The pain in the ankle when you wake up from sleep may be caused by gout, acute synovitis, rheumatoid arthritis, etc. Gout is a joint disease caused by the deposition of sodium urate in the body. 1. gout: a joint disease caused by the deposition of monosodium urate in the body, the patient may manifest fever, fatigue, joint pain and other symptoms, there will be a sleep up ankle with the same pain as a wrench. 2. acute synovitis: when the synovial membrane is infected or irritated, it may lead to synovitis, synovitis is mainly manifested as knee joint swelling, pain, if the disease continues to progress, can lead to joint adhesion, there will be a sleep up ankle with the same pain as waking up. 3. Rheumatoid arthritis: refers to inflammatory lesions of the joints caused by inflammation, infection, trauma or other factors, the main manifestations of joint redness, swelling, pain, stiffness, joint dysfunction, there will be a sleep up the ankle with the same pain as waking up. There may be other reasons for the pain of ankle waking up from sleep, it is recommended to go to the hospital in time, improve the examination to clarify the cause of the disease, give targeted treatment or treatment, under the guidance of the doctor for treatment.