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The Effects of Carpal Tunnel Syndrome and its Release on Sleep
Chad M. Turner, MD; Thomas J. Fischer, MD
The Indiana Hand to Shoulder Center, Indianapolis, IN

Introduction: Carpal Tunnel Syndrome (CTS) is the most common compressive neuropathy of the upper extremity. Many patients with CTS complain of nocturnal symptoms, primarily waking with numbness and pain, which affects their sleep quality. Surgeons have recognized that patients' sleep complaints resolve after carpal tunnel release. The rate of nocturnal symptom resolution along with subjective and objective sleep quality outcomes have not been scrutinously evaluated.

Materials & Methods: A prospective study was conducted including 100 patients undergoing carpal tunnel release. The Pittsburg Sleep Quality Index (PSQI) and a carpal tunnel survey were administered preoperatively, 2 weeks postoperatively, and 6 months postoperatively to evaluate time to resolution of nocturnal symptoms and improvement of sleep quality.

Results: Nocturnal symptoms were present in 87% of patients and 50% of patients sought care because of these symptoms. Preoperative PSQI scores averaged 8, (>5 indicates poor sleep quality) with 80% of patients with a PSQI >5. The two week average PSQI had improved to a mean of 5, with 53% of patients with a PSQI score >5. Subjectively 60% of patients reported immediate resolution of their nocturnal symptoms and at two weeks postoperatively 93% reported complete resolution. At 6 months, only 1 patient complained of persistent numbness, however he reported improved sleep quality postoperatively.

Conclusions: Sleep quality is negatively affected by CTS. Most patients can expect resolution of their nocturnal symptoms in the immediate postoperative period, with 60% obtaining immediate resolution, and 93% obtaining resolution by two weeks postoperatively.

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