Interesting “Sleep Apnea & Gout” read

[d q]

Hey everyone!

Stumbled upon this “Sleep Apnea & Gout” article, and found it to be very informative (more specifically the answer by Burton Abrams below the main article).

I know it might be trivial for the experts but very informative for us newbies!

🙂

James

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Snoring after reading “Sleep Apnea & Gout”?

[Keith Taylor]

Yes, Burton Abrams work on sleep apnea and gout is interesting. He has contributed to the gout forum in the past.

It’s an area that would probably benefit from greater recognition during gout diagnosis. There is some relevant information if you use the GoutPal search box at the top of the page, for sleep apnea. I can’t find any other recent research into sleep apnea and gout. But, there is an interesting 2003 study that includes summaries of sleep apnea and uric acid research (Obstructive sleep apnoea syndrome: an oxidative stress disorder). Warning: it’s very technical.

[d q]

Yes, it does sort of make sense (sleep apnea) and uric acid levels.
I’m definitely going to read that technical article. It seems interesting. My sleeping patterns aren’t great being in the IT industry and it would be nice to know if resolving sleep problems could potentially help with attack frequencies.

I don’t know if rheumatologists these days are just being lazy in trying to assist and make information more readily available in consultations or if they are looking for more ways to make money by trying to maintain as many visits by patients as possible.

Thanks Keith!

[Keith Taylor]

I’m not sure what you mean in your second paragraph, James.

With respect to sleep apnea, I believe it has different causes. Therefore, likely different solutions for different sufferers. I knew a man who required some sort of machine to help with overnight breathing. Burton has suggested that sleeping on ones back is a significant cause of sleep apnea. And, that proved to be the case for me.

Burton suggested sewing small plastic balls into his pyjama jacket to encourage himself to avoid sleeping on his back. As my “pyjama jacket” is my skin, I avoided that. But, I found that I could train myself to sleep on my side. In my case, sleep apnea had little to do with my gout. I guess it might have raised uric acid levels that were already too high. I’ll never know.

Also in my case, I never realized I had a problem until my daughter shrieked that I had stopped breathing when falling asleep watching TV.

On the whole, I think it’s something that is important to be aware of. That technical article explains the low level inflammation that is associated with sleep apnea. That’s not good for cardiovascular health. And, it might have a significant impact on gout.

[d q]

Hi Keith,

With regards to the second paragraph, it seems that rheumatologists never give all this information out. They just give the very basic and prescribe medication. It would be nice if they discussed sleep patterns and maybe a little information on self test uric acid kits.

Funny actually as I’ve always preferred sleeping on my front but it makes me bend my toes more (worried that causes attacks) so I started avoiding sleeping in that position and moved over to my back but after reading those last articles it seems as sleeping on your side is the ideal compromise.

Ive recently started using sleep monitoring apps to see which time and position works best for me.

Regards,
James

[Keith Taylor]

I don’t think any doctor has the time to give all relevant information. It would take a long time to prepare different levels of information to suit each individual patient. So, I’ve taken that on as my job. Speaking of which, the rheumatologist’s advice on self test uric acid kits should be: “That’s my job”.

But, we’re moving away from sleep apnea. So, better to start a new topic, if you want to discuss rheumatologist advice.

I never asked, James. Have you been diagnosed with sleep apnea? Or, is it general, undiagnosed sleep issues.

Has anyone else got any thoughts on sleep apnea and gout?

[d q]

Hello Keith,

Believe it or not I completely forgot that time is a huge limiting factor with regards to the amount of advice that can be provided during a consultation.

With regards to Sleep Apnea, I’ve never had myself checked / diagnosed however to be honest I think a significant proportion of my sleep problems have only recently become an issue and are a result of “worry or stress” of a Gout flare possibility when waking up. (Ridiculous I know). 🙂

I’ve started using an iPhone App to monitor my sleep over the next month or so to better understand what could be the problem. Making small adjustments to see what can improve sleep. I can guarantee that being in the IT industry doesn’t help however 🙂

Regards,
James

[Patrick]

With regards to Sleep Apnea, I’ve never had myself checked / diagnosed however to be honest I think a significant proportion of my sleep problems have only recently become an issue and are a result of “worry or stress” of a Gout flare possibility when waking up. (Ridiculous I know). 🙂

I’ve started using an iPhone App to monitor my sleep over the next month or so to better understand what could be the problem. Making small adjustments to see what can improve sleep. I can guarantee that being in the IT industry doesn’t help however 🙂

Regards,
James

Hey fellas. Just got back from an awesome snowboarding trip up north and thought I’d check in. Sleep apnea and Gout….hmmmm.

