Sleep Apnea and Gout: A Painful Connection?

A letter posted in the online Medscape Journal of Medicine on Jan. 5 suggests that there is a clear link between obstructive sleep apnea and gout.

What is gout? It is a painful condition that affects the joints. It occurs when high levels of uric acid build up in the blood.

Uric acid is produced when food is digested. Normally it is dissolved in the blood. Then it goes through the kidneys. Finally it passes out of the body through urine.

But excess uric acid forms salt crystals called monosodium urate. These crystals collect in or around the joints. These chalky deposits are called tophi.

This causes inflammatory arthritis. The result is intense pain and swelling. Lumps also can appear under the skin around the joints.

Often gout will first affect the big toe. It can also affect other joints such as the ankles, knees, fingers and elbows.

The letter describes research that links sleep apnea to gout. Sleep apnea involves repeated breathing pauses. These pauses cause drastic changes in your oxygen levels.

The low oxygen levels cause a cellular reaction that ends in the generation of excess uric acid. According to the author, this explains why episodes of gout often occur at night.

The author recommends that everyone who has gout should be screened for sleep apnea.