Improvement of Sleep Quality after Carpal Tunnel Release

Authors

DOI:

https://doi.org/10.15417/issn.1852-7434.2021.86.5.1310

Keywords:

Carpal tunnel syndrome, carpal tunnel release, insomnia, sleep disturbance

Abstract

Introduction: Sleep disturbances caused by night pain and paresthesia are usual symptoms in carpal tunnel syndrome (CTS), and are often the cause of medical consultation. Objective changes following the Carpal Tunnel Release (CTR) have been thoroughly analyzed. However, evidence related to improvement in sleep quality is lacking. We consider that the immediate improvement in sleep quality is directly related to CTR. The main purpose of this study is to assess these changes following this procedure. The secondary objective is to evaluate if the severity of the median nerve compression or patient-related factors could have an impact on sleep quality.

Materials and Methods: Prospective case study of 67 patients diagnosed with CTS who underwent CTR procedure. We grouped all cases based on age, sex, and nerve conduction study (NCS) results. Sleep quality was evaluated with the Athens Insomnia Score before surgery and in the fourth follow-up day, asking specifically about symptoms from the first night after the procedure.

Results: Sleep disorders were found in 74.62% of cases before surgery. After CTR, sleep quality improved in all cases (p<0.05). We found no relation between sleep quality improvement and sex, age, or NCS severity.

Conclusions: CTR is commonly indicated to stop nerve damage, and to improve sensitive and motor symptoms. However, sleep disturbances are not the main indication for it, even if it is a frequent reason for medical consultation. Sleep quality improves from the first night after CTR, and this outcome is independent of age, sex, or severity of CTS.

Downloads

Download data is not yet available.

Author Biographies

  • Gonzalo Viollaz, Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Nicolás N. Altamirano, Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Diego Gómez, Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Álvaro Muratore, Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Alejandro Tedeschi, Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Gustavo Teruya, Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Británico de Buenos Aires, Autonomous City of Buenos Aires, Argentina

References

Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report, 2011. Disponible en: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6049a4.htm

Tinel J. Le signe du “fourmillement” dans les lésions des nerfs périphériques. Presse Médi 1915;47:388-9.

Durkan JA. A new diagnostic test for carpal tunnel syndrome. J Bone Joint Surg Am 1991;73:535-8. PMID: 1796937 DOI: https://doi.org/10.2106/00004623-199173040-00009

Phalen GS. The carpal-tunnel syndrome. Seventeen years’ experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg Am 1966;48(2):211-28. PMID: 5934271 DOI: https://doi.org/10.2106/00004623-196648020-00001

Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. Scratch collapse test for evaluation of carpal and

cubital tunnel syndrome. J Hand Surg 2008;33(9):1518-24. https://doi.org/10.1016/j.jhsa.2008.05.022 DOI: https://doi.org/10.1016/j.jhsa.2008.05.022

Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Akeson WH. The carpal tunnel syndrome. A study of carpal canal pressures. J Bone Joint Surg Am 1981;63:380-3. PMID: 7204435 DOI: https://doi.org/10.2106/00004623-198163030-00009

. McCabe S, Uebele A, Pihur V, Rosales R, Atroshi I. Epidemiologic associations of carpal tunnel syndrome and

sleep position: is there a case for causation? Hand (N Y) 2007;2(3):127-34. https://doi.org/10.1007/s11552-007-9035-5 DOI: https://doi.org/10.1007/s11552-007-9035-5

Wilbourn A. The electrodiagnostic examination with peripheral nerve injuries. Clin Plast Surg 2003;30:139-54.

https://doi.org/10.1016/s0094-1298(02)00099-8 DOI: https://doi.org/10.1016/S0094-1298(02)00099-8

Louie DL, Earp BE, Collins JE, Losina E, Katz JN, Black EM, et al. Outcomes of open carpal tunnel release at a

minimum of ten years. J Bone Joint Surg Am 2013;95:1067-73. https://doi.org/10.2106/JBJS.L.00903 DOI: https://doi.org/10.2106/JBJS.L.00903

Graham B, Regehr G. Development and validation of diagnostic criteria for carpal tunnel syndrome. J Hand Surg Am 2006;31(6):919-24. PMID: 16886290 DOI: https://doi.org/10.1016/j.jhsa.2006.03.005

Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve 2011;44(4):597-607. https://doi.org/10.1002/mus.22208 DOI: https://doi.org/10.1002/mus.22208

Soldatos C. The assessment of insomnia: rationale for a new scale based on ICD-10 principles. En: Szelenberger W, Kukwa A (eds). Sleep: physiology and pathology. Warsaw: Elma Books; 1995.

