Patients with obstructive sleep apnea more likely to have gout, study finds

Australia: Researchers have found in a new study that gout is more prevalent in patients with either diagnosed or suspected obstructive sleep apnea (OSA). Also, gout patients are more likely to report suffering from insomnia, restless leg syndrome, and worry about their sleep. 

The study has been published in the journal BMC Rheumatology.

Gout is the most common prevalent inflammatory arthropathy and is the most common form of inflammatory arthritis in men. It is associated with co-morbidities including cardiovascular disease and metabolic syndrome. Obstructive sleep apnoea, which is also associated with cardiovascular morbidity, is also very common. 

Against the above background Julia New-Tolley, The Queen Elizabeth Hospital, Woodville, SA, Australia, and colleagues aimed to determine if there is an association between gout and OSA in a representative Australian adult population. And they also explored associations between gout and patient-reported sleep outcomes.

The study was designed as a cross-sectional national online survey of a representative sample of Australian adults > 18 years assessed self-reported doctor-diagnosed OSA, insomnia, and patient-reported sleep outcomes. Possible undiagnosed OSA was estimated using self-reported frequent loud snoring and witnessed apnoeas. Participants self-reported physician-diagnosed gout and other health conditions. Multivariable logistic regression analyses were performed for both objectives. Odds ratios with 95% confidence intervals were reported.

The results of the study were found to be: 

• Out of the survey, a total of 1948 participants of whom 126 (6.5%) had gout and 124 (6.4%) had diagnosed sleep apnoea.

• After adjusting for age, body mass index (BMI), sex, alcohol intake, and the presence of arthritis, those with obstructive sleep apnoea diagnosed on polysomnography it was found there were twice as likely to report having gout compared to those without. (OR = 2.6).

• Additionally, participants with symptoms suggestive of sleep apnoea were also found to be twice as likely to have gout compared to those without (OR = 2.8).

• They also found a higher likelihood of restless legs syndrome, insomnia and worry about sleep in patients with gout.

Tolley and team concluded that "Diagnosed and suspected OSA are associated with higher likelihood of gout. Participants with gout are also more likely to report suffering from restless legs syndrome, insomnia, and worry about their sleep. Given the morbidity associated with sleep problems, we should be vigilant regarding sleep health in our patients with gout."

For further information: New-Tolley J, Reynolds AC, Appleton SL, et al. "Sleep disorders and gout in Australian adults." BMC Rheumatol. 2021;5(1):30. doi:10.1186/s41927-021-00199-y