Many people with gout know that specific foods and drinks can contribute to gout attacks. But obstructive sleep apnea (OSA) — a sleep disorder in which the upper airway becomes blocked or narrowed during sleep — may also be linked to gout.

In this article, we’ll explore what current evidence says about the link between sleep apnea and gout.

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How Sleep Apnea May Raise Uric Acid Levels

Obstructive sleep apnea can lower the amount of oxygen in your blood while you sleep. During an OSA episode, your airway becomes blocked or narrowed for a short time, causing your blood oxygen level to drop until you start breathing normally again. These repeated drops in oxygen are called intermittent hypoxia.

Your cells use a molecule called adenosine triphosphate (ATP) for energy. When oxygen levels repeatedly fall, ATP can break down more quickly than usual, increasing purine by-products that can ultimately contribute to higher uric acid levels.

An enzyme called xanthine oxidase converts purine by-products into uric acid. Research suggests that intermittent hypoxia may increase this pathway’s activity, leading to more uric acid production.

Crystal Deposits in Joints

OSA may also create conditions that make it easier for uric acid crystals to form and deposit in joints. During episodes of interrupted breathing, carbon dioxide levels rise, which can make the blood more acidic and promote the formation of uric acid crystals.

Low-oxygen episodes can also produce lactic acid, which may cause the kidneys to reabsorb more uric acid. These mechanisms may help explain why OSA is associated with higher uric acid levels and gout risk.

The Link Between Sleep Apnea and Gout Risk

Research has shown an association between sleep apnea and gout. Overall, people living with OSA appear to have a higher risk of developing gout than those without sleep apnea.

One large study followed 9,865 people with OSA and 43,598 without the sleep disorder. Over one year, gout incidence rates were 8.4 per 1,000 person-years in the OSA group and 4.8 per 1,000 person-years in the comparison group. After adjustment for other factors, people with OSA had a 50 percent higher risk of developing gout.

Health Conditions That May Contribute

OSA and gout share several risk factors, including older age, obesity, kidney disease, and heart failure, a type of heart disease.

One study analyzed more than 3.5 million people with a body mass index (BMI) of 30 or higher. About 23 percent had OSA, and gout was recorded in about 7.2 percent of those with OSA compared with 2.8 percent of those without OSA. After matching the groups for several factors, including age, sex, race, kidney disease, heart failure, and diuretic use, OSA was associated with about 1.5 times the odds of gout.

In contrast, a 2020 study found that the overall association between OSA and gout disappeared after researchers adjusted for smoking, BMI, alcohol use, heart failure, diabetes, kidney function, and medication use. This suggests that shared risk factors may explain much of the association seen in some studies.

OSA and Uric Acid

These findings suggest that OSA may contribute to elevated uric acid levels, which may increase the risk of gout in some people. One study found that people at higher risk for OSA were more likely to have elevated uric acid levels than those at lower risk. Meanwhile, other research suggests that as many as half of people with OSA may have hyperuricemia.

Even without sleep apnea, gout attacks are more likely to occur during sleep. Health experts believe lower body temperature during sleep may make urate crystals more likely to form. Mild dehydration overnight may also make it harder for the body to clear excess uric acid.

Can Treating Sleep Apnea Help Prevent Gout Attacks?

Untreated sleep apnea is linked to higher risks of conditions such as hypertension, heart disease, and stroke. Some of these conditions are also risk factors for gout. Treating sleep apnea is important for your overall health, but researchers are still studying whether it can prevent gout attacks.

Continuous positive airway pressure (CPAP) therapy has shown promising results for lowering uric acid. One 2026 meta-analysis of 17 studies found that CPAP lowered serum uric acid levels in people with OSA. The reductions were greater among people who used CPAP for at least four hours per day or continued treatment for at least six months.

Other sleep apnea treatments, including weight management when appropriate, may help address risk factors shared by OSA and gout. For gout, a low-purine diet may help lower uric acid. Cleveland Clinic recommends varying protein sources and choosing fruits, vegetables, and grains other than oats, with whole grains making up at least half of grain choices.

Join the Conversation

On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

If you live with both sleep apnea and gout, what has your experience been with managing them? Let others know in the comments below.