Medicine Service, Birmingham VA Medical Center, University of Alabama, Birmingham, AL, USA.
Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama, Birmingham, AL, USA.
Rheumatology (Oxford). 2018 Nov 1;57(11):1925-1932. doi: 10.1093/rheumatology/kex535.
There are no qualitative studies of sleep in gout; the aim of this study was to examine the impact of gout on sleep.
Nine nominal groups were conducted, oversampling for African-Americans and women with gout. Patients discussed and rank-ordered their concerns.
Nine nominal groups with 46 gout patients were conducted with mean age, 61 years (s.d. 10.6) and gout duration, 14.9 years (s.d. 12); 63% were men, 46% African-American, 52% married, 46% retired and 63% were allopurinol users. The most frequently cited highly ranked concerns could be divided into three categories. The first category, character of sleep interruption, included the concerns: severe and complete sleep interruption by gout flare pain (nine groups); and inability to get rapid eye movement sleep (one group). The second category, causes of sleep interruption, included: inability to get into a comfortable position during sleep (six groups); anxiety and depression associated with severe gout pain (seven groups); sleep interruption by moderate chronic joint pain (three groups); frequent trips to the bathroom interfering with sleep (two groups); gout medication side effects (four groups); frequent trips to the emergency room (one group); joint swelling with physical/functional deficit interfering with sleep (two groups); and flare pain interfering with sleep apnoea management (two groups). The final category, consequences of sleep interruption, included: effect on daily functioning (two groups); worsens other health conditions, which then affect sleep (four groups); and cumulative effect on sleep (one group).
Gout has significant impact on sleep quantity, quality and architecture. Sleep disruption due to gout has several pathways and significant consequences.
痛风领域尚无关于睡眠的定性研究；本研究旨在探讨痛风对睡眠的影响。
共开展了 9 个名义组研究，对痛风患者进行了过度抽样，包括非裔美国人和女性患者。患者讨论并对他们的关注点进行了排序。
共开展了 9 个名义组研究，纳入了 46 例痛风患者，平均年龄为 61 岁（标准差 10.6），痛风病程为 14.9 年（标准差 12）；63%为男性，46%为非裔美国人，52%已婚，46%退休，63%为别嘌醇使用者。被引用频次最高的高度关注问题可分为三个类别。第一类，睡眠中断的特征，包括：痛风发作疼痛严重且完全中断睡眠（9 个组）；无法进入快速眼动睡眠（1 个组）。第二类，睡眠中断的原因，包括：睡眠时无法保持舒适体位（6 个组）；严重痛风疼痛相关的焦虑和抑郁（7 个组）；中度慢性关节疼痛导致的睡眠中断（3 个组）；频繁起夜影响睡眠（2 个组）；痛风药物副作用（4 个组）；频繁去急诊室（1 个组）；关节肿胀伴身体/功能障碍影响睡眠（2 个组）；以及痛风发作疼痛干扰睡眠呼吸暂停管理（2 个组）。第三类，睡眠中断的后果，包括：对日常功能的影响（2 个组）；加重其他健康状况，进而影响睡眠（4 个组）；对睡眠的累积影响（1 个组）。
痛风对睡眠的数量、质量和结构有重大影响。痛风引起的睡眠中断有多种途径，并产生重大后果。
