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Why Does Gout Attack At Night?
Joint pain usually begins over a window of 2-4 hours and more commonly during the night. A Boston online Gout study set out to examine the risk of acute Gout attacks with relation to the time of day. They found the risk for gout flares to be 2.36 times higher overnight than in the daytime, and 1.26 times higher overnight than in the evening. These nocturnal risk results persisted regardless of alcohol intake, reduced purines in the days leading up to the attacks, age, weight, sex, gout medications, diuretic usage, and NSAIDs use. One reason for onset at night is due to a reduced body temperature which provides an ideal environment for uric acid crystallization. Others include:
Dehydration (from breathing and lack of water intake):
Much of the weight lost during sleep is water weight that disappears through respiration and perspiration. You regain this weight as you drink fluids during the day. Your lungs require moisture to function properly, so the air you exhale contains water. Exhale on to a mirror and you'll see the moisture. During an autumn day, you lose 3 to 4 cups of water through breathing, according to naturopathic physician Jennifer Brett. That amounts to as much as 2 lbs. of water. During the winter, when it's much dryer, you can lose an additional pound. On a dry winter night, you can lose 1 lb. of water breathing while you sleep. Both weight loss and dehydration increase your risk for a gout attack.
Slowed metabolism reduces the need to urinate and increases chances of crystal formation:
For the most part, there is no movement in the joint at rest. When we are in motion the joint's synovial fluid help to keep them clean. Without movement the cleansing action of the synovial fluids are less active enabling uric acid crystals to settle in your joints. Our extremities also tend to cool down during the night, lending a better environment for the uric acid to crystallize.
Additionally, many people have their main meal in the evening, not long before bed. This increases the amount of purines entering the system before rest and before other factors that increase our chances of an attack are already in motion, as well.
Can Sleep Apnea trigger an attack?
Reports of this are far from uncommon. Considering decreased oxygen in the blood can increase uric acid concentration, there could certainly be a link. The combination of hypoxia and apnea could lead to the creation of purines. More than half of the patients that suffer from sleep apnea have been found to have hyperuricemia, as well. An increased ratio of uric acid excretion to that of creatinine excretion can also raise the risk of a gout flare. There have not been any large scale studies between apnea and gout, but one could conclude since both decreased oxygen and the obesity factor generally present in both of these conditions, your chances for a gout attack at night could potentially be increased.
How to Prevent and Protect Against Attacks at Night?
Be cognizant of what you are consuming close to bedtime. Alcohol and imbalanced meals will make it more difficult for you to process before the body is at rest.
Remain hydrated and attempt to take some water to bed with you, as well. Should you awake at night, you'll have it close to you to assist with rehydration.
As important as a good night's sleep can be, don't ignore your need to urinate at night. Should you feel the urge, do not ignore it.
Maintain a healthy weight and exercise routine. This will help with both better sleep patterns, reduced apnea risk, and overall health.
Try to keep the extremities warm with cozy socks and under the covers when possible.
Take GC® Gout Care/Flamasil® and Friendly Fighters® Probiotic about an hour before bed with a glass of warmed water with fresh squeezed lemon. Assisting to bring the body into more of an alkaline state and having herbs to balance the organs and increase uric acid solubility/excretion can go a long way towards your preventative measures.
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