Why is Gout Worse at Night? Causes and Relief

Discover why gout flare-ups intensify during the night and effective strategies to alleviate nocturnal gout pain and discomfort.

Gout affects millions in the U.S. It causes sudden, intense pain and swelling in joints. This makes everyday tasks hard to do. Gout attacks happen mostly at night. The pain can be so bad that it keeps people awake.1 It often starts in the big toe but can happen in other places too.1

Gout can hit out of nowhere, especially at night. It wakes you up and can stop you from sleeping again.21 This can break your sleep and make you tired during the day. Knowing why gout gets worse at night is key. It helps you look for ways to handle the pain. Plus, it helps you get the sleep you need.

Key Takeaways

  • Gout attacks are 2.4 times more likely to occur during the night and early morning than during the day.
  • Individuals with sleep apnea are 1.86 times more likely to develop gout compared to those without the sleep disorder.
  • Corticosteroid levels, which help reduce inflammation, are lowest at night, contributing to increased gout pain.
  • Resting the affected joint and taking anti-inflammatory medications before bed can help relieve nighttime gout pain.
  • Proactively managing gout through diet, lifestyle changes, and medications can help prevent disruptive nighttime flare-ups.

Understanding Gout

What is Gout?

Gout is a type of inflammation. It happens when there’s too much uric acid. This acid turns into small crystals in joints, usually in the big toe. That’s why many gout troubles are in the big toe.1 The body usually gets rid of uric acid through the kidneys. But sometimes, there’s more than it can handle. Then, these sharp crystals cause a lot of pain and make the area swollen.

Causes of Gout

Having too much uric acid causes gout. A big part of having too much is being overweight.3 Also, eating foods high in purines, like red meat, shellfish, and sugary drinks, can add to uric acid. This can bring on gout episodes.3 Drinking alcohol increases how often gout can happen to a person.

Risk Factors for Gout

3 Gout happens more in men between 30 and 50 years old. Women are at less risk until after menopause. Other chance-givers for gout are age, diet, being overweight, and some illnesses. Like, having high blood pressure, heart disease, and kidney problems makes gout more likely.1 Men are also more likely to have high uric acid. Taking diuretics can raise the chance of high uric acid, leading to gout.1

Why is Gout Worse at Night?

There are several reasons why gout is worse at night and in the morning. First, when you sleep, your body gets a little colder. This makes uric acid crystals more likely to form in your joints.2

Second, your breathing slows down at night. This means your body doesn’t get rid of as much carbon dioxide. So, your blood can get more acidic, which makes uric acid.2

Third, if you have sleep apnea, you might be more likely to get gout. People with sleep apnea have a harder time breathing at night. They are 1.86 times more at risk for gout than those who don’t have sleep apnea.23

Body Temperature Drop

When your body gets cooler at night, it can start forming uric acid crystals. This leads to more pain from gout in the night.2

Changes in Breathing Pattern

At night, since you breathe slower, your body keeps more carbon dioxide. This makes your blood more acidic, which can then make more uric acid. So, gout can get even worse at night.2

Sleep Apnea and Gout Risk

If you have sleep apnea, you’re at a higher risk for gout. Sleep apnea is when you stop and start breathing during sleep. People with this condition are 1.86 times more likely to get gout.23

Circadian Rhythms and Gout Pain

Your body has a natural cycle for fighting pain, with more help in the morning. But, this often means gout pain hits harder at night. Gout attacks have more power when your joints are not protected well.4 Also, your body makes more uric acid at night. This extra acid makes gout attacks more likely while you sleep.4

Corticosteroid Circadian Cycle

The way your body works on fighting gout changes during the day. It’s most active in this fight early in the day but slows down later on.4 So, gout pain gets worse at night because your body can’t fight it as well then.4

Uric Acid Levels and Sleep

Your body also makes more uric acid at night. This can lead to sudden gout pain while you’re asleep. Gout attacks happen when these extra crystals cause pain and swelling.4 Knowing about these night-time changes in your body is important. It can help you manage gout better and prevent painful nights.4

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gout and circadian rhythms

Nocturnal Gout Symptoms

The main signs of gout are severe joint pain, swelling, redness, and tenderness. They often hit at night.3 These symptoms may stop you from sleeping well. You can wake up tired and not ready for the day.3 Dealing with unexpected joint pain at night is tough for gout sufferers.

