Association between obstructive sleep apnea and gout risk, and the urate-lowering effects of continuous positive airway pressure: A meta-analysis
In brief
Obstructive sleep apnea raises gout risk by about 30%
A meta-analysis of 17 studies found people with obstructive sleep apnea are 29% more likely to develop gout than those without the disorder. Using continuous positive airway pressure reduced serum uric acid by a moderate amount, especially when worn at least four hours daily for six months or more. The findings suggest CPAP may help manage uric acid in OSA patients, but optimal dosing and long-term impact remain unclear.
- Journal
- Sleep medicine (Q1)
- Published
- 27 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Siqi Guan, Yuan Shi, Longhua Sun, Zhaohua Chen, Fei Lei, Rong Ren, et al.
- PMID
- 42526100
- DOI
- 10.1016/j.sleep.2026.109171
Why clinicians should know about it
- Picked for Rheumatology (top studies of the week, 2 August 2026): OSA associated with gout risk; CPAP lowers uric acid levels
- Picked for Epidemiology (paper of the day, 30 July 2026): Meta‑analysis of obstructive sleep apnea and gout risk
Abstract
OBJECTIVES: The objective of this meta-analysis was to examine if obstructive sleep apnea (OSA) is associated with gout risk and the effect of continuous positive airway pressure (CPAP) therapy on serum uric acid in patients with OSA. METHODS: We conducted a systematic search of PubMed, Embase, Cochrane Library, Web of Science and Ovid Medline for articles published up to April 8, 2025. A total of 17 studies (4 cohort studies and 3 non-cohort studies on the association between OSA and gout, 2 randomized controlled trials and 8 non-RCT on urate-lowering effects of CPAP) met the inclusion criteria for this meta-analysis. Our registration number is CRD42024520049. RESULTS: The meta-analysis revealed that (1) OSA patients have higher gout risk (RR = 1.29, 95% CI: 1.11-1.48, p < 0.001); (2) CPAP lowers serum uric acid levels in OSA patients with an effect size approaching moderate magnitude (Hedges's g = -0.49, 95%CI: -0.79 to -0.18). The effects are further enhanced by daily CPAP usage of 4 h or more or a treatment duration of 6 months or longer; (3) Baseline uric acid levels, age, and CPAP adherence are key modulating factors influencing treatment efficacy. Patients with higher baseline uric acid levels and younger age are likely to experience a better response to treatment. CONCLUSIONS: Patients with OSA are prone to developing gout compared to patients without OSA, and sufficient CPAP therapy may serve as an adjunctive treatment to lower serum uric acid levels in patients with OSA.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.