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 The intense pain and swelling of a joint, often a big toe, that
marks gout is caused by the deposition of uric acid crystals in
joints and tissues. Sleep apnea, the study team notes, causes
periods of oxygen deprivation during the night when people stop
breathing, which triggers overproduction of uric acid in the
bloodstream.
But little was known about the relationship between the two
conditions, the study team writes in Arthritis and Rheumatology.
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 much more common, can increase the risk of
high blood pressure, heart attack, stroke and heart failure, among
other conditions, if untreated.
Obesity plays an important role in both sleep apnea and gout, but
sleep apnea still increased the risk for gout even when weight was
accounted for, said lead author Yuqing Zhang of Boston University
Clinical Epidemiology Research and Training Unit.
The researchers used data on almost 10,000 people with a new
diagnosis of sleep apnea from a U.K. database and compared them to
more than 40,000 people of similar sex, age, birth year and body
composition but without sleep apnea.
Over a one-year period, there were 270 cases of gout, 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.
“When people have a gout attack it’s so painful, they have limited
mobility, they cannot put even one piece of paper on the toe,” Zhang
told Reuters Health.
Although obesity increases the risk for sleep apnea, some thin
people have sleep apnea, too, and even in these people the risk of
gout was increased by 80 percent, he said.
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The next step is to test whether treating sleep apnea also reduces
the risk for gout, which seems likely, he said.
“Some studies show that if you get treatment, your uric acid may go
down,” Zhang said.
Sleep apnea can be treated with lifestyle changes, such as losing
weight or wearing mouthpieces or 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.
SOURCE: http://bit.ly/20dJn30 Arthritis and Rheumatology, online
October 19, 2015.
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