Every time I see a patient in my practice that has gout, almost invariably, they have signs and symptoms of untreated obstructive sleep apnea. Gout is an arthritic condition that’s caused by uric acid buildup. Allopurinol is the medication of choice, which works by reducing levels of uric acid in the body. Gout is also associated with the metabolic syndrome (obesity, hypertension, high cholesterol, and insulin resistance).
A recent study showed that gout rates in the US are climbing. About 6% of US men and 2% of women have this painful and often debilitating condition.
Despite strong evidence that sleep apnea is a major contributor to gout, little has been done to screen for sleep problems upon initial diagnosis. Chronic hypoxia promotes excess uric acid production in the bloodstream, which the kidneys try to eliminate, leading to higher concentrations in urine. This can also lead to kidney stones.
I’ve had numerous patients that report to me that their gout has improved significantly since starting sleep apnea treatment, whether through conservative lifestyle changes or more definitive options such as CPAP and surgery.
There are a number of very common medical conditions where sleep-breathing problems should be screened for (obstructive sleep apnea or upper airway resistance syndrome). Add gout to this long and growing list.