Soldatos C, Dikeos DG, Paparrigopoulos TJ. Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. J Psychosom Res 2000;48:555-60. https://doi.org/10.1016/s0022-3999(00)00095-7 DOI: https://doi.org/10.1016/S0022-3999(00)00095-7

Portocarrero AN, Jimenez Genchi A. Estudio de Validación al español de la Escala Atenas de Insomnio.

Salud Mental 2005;28(5):35-9. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid

=S0185-33252005000500034

Learmonth J. The principle of decompression in the treatment of certain diseases of peripheral nerves. Surg Clin North Am 1933;13:905-13.

Kadzielski J , Malhotra LR, Zurakowski D, Lee SGP, Jupiter JB, Ring D. Evaluation of preoperative expectations

and patient satisfaction after carpal tunnel release. J Hand Surg Am 2008,33(10):1783-8. https://doi.org/10.1016/j. DOI: https://doi.org/10.1016/j.jhsa.2008.06.019

jhsa.2008.06.019 DOI: https://doi.org/10.1088/1475-7516/2008/06/019

Leit M, Weiser R, Tomaino M. Patient-reported outcome after carpal tunnel release for advanced disease: a

prospective and longitudinal assessment in patients older than age 70. J Hand Surg Am 2004;24(3):379-83. https://doi.org/10.1016/j.jhsa.2004.02.003 DOI: https://doi.org/10.1016/j.jhsa.2004.02.003

Jerosch-Herold C, Chojnowski A. A qualitative study of the experiences and expectations of surgery in patients with carpal tunnel syndrome. J Hand Ther 2008;21:54-61. https://doi.org/10.1197/j.jht.2007.09.001 DOI: https://doi.org/10.1197/j.jht.2007.09.001

American Academy of Sleep Medicine (AASM). The International Classification of Sleep Disorders. 2nd ed.

Westchester, IL: American Academy of Sleep Medicine; 2005.

Gaspar M, Kane P. Evaluation and management of sleep disorders in the hand surgery patient. J Hand Surg Am 2016;41(10):1019-26. https://doi.org/10.1016/j.jhsa.2016.08.006 DOI: https://doi.org/10.1016/j.jhsa.2016.08.006

Patel J, McCabe S. Characteristics of sleep disturbance in patients with carpal tunnel syndrome. Hand (N Y)

;7(1):55-8. https://doi.org/10.1007/s11552-011-9373-1 DOI: https://doi.org/10.1007/s11552-011-9373-1

Tulipan J, Nayoung K, Abboudi J, Jones C, Liss F, Kirkpatrick W, et al. Prospective evaluation of sleep

improvement following carpal tunnel release surgery. J Hand Surg Am 2017;42(5):390.e1-390.e6. https://doi. DOI: https://doi.org/10.1016/j.jhsa.2017.02.009

org/10.1016/j.jhsa.2017.02.009

Rubin G, Orbach H, Rinott M, Rozen N. The effectiveness of splinting and surgery on sleep disturbance in carpal tunnel syndrome. J Hand Surg (Eur vol) 2018;43(3):286-28. https://doi.org/10.1177/1753193417729110 DOI: https://doi.org/10.1177/1753193417729110

Erickson J, Polatsch D, Beldner S, Melamed E. An assessment of sleep disturbance in patients before and after

carpal tunnel release. J Hand Surg Asian Pac Vol 2019;24(2):144-6. https://doi.org/10.1142/S2424835519500188 DOI: https://doi.org/10.1142/S2424835519500188

Niedermeier S, Pettit RJ, Frantz TL, Colvell K, Awan H. Early postoperative improvement in sleep and pain after

carpal tunnel release. Hand 2020;15(3):311-4. https://doi.org/10.1177/1558944718793984 DOI: https://doi.org/10.1177/1558944718793984

Published

2021-10-10

Issue

Section

Clinical Research

Categories

How to Cite

Improvement of Sleep Quality after Carpal Tunnel Release. (2021). Revista de la Asociación Argentina de Ortopedia Y Traumatología, 86(5), 613-620. https://doi.org/10.15417/issn.1852-7434.2021.86.5.1310

Most read articles by the same author(s)

1 2 > >>