Poor Sleep Behaviors Predict Risk for New

A healthy sleep pattern, including early chronotype, 7 to 9 hours of sleep per day, and lack of insomnia, is associated with a decreased risk for new-onset gout, according to study results published in Journal of Psychosomatic Research.

Gout is associated with many comorbidities, including hypertension, cardiovascular disease (CVD), and chronic kidney disease (CKD), with poor sleep behaviors increasing the risk for these conditions.

To study the association between sleep patterns and risk for new-onset gout, researchers from Southern Medical University in China collected data from the UK Biobank, a prospective population-based study of UK residents.

In the current study, individuals (N=403,630) were evaluated for new-onset gout on the basis of sleep behaviors and genetic risk score (GRS). Sleep behaviors were self-reported at study recruitment. Low-risk sleep behaviors were defined as obtaining 7 to 9 hours of sleep per day, early chronotype, and no snoring, insomnia, or frequent daytime sleepiness. Each of these sleep behaviors was awarded a point; a sleep score of 4 to 5 points was defined as healthy sleep, 2 to 3 points as intermediate sleep, and 0 to 1 points as poor sleep.

The study population had a mean age of 56.4 (SD, 8.1) years and 44.2% of participants were men. In general, individuals with healthy vs poor sleep were more likely to be nonsmokers, fewer had CVD, hypertension, diabetes, used diuretics, had lower body mass index (BMI), blood pressure, and Townsend deprivation index, and higher levels of education.

During a median follow-up of 12.0 years, 1.1% of individuals (n=4270) were diagnosed with new-onset gout.

Risk for new-onset gout was decreased among individuals with no insomnia symptoms (adjusted hazard ratio [aHR], 0.87; P <.001), a healthy duration of sleep (aHR, 0.93; P =.036), and no self-reported snoring (aHR, 0.93; P =.027).

Risk for gout was lower among those with a score of 5 (aHR, 0.79; P =.011) and 4 (aHR, 0.80; P =.001) compared with individuals with a sleep score of 0 to 1. Compared with poor sleep, those with healthy sleep were at lower risk for gout (aHR, 0.79; P =.001).

Stratified by GRS for gout, risk for new-onset gout was lower among individuals with low genetic risk and intermediate (hazard ratio [HR], 0.71) or healthy (HR, 0.68) sleep or with intermediate genetic risk and healthy sleep (HR, 0.78) vs individuals with poor sleep. There was no relationship with sleep among the cohort of individuals with high genetic risk for gout, indicating the relationship between gout risk and sleep was modified by genetics (P =.043).

In the subgroup analyses, age, sex, BMI, smoking status, alcohol consumption, diuretic use, estimated glomerular filtration rate, and uric acid levels did not significantly modify the relationship between sleep and gout risk (all P >.05).

"[O]ur results suggested that a healthy sleep pattern, including early chronotype, sleep 7-9 [hours]/day, never or rarely insomnia, no snoring, and no frequent excessive daytime sleepiness, was significantly associated with a lower risk of new-onset gout, especially in those with lower genetic risks of gout," the study authors noted.

"If further confirmed, our findings highlight the importance of primary prevention of gout by improving sleep patterns in participants with relatively low genetic risks of gout, as well as more comprehensive intervention strategies for participants with high genetic risks of gout," they concluded.

Wu Q, He P, Ye Z, et al. Sleep patterns, genetic susceptibility, and risk of new-onset gout: the UK Biobank prospective cohort study. J Psychosom Res. 2023;170:111381. doi:10.1016/j.jpsychores.2023.111381