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Gout: Sleep apnea may raise your risk

November 17, 2015


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Burton Abrams
November 20, 2015

It is misleading to identify the “control” group as people without the sleep apnea disorder. They should more correctly be identified as people who had never been tested for sleep apnea. Since sleep apnea is so woefully underdiagnosed, it is very likely that many individuals in the control group did indeed have sleep apnea, and the gout sufferers in the control group may have been concentrated among those with undiagnosed sleep apnea. Thus the likelihood of incident gout among those with sleep apnea vs. those without sleep apnea may be much higher than reported in this paper.

The hypoxia from sleep apnea exacerbates the likelihood of gout not only by the effect mentioned in the paper, namely excess cellular generation of uric acid. It also makes the blood more acidic, so that it can retain less uric acid in solution, making urate crystal precipitation more likely. And over the long term, the chronic intermittent hypoxia causes deterioration of kidney function, so uric acid is removed from the blood more slowly, exacerbating its crystal precipitation even further. These are perfect storm conditions for precipitation of the urate crystals which cause gout.

November 17, 2015

I am 46 and have been having progressively worse snoring so I went and did a sleep study. I was diagnosed with moderate sleep apnea which is not a huge surprise. I have gout as well which has been more persistent lately but not terribly severe as it has been in past years. I am 5’11” and weigh 196 which is I think technically overweight. I guess I’m not really surprised about this article but I hadn’t heard the sleep apnea / gout connection before.

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