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Study Shows Gout Attacks More Common at Night

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The risk of acute gout attacks is significantly greater at night, new research has confirmed.

The Boston Online Gout Study found that people with gout were more than twice as likely to have an attack during the night or in the early morning hours compared to the daytime.

Gout is a type of arthritis that occurs when crystals of sodium urate form inside and around joints. It is caused by a build-up of uric acid in the blood. Uric acid, a waste product, forms when the body breaks down chemicals in the cells known as purines.

Nocturnal attacks persist even among those who did not consume alcohol and had a low intake of purine during the 24 hours prior to the gout flare, the research showed.

“It is speculated that lower body temperature, nighttime dehydration, or a nocturnal dip of cortisol levels may contribute to the risk of gout attacks at night,” commented lead author Dr. Hyon Choi of Massachusetts General Hospital/Harvard Medical School (formerly at Boston University School of Medicine). “Despite the possibility of a nighttime link to gout, no study prior to our current investigation has looked at the association between gout attack risk and the time of day.”

The study included 724 gout patients, who experienced a combined 1,433 gout attacks – 733 in the overnight hours (midnight to 7:59 a.m.), 310 in the daytime (8:00 a.m. to 2:59 p.m.) and 390 in the evening (3:00 p.m. to 11:59 p.m.) – during the one-year study period.

The risk of a gout flare was found to be 2.4 times higher overnight and 1.3 times higher in the evening compared to daytime hours.

“As a result of our study, prophylactic measures that prevent gout flares, especially at night, may be more effective,” Dr. Choi concluded.

The findings of the study have been published in Arthritis & Rheumatology, a journal of the American College of Rheumatology.