Joint Pain and Swelling

Gout causes quick, intense pain in joints, mainly the big toe. It can also hurt knees, ankles, and elbows. This pain comes with swelling, redness, and tenderness.3 It’s so bad you might find wearing shoes or socks hard.

Disrupted Sleep and Fatigue

Gout pain that starts at night messes up your sleep. This leaves you very tired the next day.3 People with gout often have trouble sleeping. Most feel sleepy three to four times a month or more.3 Not getting enough sleep really affects your health.

Managing Gout Pain at Night

Gout is a very painful type of arthritis. It can make sleeping at night hard. This leaves people tired the next day. But, there are ways to help deal with gout pain at night.

Cold Compresses and Ice Packs

Putting a cold compress or ice pack on the sore joint can cut down on swelling. It also helps ease the sharp pain gout causes.3 A study shows that cold works better than heat for gout pain relief.

Anti-Inflammatory Medications

Taking certain medicines helps a lot. These include NSAIDs and steroids. They quickly lessen gout pain and swelling.2 Yet, steroids might make it hard to sleep well.

Rest and Elevation

Resting the sore joint and keeping it up is good.2 Doing this along with the right meds before bed can calm gout pain.2 Gout pain and swelling can stay for days to weeks, making sleep tough.

Trying different treatments can help those with gout find relief at night. It allows them to get the sleep they need.2 Seeing a doctor who knows a lot about gout can also really help.

Gout and Sleep Disturbances

Gout flares cause pain that can mess up your sleep. You might feel tired and not work well the next day.3 A study online showed that folks diagnosed with gout often find it hard to sleep well. About two-thirds feel tired three to four times every month.3 If you want to sleep better with gout, try to prevent flares. You can use medicines, cold packs, and remember to rest. Don’t forget to keep a sleep routine. Stop taking caffeine and looking at screens before bed.

Sleep Quality and Gout Flares

Gout attacks can make sleeping hard. When your joints hurt a lot, it’s tough to get a good night’s rest.3 A research in Arthritis Rheumatology discovered that gout attacks happen more at night than in the day.3 People with sleep apnea, a sleep problem, are also more likely to get gout. Studies show they have almost double the chance. This shows a problem between gout and not sleeping well. One makes the other worse.

Strategies for Better Sleep

Improving sleep while dealing with gout means doing a few important things.3 Try to always go to bed and wake up at the same time. This helps your body’s sleep clock. About seven to eight hours of sleep every night is good.3 Exercise can also help. It keeps uric acid levels low and helps you stay a healthy weight. This lowers your chance of having a gout attack.3 The Arthritis Foundation says you should drink at least eight drinks a day. Water is the best choice. But if you get gout often, try to drink 16 drinks a day. This complete plan can improve your sleep and health by preventing nighttime gout attacks.

Dietary Considerations

It’s key to eat right to help with gout and cut down on nighttime pain. Picking foods low in purines is important. Drinking lots of water and not drinking too much alcohol also help. These steps can keep your uric acid levels in check and ease the painful signs, letting you sleep better.

Low-Purine Foods

Choosing foods that are low in purines is a smart move. Vegetables, whole grains, citrus fruits, and more are good choices. Adding these foods to your meals can really help. They lower your uric acid levels, making gout attacks less likely.

Hydration and Uric Acid Levels

Drinking plenty of water is very important for gout.5 Not having enough water in your system can make uric acid build up. This leads to more and worse gout flares, even at night. Staying hydrated all day helps your body get rid of extra uric acid. This cuts the chance of nighttime gout attacks.

