Özgür Zeliha KARAAHMET, Mufit AKYÜZ, Gülşah KARATAŞ, Öznur KÜTÜK, Elif YALÇIN

The effects of carpal tunnel syndrome on sleep quality

Aim: Carpal tunnel syndrome (CTS) is the most common mononeuropathy of the upper extremities. The aim of this study was toinvestigate the relationship between different compression levels and sleep quality in patients with clinically and electrophysiologicallydiagnosed CTS.Material and Methods: Patients with CTS diagnosed by electroneuromyographic evaluation and healthy controls were included inthe study. Demographic characteristics and disease symptoms were recorded carefully. The Boston Carpal Tunnel Questionnaire[symptom severity scale (SSS) and functional status scale (FSS)] was used to assess the severity of symptoms. Pittsburgh SleepQuality Index (PSQI) was used to evaluate sleep quality and disorders.Results: A total of 94 CTS patients (80 female, 14 male) and 33 healthy controls were included. The median ages were similar among thegroups (patient vs. control, mild-CTS vs. moderate-CTS, unilateral CTS vs. bilateral CTS; p = 0.11, p = 0.54, p = 0.22, respectively). Themean PSQI of patient group was higher than control group (7.81 ± 3.97 vs. 3.66 ± 2.08, p=0.000). While PSQI values were significantlydifferent (p= 0.03) between unilateral-CTS and bilateral-CTS patients, no significant difference was observed in Boston-SSS, BostonFSS, and total Boston values (p= 0.51, p= 0.29, p= 0.34 respectively). There was no significant difference between patients with mildCTS and those with moderate-CTS in terms of PSQI, Boston-FSS, Boston-SSS, and total Boston values (p= 0.61, p= 0.54, p= 0.62, andp= 0.53 respectively). There was a positive correlation between PSQI and Boston-SSS, Boston-FSS, and total Boston values (p

PDF

___

1. Hadler NM. Nerve entrapment syndromes. In: McCarty DJ, Kopman WJ (Editors). Arthritis and allied conditions. Lea and Febiger: Philadelphia, 1993;1619- 24.
2. Werner RA, Andary M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol 2002;113:1373-81.
3. Gao Y, Weng C, Wang X. Changes in nerve microcirculation following peripheral nerve compression. Neural Regen Res 2013;8:1041-7.
4. Umay E, Karaahmet ZÖ, Avluk Ö, et al. Karpal Tünel Sendromlu Hastalarda Kompresyonun Şiddeti ile Klinik Semptomlar, Fiziksel, Fonksiyonel ve Yaşam Kalitesi Bulgularının İlişkisi. Turk J Phys Med Rehab 2011;57:193-200.
5. AKYÜZ M, KARATAŞ G. Üst Ekstremite Tuzak Nöropatilerinde Elektrofizyolojik Değerlendirme. Turkiye Klinikleri Physical Medicine RehabilitationSpecial Topics 2019;12:46-57.
6. Wainner RS, Fritz JM, Irrgang JJ, et al. Development of a clinical prediction rule for the diagnosis of carpal tunnel syndrome. Arch Phys Med Rehabil 2005;86:609-18.
7. Katz JN, Larson MG, Sabra A, et al. The carpal tunnel syndrome: diagnostic utility of the history and physical examination findings. Ann Inter Med 1990;112:321-7.
8. Shapiro BE, Preston DC. Entrapment and compressive neuropathies. Med Clin North Am 2009;93:285-315.
9. Patel A, Culbertson MD, Patel A, et al. The negative effect of carpal tunnel syndrome on sleep quality. Sleep Disord 2014;2014:962746.
10. Cappuccio FP, D’Elia L, Strazzullo P, et al. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep 2010;33:585-92.
11. Stevens JC. AAEM minimonograph : The electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 1997;20:1477-86.
12. Phalen GS. Spontaneous compression of the median nerve at the wrist. J Am Med Assoc 1951;145:1128- 33.
13. Phalen GS. The Carpal-tunnel Syndrome: Clinical Evaluation of 598 Hands. Clin Orthop Relat Res 1972;83:29-40.
14. Stewart J, Eisen A. Tinel’s sign and the carpal tunnel syndrome. Br Med J 1978;2:1125-6.
15. Levine DW, Simmons BP, Koris MJ, et al. A selfadministered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993;75:1585- 92.
16. Sezgin M, İncel NA, Sevim S, et al. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and validity of the Turkish version of the Boston Questionnaire. Disabil Rehabil 2006;28:1281-6.
17. Buysse DJ, Reynolds III CF, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
18. Agargun M. Pittsburgh uyku kalitesi indeksinin gecerligi ve guvenirligi. Turk Psikiyatri Derg 1996;7:107-15.
19. Karatas G, Bal A, Yuceege M, et al. The evaluation of sleep quality and response to anti-tumor necrosis factor α therapy in rheumatoid arthritis patients. Clin Rheum 2017;36:45-50.
20. Karatas G, Bal A, Yuceege M, et al. Evaluation of sleep quality in patients with ankylosing spondylitis and efficacy of anti-TNF-α therapy on sleep problems: A polisomnographic study. Int J Rheum Dis 2018;21:1263-9.
21. Lehtinen I, Kirjavainen T, Hurme M, et al. Sleep related disorders in carpal tunnel syndrome. Acta Neurol Scand 1996;93:360-5.
22. Burcu T, Zilan B. The Effects of Sensory Therapy on Pain, Upper Extremity Functions and Sleep Quality in Patients with Carpal Tunnel Syndrome. Ann Yoga Phys Ther 2016;1:1007.
23. McCabe SJ, Gupta A, Tate DE, et al. Preferred sleep position on the side is associated with carpal tunnel syndrome. Hand 2011;6:132-7.
24. McCabe SJ, Xue Y. Evaluation of sleep position as a potential cause of carpal tunnel syndrome: preferred sleep position on the side is associated with age and gender. Hand 2010;5:361-3.
25. Rubin G, Orbach H, Rinott M, et al. Relationship between electrodiagnostic findings and sleep disturbance in carpal tunnel syndrome: A controlled objective and subjective study. J Int Med Res 2019:0300060519862673.
26. Aydın E, Turan Y, Ömürlü İK. Karpal tünel sendromlu hastalarda uyku kalitesinin değerlendirilmesi. Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi 2014;15:96-8.
27. Patel JN, McCabe SJ, Myers J. Characteristics of sleep disturbance in patients with carpal tunnel syndrome. Hand 2012;7:55-8.
28. Tanik N, Sarp U, Ucar M, et al. Pain, depression and sleep disorders in patients with diabetic and nondiabetic carpal tunnel syndrome: a vicious cycle. Arq Neuropsiquiatr 2016;74:207-11.
29. Yilmaz M, Karakurum G, Akilli Z, et al. Karpal tünel sendromlu hastalarda, uykudan uyandirma ile phalen testi ve tinel belirtisinin karşılaştırılması. Journal of Arthroplasty & Arthrosopic Surgery 2002;13:10-14.