Why gout flares during sleep | 516
Rheumatology: Current Research

Rheumatology: Current Research
Open Access

ISSN: 2161-1149 (Printed)


Why gout flares during sleep

International Conference and Exhibition on Orthopedics & Rheumatology

August 13-15, 2012 Hilton Chicago/Northbrook, USA

Burton Abrams

Accepted Abstracts: Rheumatology & Orthopedics

Abstract :

Most gout flares originate during sleep. Why? Because most gout flares are a direct result of sleep apnea, and overcoming the sleep apnea can cure the gout. The hypoxemia of sleep apnea has three effects which lead to an overnight gout flare in short order. Effect #1 is cellular catabolism in which adenosine triphosphate degradation is accelerated, culminating in the transient cellular generation of excess uric acid fed into the blood, faster than any food would cause. Effect #2 is transient hypercapnia and acidosis, so that the blood can hold less uric acid in solution. Effect #3 is a long term acceleration of the deterioration of the kidneys��? glomerular filtration rate so that removal of uric acid from the blood is slowed. Furthermore, after awakening and normal breathing is restored, the first two effects dissipate so that a blood test taken during waking hours misses their peaks. It should be no surprise that gout has been reported to have so many of the same comorbidities already known to be consequences of long-term untreated sleep apnea (eg., cardiovascular diseases, diabetes, kidney disease.) One of the first steps for treating gout should be screening and diagnosis for sleep apnea, followed by treatment of the sleep apnea where indicated. Gout is an early warning of sleep apnea, which when heeded can lead to the early treatment of sleep apnea, thereby greatly reducing the risk for the development of sleep apnea��?s life-threatening consequences.