Unit says obesity plays a role in both sleep apnea and gout. He continued that sleep apnea still increased the risk of gout even when weight was taken into account.

The researchers in the United Kingdom used data on almost 10,000 people newly diagnosed with sleep apnea and compared them to more than 40,000 people of similar sex, age, and body composition, but without sleep apnea. In a one-year period, there were 270 cases of gout with 76 in the sleep apnea group and 194 in the larger comparison group. Gout was diagnosed at an average age of 60. Gout was almost twice as common in the sleep apnea group as in the comparison group, according to the analysis.

Obesity increases the risk for sleep apnea, but some thin people have sleep apnea, too, and even in these people, the risk of gout was increased by 80 percent.

The next step is to test whether treating sleep apnea also reduces the risk for gout. Some studies show that if you get treatment, your uric acid may go down. Sleep apnea can be treated with lifestyle changes, such as losing weight, wearing mouthpieces, breathing devices at night, or with surgery.

It takes years for uric acid crystals to accumulate in the joints and lead to an eventual gout flare, so sleep apnea may not “cause” the gout, but may create a more ideal environment for a flare up, said Dr. Robert Thomas Keenan of Duke University School of Medicine in Durham, North Carolina, who was not part of the new study.”

Gout is the most common inflammatory arthritis in the western world,” he told Reuters Health by email. “Sleep apnea and gout risks can be reduced in many people by losing weight if they are overweight, eating healthy and indulging in alcohol and red meats in moderation,” he said.

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