Why does gout always strike at night?

Introduction: Many patients with gout have the experience of being awakened by pain at night.
This kind of pain has no warning, and it occurs when you fall asleep in the middle of the night, and it is often not relieved for a long time.

 Why does gout always strike at night? How to prevent it? There are roughly 4 reasons why gout is easy to attack at night.

 1.
The human body is relatively short of water at night, and uric acid is more likely to deposit.
Gout is caused by hyperuricemia.
When the uric acid in the blood is oversaturated, crystals will be precipitated.

The crystals deposited around the joints will irritate the joints, cause inflammation, and cause gouty arthritis.

At night, the human body loses water through respiration, perspiration, urination, etc.
The body will be in a relatively dehydrated state, blood concentration will increase the concentration of uric acid, crystal precipitation and increase the risk of gout attacks.

 Preventive measures: Adequate hydration is essential to prevent gout.
Drinking water should ensure that the urine output is more than 2000 ml throughout the day.

However, it should be noted that it is not advisable to drink too much water before going to bed, so as not to wake up too many times to affect sleep.

 2.
The body temperature is relatively low, and uric acid is easy to deposit.
During sleep, the metabolism rate is low, the body temperature is relatively low, the saturation of urate is lowered, and precipitation is easy to occur.

 Preventive measures: Keep your limbs (especially the distal ends of your feet) warm during sleep.

 3.
Decreased hormone secretion at night Adrenal cortex hormones have the effect of inhibiting inflammation, preventing gout attacks and improving symptoms of attacks.

But its secretion has a circadian rhythm, that is, it is the lowest at 0-2 midnight, starts to rise at 3-5 am, reaches a peak at 6-8 am, and then gradually decreases.

It can be seen that the secretion of adrenal cortex hormones decreases at midnight, which gives an opportunity for gout attacks.

Although the hormone secretion rhythm cannot be adjusted, hormone supplementation can be used to prevent gout attacks.

 4.
Decreased blood oxygen concentration There are many gout patients with obesity, high blood pressure, and hyperlipidemia.
It is not uncommon for them to snore during sleep.
It is accompanied by recurrent apneas, which in severe cases will cause the body's blood oxygen concentration to decrease.

 In response to tissue hypoxia, the metabolism of nucleotides in the body will increase.

Although the patient does not eat or drink, a large amount of endogenous purine is produced in the body, and the final product of purine metabolism is uric acid that causes gout.

Therefore, gout patients with severe snoring should correct sleep apnea as soon as possible.

 Preventive measures: Patients can choose to wear orthoses, undergo surgery, and continuous positive pressure ventilation through the nose.

When sleeping, it is advisable to choose a side or semi-prone position, raise the head of the bed or pillow to keep the nasal cavity unobstructed.

Reference: [1] Shen Jie.
Why does gout love to commit at night[J].
China Health Care.
2016.
[2]Chen Yumin.
Why does ventilation always occur at night[J].
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2016.