title: The association of gout with sleep disorders: a cross-sectional study in primary care.
abstract: BACKGROUND
  Both gout and sleep apnoea are associated with the metabolic syndrome. Hyperuricaemia is also prevalent in sleep apnoea syndrome. The objective of this study was to examine the association between gout and sleep apnoea and other sleep disorders.
  
  
  METHODS
  Data were taken from a validated database of general practice records from nine practices in the UK between 2001 and 2008. People consulting for gout were identified via Read codes and each matched with four controls for age, gender, practice and year of gout consultation. Sleep problems and confounding comorbidities were also identified via Read codes. Medications were identified through a linked database of prescription records. The association between gout and sleep disorders was assessed using a logistic regression model, adjusting for ischaemic heart disease, hypertension, diabetes mellitus and diuretic use.
  
  
  RESULTS
  1689 individuals with gout were identified and each successfully matched to four controls. Amongst those with gout, the prevalence of any sleep problem was 4.9%, sleep problems other than sleep apnoea 4.2%, and sleep apnoea 0.7%, compared to 3.5%, 3.2% and 0.3% respectively in controls. Gout was associated with any sleep problem (odds ratio (OR) 1.44; 95% confidence interval (CI) 1.11, 1.87), sleep problems other than sleep apnoea (OR 1.36; 95% CI 1.03, 1.80), and sleep apnoea (OR 2.10; 95% CI 1.01, 4.39). On multivariable analysis, gout remained significantly associated with any sleep problem (OR 1.39; 95% CI 1.06, 1.81) and sleep problems other than sleep apnoea (OR 1.37; 95% CI 1.03, 1.82), however the association with sleep apnoea was attenuated (OR 1.48, 95% CI 0.70, 3.14).
  
  
  CONCLUSIONS
  Gout and sleep problems appear to be associated and clinicians should be aware of the co-existence of these two conditions. Larger prospective epidemiological studies are required to explore causality.
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Keele, UK. e.roddy@keele.ac.uk
authors.forename: Edward
authors.initials: E
authors.lastname: Roddy
authors.forename: Sara
authors.initials: S
authors.lastname: Muller
authors.forename: Richard
authors.initials: R
authors.lastname: Hayward
authors.forename: Christian D
authors.initials: CD
authors.lastname: Mallen
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006073:Gout / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy
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