The reduced oxygen intake from sleep apnea has two effects which cause a gout attack to develop while sleeping. The first effect is that the reduced oxygen level in the blood causes the cells of the body to start disintegrating, which causes them to overproduce uric acid fed into the blood. Once the uric acid is formed, the process is irreversible, so that periods of restored breathing do not cause the uric acid to revert to a prior chemical form in the cells
Thus, each epneic period feeds more uric acid into the blood, faster than the kidneys can remove it. The second effect is that the reduced oxygen level in the blood causes the blood to be more acidic, thereby reducing the solubility of uric acid. As a result the overconcentration of uric acid precipitates out of the blood in the form of crystals of monosodium urate. When these crystals lodge in a joint, they initiate the immune system response of intense pain and inflammation known as gout. Snoring is often a symptom of sleep apnea, but a tell-tale sign is when the person stops snoring for many seconds because he isn’t breathing and then restarts with a loud snort.