First off James, if you are REALLY going to do a comprehensive sleep study (not an iPhone app) better be prepared to pay. They are very expensive. I’ve had guys at work do them and they are $4,500 to get them done. But the flip side to that is the guys I know, state they have never felt better in the morning. The machine is called a “CPAP” machine and it works wonders. I’ve never been dianosed with sleep apnea before, but I know a lot of guys that have. Yes, the facepiece is odd and cumbersome, but once you get used to it, it works amazing.

I suppose there could be some correaltion between sleep apnea and Gout. My first reaction would be to say it’s because most people (not all) who experience sleep apnea tend to be overweight. Again, most….not all. In my opinion, there would tend to be some connection there between sleep apnea and Gout just due to that fact alone. I’d have to read more about it.

Just wanted to let you know about the cost for the comprehensive sleep study. Yes its expensive, but it also could be a life saver. The connection between sleep apnea and hypertension, stroke and sudden respiratory arrest are valid. So if you look at it that way, it’s really a small price to pay.

[d q]

What a lucky guy you are! I just don’t have the courage to get myself on a snowboard 🙂

Yikes, $4500 for the study! I’m based in the UK so at the current rates that’s probably around £4000.

Just out of interest Patrick, why would sleep apnea and overweight people be higher gout linked? I thought that the general idea is lack of sleep being the actual disturbing factor?

p.s. Is there any specific symptoms that immediately give a pretty good idea that someone may have sleep apnea.

Thanks mate. 🙂

[Patrick]

James,

There are actually 2 types of sleep apnea, but for purposes of this thread, and not to go on a tangent, I will focus on obstructive sleep apnea. That is the actual obstruction of the opening of the trachea, usually caused by the collapsing of the soft palate in the back of the throat.

The only connection that a layman like myself could draw that Gout and sleep apnea would be connected would be that people who tend to be overweight usually have sleep apnea. SOME gout sufferers tend to be overweight, linking diet, lifestyle, and health issues as contributing factors. Notice I said some, because what these doctors who use these contributing factors are failing to say is that for the majority of Gout sufferers, it was inherited through family DNA. In my OPINION, this could be a link. I don’t really understand how sleep apnea itself could lead to higher Uric Acid in your blood stream, in and of itself. But then again, I don’t tend to read JAMA or other medical journals for light reading.

The only connection that I could link all this together is that being overweight has significant health risks. One of those issues is kidney problems, which can be linked to Uric Acid filtration and Gout. So in a roundabout way, there may be a connection, but several other factors would have to come into play. Again, I’m not a doctor and this is just my opinion, FWIW.

[d q]

Hi Patrick,

Thanks for the valuable information.

I think that sleep apnea may also have to do with oxygen levels and premature ageing / stress and as a result may contribute to gout or generally higher uric acid levels.

I too am not a doctor but as we both agree sleep plays such an important role in our general health and lack of sleep (sleep deprivation) or even low quality sleep can cause so many general issues that may even relate back to uric acid / gout that even scientists have ye to explore / discover.

Again I am not a doctor though.

[Keith Taylor]

Sleep apnea is a specific sleep disorder that is definitely associated with gout. And, as James says:

sleep plays such an important role in our general health and lack of sleep (sleep deprivation) or even low quality sleep can cause so many general issues

There is help and information from a trio of websites from American Sleep Apnea Association.

[Junior GoutPal]

In the old forum, Utubelite wrote about Uric Acid Levels and Snoring:

It is amazing but looks like there is some link. I used to snore heavy before I have taken the UA lowering drug therapy. I was not able to sleep on my back( face up) as I would snore very heavy which would not let anyone else sleep, besides I will get up myself as I was not able to breathe properly.

Since I have started Allopurinol, my snoring has improved.

For last one week that I am on UA level of less than 4, the snoring has stopped altogether.

My wife told me that I do not snore any more. I also tried sleeping on my back and I was able to do so without any snoring.

I am surprised on it and do not know if it is due to UA levels dropping below 4.

At-least there is some positive side of it, not related to gout.

This was followed by references to sleep apnea. And, Keith chipped in with a quote from a Royal Society of Medicine article from PubMed about snoring:

Three of the 200 patients had considerably raised serum uric acid, and had marked relief of snoring with anti-gout treatment. I have assumed that this was due to lessening of mucosal oedema of the soft palate.