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Alcohol Consumption and Gout Risk

Cutting back on beer and hard liquor is crucial for those with gout.5 These drinks can make uric acid levels go up. This boosts your risk of gout flares, especially at night. Less alcohol in your diet means better sleep and a happier life.

Lifestyle Changes for Gout Management

Changing what you eat is key, but so is living healthy. Doing easy exercises like walking keeps you fit. This helps lower the acid in your body and builds muscle.6 You can see this in the info given.

Creating a Sleep-Friendly Environment

To sleep well, avoid coffee at night. Also, turn off screens before sleep and stick to a sleep routine. This makes night gout pain less and sleep better.6 Dr. Toprover recommends aiming for 7 to 8 hours of sleep every night. Keeping good sleep habits makes sleep better.

7 Drink lots of water, skip alcohol, eat well, move your body, and rest enough. All these help stop gout at night.

Lifestyle FactorImpact on Gout
Exercise6 Exercise helps control gout by lowering uric acid levels, as outlined in the provided material.
Sleep Quality6 Dr. Toprover advises getting 7 to 8 hours of sleep each night. Good sleep habits make sleep better.
Hydration7 Drinking water often, avoiding alcohol, eating right, exercising, and getting enough sleep help stop gout at night.
Alcohol Consumption7 Drinking water often, avoiding alcohol, eating right, exercising, and getting enough sleep help stop gout at night.

Adding these changes to your life every day helps you control gout. It also makes nighttime gout less hard on you and your sleep.

Treatment Options for Gout

Medicine is a big part of handling gout. It helps lower uric acid levels. This stops future attacks.8 These drugs work to keep uric acid under control to avoid more issues.8

To deal with the intense pain of gout, there are quick-acting drugs. Anti-inflammatory medicines and corticosteroids are used. These can stop the pain fast.8 Treatments also include options like NSAIDs, colchicine, and corticosteroids. These help reduce pain and swelling.9 It’s vital to work with your doctor to pick the best plan.

If gout is severe, there are more options. Pegloticase is given through IV every two weeks. It fights gout differently as a biologic drug.8 Anakinra and canakinumab are also biologic drugs. They work as IL-1 inhibitors to treat gout.8 Sometimes, surgery like joint fusion or replacement is needed. This is for bad cases of gout.9

Diet changes can help manage gout for some.8 Exercises that are not too hard can lower uric acid.8 If you are overweight, losing weight can help a lot. It lowers uric acid and the risk of gout.8 You can also ease the pain by using ice or special tools.8 Raising the foot that hurts can also give relief.

Preventing Nighttime Gout Flares

To stop nighttime gout flares, you should watch your diet and lifestyle. Also, use any medicines your doctor gives you.3 Eat fewer foods with purines, drink lots of water, and cut back on alcohol. Exercising regularly is good for you. It can lower your uric acid. This lessens your troubles from sudden gout attacks, especially at night.3 With a well-rounded plan, you can sleep better and enjoy your days more.

10 In the US, a study from 2011 showed 3.9% have gout and 21% have high uric acid.10 A 2012 study linked gout and sleep apnea.10 A 2013 study found gout and sleep problems often go together.3 The risk of gout goes up for people with sleep apnea. This was shown in a study in Arthritis Research & Therapy.3 Gout mostly affects men 30 to 50 years old. Yet, women can get it more often after menopause.

3 Research says eating red meat, seafood, too much fructose, and drinking a lot can make gout chances go up.3 A study with over 700 people found drinking and gout are linked.3 How you live, like what you eat and drink, can change how often gout flares up.3 Tips include eating foods low in purines, drinking enough water, moving your body, and sleeping well. These can help you manage gout and live a better life.

10 In 1987, it was found that your body makes more uric acid at night if you don’t breathe well while sleeping.10 People with sleep problems often have too much uric acid in their blood. This was shown in studies from 2006.10 Women with sleep apnea often have high uric acid. This was discovered in 2006.10 In 2005, it was found that men with sleep apnea also tend to have too much uric acid.10 A study from 2010 found that many people with sleep breathing problems also have too much cholesterol.

