New-Tolley Julia, Reynolds Amy C, Appleton Sarah L, Gill Tiffany K, Lester Susan, Adams Robert J, Hill Catherine L
Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, SA, Australia.
Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
BMC Rheumatol. 2021 Aug 28;5(1):30. doi: 10.1186/s41927-021-00199-y.
The aims of our study were two-fold. Firstly, to determine if there is an association between gout and OSA in a representative Australian adult population. Secondly, to explore associations between gout and patient reported sleep outcomes.
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.
There were 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 were twice as likely to report having gout compared to those without. (OR = 2.6, 95% CI 1.5-4.6). Additionally, participants with symptoms suggestive of sleep apnoea were also twice as likely to have gout compared to those without (OR = 2.8, 95%CI 1.6-5.1). There was also a higher likelihood of restless legs syndrome, insomnia and worry about sleep in patients with gout.
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.
我们研究的目的有两个。第一,确定在具有代表性的澳大利亚成年人群中痛风与阻塞性睡眠呼吸暂停(OSA)之间是否存在关联。第二,探讨痛风与患者报告的睡眠结果之间的关联。
对年龄大于18岁的具有代表性的澳大利亚成年人样本进行全国性横断面在线调查,评估自我报告的医生诊断的OSA、失眠和患者报告的睡眠结果。使用自我报告的频繁大声打鼾和观察到的呼吸暂停来估计可能未被诊断的OSA。参与者自我报告医生诊断的痛风和其他健康状况。对两个目标都进行了多变量逻辑回归分析。报告了具有95%置信区间的比值比。
共有1948名参与者,其中126人(6.5%)患有痛风,124人(6.4%)被诊断为睡眠呼吸暂停。在调整年龄、体重指数(BMI)、性别、酒精摄入量和关节炎的存在后,经多导睡眠图诊断为阻塞性睡眠呼吸暂停的患者报告患痛风的可能性是未患阻塞性睡眠呼吸暂停患者的两倍。(比值比=2.6,95%置信区间1.5 - 4.6)。此外,有睡眠呼吸暂停症状的参与者患痛风的可能性也是没有这些症状参与者的两倍(比值比=2.8,95%置信区间1.6 - 5.1)。痛风患者出现不安腿综合征、失眠和睡眠担忧的可能性也更高。
已诊断和疑似的OSA与痛风的较高可能性相关。痛风患者也更有可能报告患有不安腿综合征、失眠和担心自己的睡眠。鉴于睡眠问题相关的发病率,我们应该对痛风患者的睡眠健康保持警惕。