Nighttime Gout Attacks
Most people who suffer from gout will experience repeated attacks, sometimes in the middle of the night. Startling, painful and frustrating, a nighttime attack can be particularly difficult to overcome, plus it can affect your energy stores and attitude throughout the next day. Luckily, there are ways to reduce your risk of nighttime attacks, and when they do occur, deal with them quickly so you can get a better sleep.
The Reasons behind Sudden Nighttime Gout Attacks
Most gout sufferers have experienced a painful attack in the middle of the night, and once is certainly enough. The first step to preventing future nighttime attacks is a better understanding of the risk factors:
- Inactivity. When joints are stationary, fluid won’t move through them as quickly or efficiently, and that can set the stage for uric acid crystals to build and settle in problem sites. It follows that when you’ve been asleep for a few hours, your body is at a greater risk for a gout attack.
- Alcohol. That nightcap before bed might be worse for your sleep than you thought. Alcohol is known to increase your chances of developing gout, and since most booze is high in purines, it can also bring on a late night attack.
- Heavy dinners. Eating big dinners late in the evening is a recipe for uric acid buildup, especially if they include purine-rich foods. If you go to bed while you’re still digesting, the purines will be converted to uric acid crystals and could lodge in your joints when you’re asleep.
- Cooler temperatures. Uric acid is more likely to crystallize in lower temperatures, and since it usually gets cooler as the sun goes down, night time is the prime climate for gout attacks.
How to Prevent and Protect Against Attacks at Night
Although the big toe is the most common site of gout attacks, any extremity can feel the effects of uric acid crystals. Your best bet for a good sleep is to prepare your body with the right foods and smart sleep habits.
Eat well: Although food is only responsible for about 10% of the uric acid in your body, eating the wrong foods can put you at risk for an attack. Eliminate meat and seafood from your diet or at least your dinner plate. Go easy on beans, lentils, spinach, asparagus and mushrooms, too – they’re all high in purines.
Medicate ahead of time: Daily low doses of NSAIDs and colchicine can help prevent attacks, so talk to your doctor about including a pain med in your treatment plan. But stay away from aspirin, which can raise uric acid levels.
Improve sleep quality: Some studies have shown a connection between sleep apnea and nighttime gout attacks, possibly because apnea brings periods of decreased oxygen intake (hypoxia), and less oxygen in your blood can lead to more uric acid. Make some lifestyle changes for better sleep, like increasing your exercise and losing weight.
It is nearly impossible to get back to sleep once a gout attack wakes you up, so you’ll want to treat your symptoms quickly and thoroughly with the right medication. NSAIDs (like ibuprofen) can be very effective at relieving pain quickly, colchicine can help reduce swelling, and corticosteroids will fight inflammation. Although all three types of medication can decrease the severity and duration of gout attacks, there is always the possibility of side effects, so don’t begin any medication without first consulting your doctor.