Jasvinder A. Singh
In an anonymous online survey among patients with self-reported physician-diagnosed gout, nearly a quarter of respondents described frequent sleep disorders, as well as daytime sleepiness.
“In our recent work with patients with gout, we learned that sleep disorders were experienced commonly by a significant proportion of the patients, and many indicated that sleep problems likely contributed to their poorer quality of life,” Jasvinder A. Singh, MD, of the Birmingham Veterans Affairs Medical Center, told Healio Rheumatology.
“We also know data indicate that sleep disorders are common in the general population and often under-diagnosed and under-treated,” he added. “Several recent studies also have invoked a link between sleep apnea — a common sleep disorder related to obesity and metabolic syndrome — and gout. Patients in our gout clinic frequently complained about poor sleep. These emerging and important findings drove us to examine this question.”
Figure 1. Nearly a quarter of survey respondents with gout described frequent sleep disorders and daytime sleepiness, according to findings.
To analyze the burden caused by sleep disorders among patients with gout, Singh developed a brief, anonymized internet survey of visitors to the Gout and Uric Acid Education Society’s website. From January to October 2017, respondents who reported physician-diagnosed gout were asked to complete the survey, which assessed the frequency of sleep problems, sleep quality, daytime sleepiness during a typical day, sleep quality and the frequency of snoring, gasping, snorting or stopped breathing during the sleep.
Respondents rated their sleep quality over the past 24 using a 0 to 10 scale, with 0 being the best possible sleep and 10 being the worst. Daytime sleepiness was also measured on a 0 to 10 scale, with 0 denoting no sleepiness during the day. Sleep quality was measured in the number of hours of sleep achieved. All questions originated from validated surveys, including the NHANES 2016 sleep questionnaire. In addition, Singh used the Chi-square test to compare the categorical and t test the continuous variables. Among the 454 visitors who clicked on the survey, 320 reported having physician-diagnosed gout.
According to Singh, 23% of the respondents with gout reported a physician-diagnosed sleep disorder, including 17% who reported having sleep apnea. Respondents reported achieving a mean of 6.7 hours each night (SD = 1.3). In addition, 86% reported snoring, and 45% reported having snorted, gasped or stopped breathing during sleep. Two-thirds of respondents said they felt sleep during the day at least three to four times or more each month. Across the participants, sleep quality was rated a 5.5 (SD = 2.6), and daytime sleepiness was rated 3.5 (SD = 2.6)
“Screening of gout patients for sleep disorders, proactively, may help diagnose sleep disorders,” Singh said. “An early diagnosis and appropriate treatment for sleep disorder in people with gout can likely improve their quality of life. Awareness of a link between sleep disorders and gout disease can trigger additional clinical and translational studies into common mechanisms that underlie both conditions, and help in co-management of other conditions that commonly occur in patients with gout, such as metabolic syndrome, obesity etc.” – by Jason Laday
Disclosure: Singh reports consulting fees from Crealta/Horizon, Fidia, UBM LLC, Medscape, WebMD, the National Institutes of Health and the American College of Rheumatology, as well as ownership of stock options in Amarin Pharmaceuticals. Please see the study for all other relevant financial disclosures.