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3 An internet survey showed that if you have gout, you might also have trouble sleeping.3 About 66% of people in the survey said they felt very sleepy several times a month from gout.

When to Seek Medical Attention

Feeling a lot of pain from gout flares that keep you up at night? If so, it’s time to see a doctor.11 They can find out what’s causing your gout and make a plan to treat it. They’ll also show you how to handle bad times and stop new attacks.1 So, don’t be shy about saying how gout bothers your sleep and life. There’s a lot that can be done to help get it under control.

Gout and Comorbidities

Gout often links with other health issues, called comorbidities. It’s key to manage gout well. This helps improve life, including how well you sleep and function during the day.

Gout and Kidney Disease

If you have chronic kidney disease, you’re more likely to get gout10. That’s because your kidneys filter uric acid. If they don’t work well, uric acid levels can build up. This increases your chances of having gout pain or attacks.

Gout and Cardiovascular Health

Gout and heart health are closely tied10. High uric acid can lead to high blood pressure, heart disease, and stroke. Folks with gout see more heart problems than those without gout12.

It’s essential to manage gout’s related conditions. Working with doctors to treat these issues can make sleep, daily activities, and life better for gout patients.


Gout is really painful and hard to deal with. It often comes at night and keeps people from sleeping. This leads to tired days.10 Knowing what causes it helps in finding ways to manage gout and sleep better.10,13

Changing what you eat, how you live, and using the right medicines can stop gout’s bad effects at night.13 Talking with your doctor is important. Together, you can beat gout and enjoy sleep again.


Why are gout flares often worse at night?

Gout flares are worse at night for many reasons. Body temperature drops and our breathing changes. Circadian rhythms, which control our body’s clock, also play a part.

What causes the increase in gout pain at night?

Nighttime drops in body temperature can make uric acid crystals form in joints. This leads to more pain and swelling. When we breathe slower, our body can’t get rid of carbon dioxide as well. This raises acidity, making more uric acid.

How do circadian rhythms influence gout pain at night?

Our body’s natural clock affects gout pain at night. Corticosteroids that fight inflammation are high in the morning. But they’re lower at night. So, our joints are more at risk of pain and swelling.

What are the common symptoms of gout flares at night?

Gout flare symptoms usually appear at night. They include severe joint pain, redness, swelling, and tenderness. These can make you lose sleep and feel tired the next day.

How can gout pain at night be managed?

Treat nighttime gout with cold packs and anti-inflammatory drugs. Resting the joint is important too. For long-term management, change your diet, lifestyle, and take your prescribed medicines.

How does gout impact sleep quality?

Nighttime gout flares can make you lose sleep. This leads to tiredness and poor function the next day. Improve gout and sleep habits to lessen their impact.

What dietary changes can help prevent nighttime gout flares?

To prevent gout attacks at night, eat foods low in purines, drink plenty of water, and cut back on alcohol. These steps can reduce uric acid levels.

When should someone with gout seek medical attention?

If gout keeps waking you up at night, see a doctor. They can help find the cause of your gout. Your doctor will make a plan to treat it and stop future flare-ups.

Source Links

  1. https://louisvillebones.com/why-does-my-gout-flare-up-at-night/
  2. https://privatelondonrheumatologist.com/how-to-stop-gout-pain-at-night/
  3. https://creakyjoints.org/about-arthritis/gout/gout-symptoms/gout-and-sleep/
  4. https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/circadian-rhythms-and-arthritis
  5. https://www.medicalnewstoday.com/articles/315732
  6. https://creakyjoints.org/about-arthritis/gout/gout-and-sleep/
  7. https://snsrheumatology.com/how-to-stop-gout-pain-at-night/
  8. https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/treatments-for-gout
  9. https://www.medicalnewstoday.com/articles/324972
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360969/
  11. https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821424/
  13. https://www.ncbi.nlm.nih.gov/books/NBK284934/