Association between obstructive sleep apnea and gout risk, and the urate-lowering effects of continuous positive airway pressure: A meta-analysis.
Level 2 - randomized trial
Systematic review and meta-analysis combining observational studies and mixed intervention designs (2 RCTs, 8 non-RCTs)
PubMed 42526100 · doi:10.1016/j.sleep.2026.109171
What was done
A systematic review and meta-analysis (registered as CRD42024520049) of PubMed, Embase, Cochrane Library, Web of Science, and Ovid Medline up to April 8, 2025. Seventeen studies were included: 7 examining the association between obstructive sleep apnea (OSA) and gout (4 cohort, 3 non-cohort studies), and 10 examining the effect of continuous positive airway pressure (CPAP) on serum uric acid (2 randomized controlled trials, 8 non-RCTs).
What was found
OSA was associated with an increased risk of gout (RR = 1.29, 95% CI: 1.11 to 1.48, p < 0.001). CPAP therapy significantly lowered serum uric acid in OSA patients (Hedges's g = -0.49, 95% CI: -0.79 to -0.18). Effects were larger with daily CPAP usage >= 4 hours, treatment duration >= 6 months, higher baseline uric acid levels, and younger patient age. Total participant count and absolute uric acid values were not reported in the abstract.
Why it matters
This paper quantifies the elevated gout risk in OSA patients and indicates that adequate adherence to CPAP therapy may provide an adjunctive urate-lowering effect.
Limits
The abstract does not state the total number of participants across the 17 studies. Most of the CPAP evidence derives from non-randomized studies (8 of 10), introducing potential confounding from diet, weight changes, or concurrent urate-lowering medications.
Cited by
- supports Obstructive sleep apnea is strongly associated with gout and obesity.