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Gout attacks are twice as likely during the night as in the day, Arthritis & Rheumatism reports, which could influence the timing of medication, especially for drugs with short half-lives. Researchers enrolled 724 gout patients who experienced 1,433 attacks. The authors divided the day into eight-hour blocks. Attacks were 2.36 times commoner from 00:00-07:59 (51.2 per cent of attacks) than between 08:00 and 15:59 (21.6 per cent). Attacks were 1.26 times commoner between 16:00-23:59 than during the day. The nocturnal pattern persisted in various sub-groups stratified according to purine intake, sex, age, obesity and use of alcohol, diuretics, allopurinol, colchicine and NSAIDs. Lower body temperature, night-time dehydration or a nocturnal dip in cortisol levels may contribute to the peak in gout attacks. €Our findings provide the first prospective evidence that the risk of gout flares is higher during the night and early morning hours than during the day,€ says lead author Hyon Choi from Harvard Medical School.  €As a result of our study, prophylactic measures that prevent gout flares, especially at night, may be more effective.€ (DOI 10.1002/ art.38917)