Sleep Apnea and Gout Make Strange Bedfellows

September 13, 2018

Patients with obstructive sleep apnea are at increased risk for gout, even beyond the first year after the sleep disorder is diagnosed.

Patients with obstructive sleep apnea (OSA) are at higher risk for gout, even beyond the first year after the sleep disorder is diagnosed, say researchers at Keele University in the UK. Their findings were recently published in Arthritis & Rheumatology.

OSA is associated with a range of serious comorbidities, and it has previously been shown that patients with OSA are at higher risk for gout during the first year after diagnosis. A research team led by Edward Roddy, DM, and Milica Blagojevic-Bucknall, PhD, from Keele’s Research Institute for Primary Care and Health Sciences, investigated whether patients with OSA may also be more likely to develop gout over a longer term.

The study
They examined information on 15,879 patients with OSA and 63,296 without-with a median follow-up of 5.8 years. The researchers found that patients with OSA were almost twice as likely to develop gout during the follow-up period: 4.9% of patients with OSA vs 2.6% of those without OSA.

An elevated risk of gout was observed throughout the follow-up period for patients with OSA, but it was highest 1 to 2 years after diagnosis of the sleep disorder. This finding was observed in patients with normal body mass index as well as those who were overweight or obese; however, the risk was greater in those of normal weight.

Implications for practice
“People with sleep apnea are at an increased risk of gout in both the short and long term. Since this risk was highest in people with normal body mass index, doctors and other health professionals should consider the possibility of gout in patients with sleep apnea, regardless of body mass index,” says Dr Roddy.

Directions for future research
It is thought that intermittent oxygen deficiency related to OSA leads to overproduction of uric acid. “Sleep apnea is commonly treated with continuous positive airways pressure-or CPAP-therapy. Since CPAP treatment corrects low oxygen levels, it might also be expected to reduce uric acid levels, which could possibly reduce the risk of developing gout; however, further research is needed to investigate the effect of treatment with CPAP in people with gout,” says Dr Blagojevic-Bucknall.

References:

Blagojevic-Bucknall M, Mallen C, et al. The risk of gout among patients with sleep apnea: a matched cohort study. Arthritis Rheumatol. 2018 Aug 30. doi: 10.1002/art.40662. [Epub ahead of print]

Obstructive sleep apnoea linked with higher risk of gout [press release]. Staffordshire, England, UK: Keele University; August 30, 2018.