[Stephen]

What an interesting thread.
I have sleep Apnea, diagnosed a couple of years ago, and after incredible struggles getting used to a machine am now happily using an ASV CPAP machine.

It is ironic that what I now know as early gout symptoms in my 50’s
coincided with weight gain and the beginning of Sleep Apnea.

The comment re doctors not having the time to give info to patients rings true
in my case. I have a few physical things going on, as is normal at 67, so
its not surprising that I have to research my own conditions.

For anyone else who also has Sleep Apnea and has not been there yet,
a great forum is the Apnea Board

I look forward to reading this forum and hopefully will find a way
through the gout pain…
all the best,
Stephen

[Rich Blazeski]

how can you determine whether you suffer by sleep apnea or not? i m not overweight but sometimes even when i was a child i had the feeling that i forget to breath. i don t know if was just a feeling or really was related with that..but in the last time i had quite a bad sleep, as I m stressed most of the time, and became more aggressively, I get annoyed by even small things, so annoyed and nervous that I start shaking.
besides that i read a testimonial from a guy from my country who said that once he cured by sleep apnea he solved his issues with gout.

[Keith Taylor]

Sleep apnea is not easy to diagnose. But there are some hints from this thread about sleeping on your back, feeling tired through the day, and feedback from people who notice you stopping breathing. Anyway, I suggest you use the forum that Stephen suggested. Or, the forum on the websites I mentioned above at http://goutpal.net/forums/topic/found-this-interesting-read/#post-2662

You are right that sleep apnea can be a sole cause of gout for some people. But, for other gout sufferers, it is just a contributing factor.

[Stephen]

Hi Rich..
As Keith pointed out there are some folks that have gout that perhaps has been caused by Sleep Apnea…and they deal with the Apnea symptoms and the gout disappears. Good for them. For the rest of us the two diseases arise at perhaps the same time in varying forms and we have to deal with that. Mostly there are no magic bullets.

How to find out if one has Sleep Apnea, you ask.
Well the simplest and least expensive way of getting a general hint is with an “overnight oximetry test”
In Canada your doctor can request the overnight test from one of the DME (Durable Medical Equipment vendors that deal with Sleep Apnea. Here is what they look like in BC.

After you take the test, the results are assessed and if the technician at the DME will suggest a trial on a CPAP machine.
Sometimes if the results are showing a high level of Apnea your Dr will request an Overnight Sleep Study, but don’t worry about that. Get yourself an Oximetry Test and go from there, in my opinion…:-)

Also you can’t go far wrong by visiting the Apnea Board, lots of great support there…

Good luck…
Stephen

There are various apps for smart phones, but they will only tell you if you are snoring…not if you have SA (Sleep Apnea)

[Ucatsexas .]

Gout Research SLEEP APNEA

I just read in the NYTimes that there is a strong connection between gout and sleep Apnea. I have both and believe there is a connection.

“New research has found that obstructive sleep apnea — a disorder in which breathing stops and starts during sleep — is associated with an increased risk for gout, a common cause of painful arthritis.

Scientists studied 15,879 patients with apnea and 63,296 matched controls without, following them for an average of almost six years. Over that time, 4.9 percent of people with apnea developed gout, compared with 2.6 percent of those without the disorder.

Both disorders are associated with obesity, high blood pressure, diabetes and other conditions, but after controlling for these and other factors the independent association of apnea with gout was still evident. The study is in Arthritis & Rheumatology.

The mechanism is unclear, but reduced oxygen supply during sleep encourages the production of uric acid, and the accumulation of uric acid crystals in the joints is what causes the inflammation and pain of gout.

Apnea can be treated with continuous positive airway pressure, or CPAP, in which the patient wears a mask at night to allow easier breathing. There are drugs and diet restrictions used to treat gout.

The lead author, Milica Blagojevic-Bucknall, a lecturer at Keele University in England, said that this observational study does not prove cause and effect. Still, she added, “It’s possible that people who use CPAP could reduce the risk or severity of gout.”

[P Mb]

Hi Ucatsexas,

Good post.

I was diagnosed with (mild) SA too – and suffer with gout.
I am *convinced* there is a link there that needs investigation.
‘Better joints in the morning’ was the first thing I noted after going onto CPAP: it was a dead cert that I’d had a good night on the machine.

Were I a doctor I’d do a mandatory sleep study when anyone presented with gout – and probably one or two other chronic conditions too:

For ‘overweight people tend towards diabetes and gout’ read ‘overweight people tend to breathe less well at night, which encourages diabetes and gout’ – perhaps?

Could be a research project in there 🙂

pb

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