Michael's testimonial
MM Danielson, K Dubé - Annals of Internal Medicine, 2019 - acpjournals.org
MM Danielson, K Dubé
Annals of Internal Medicine, 2019•acpjournals.orgTO THE EDITOR: I listened with interest to Centor and McLean's podcast (1) about the
differences between the American College of Physicians' and American College of
Rheumatology's recommendations for the treatment of gout. Both organizations miss a major
underlying cause of gout that would greatly affect its treatment. One aspect of gout that is too
often overlooked in guidelines and practice is that most flares begin during sleep. The
connection between sleep and gout has been known at least since Dr. Thomas Sydenham …
differences between the American College of Physicians' and American College of
Rheumatology's recommendations for the treatment of gout. Both organizations miss a major
underlying cause of gout that would greatly affect its treatment. One aspect of gout that is too
often overlooked in guidelines and practice is that most flares begin during sleep. The
connection between sleep and gout has been known at least since Dr. Thomas Sydenham …
TO THE EDITOR: I listened with interest to Centor and McLean's podcast (1) about the differences between the American College of Physicians' and American College of Rheumatology's recommendations for the treatment of gout. Both organizations miss a major underlying cause of gout that would greatly affect its treatment. One aspect of gout that is too often overlooked in guidelines and practice is that most flares begin during sleep. The connection between sleep and gout has been known at least since Dr. Thomas Sydenham wrote about it in 1683. Choi and colleagues' 2015 study (2) confirms Dr. Sydenham's observation. This connection is an important clue about the pathogenesis of symptomatic and asymptomatic gout. Many gout flares are a direct result of sleep apnea; in these cases, resolving the sleep apnea can resolve the gout.
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