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American Association for Hand Surgery

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Common Hand Pathologies and Sleep: Investigating the Correlation of Preoperatively Recorded Sleep Disturbance Scores with Ratings of Pain, Quality of Life, and Functional Status
John T Hurt, BS1, Alex Dawes, BS2, Beau M McGinley, BS2, Erica Smearman, MD PhD2, Roy Toston, BS3, Eric R. Wagner, MD1 and Michael Gottschalk, MD4, (1)Emory University, Atlanta, GA, (2)Emory University School of Medicine, Atlanta, GA, (3)Emory University School Medicine, Atlanta, GA, (4)Orthopedic Surgery, Emory School of Medicine, Atlanta, GA

Introduction: Carpal tunnel syndrome (CTS), de Quervain's tenosynovitis, carpometacarpal (CMC) arthritis, and trigger finger (TF) are common conditions of the hand and wrist and generally require surgical intervention for resolution of myriad symptoms, including sleep disturbance. While sleep disturbance as a major symptom of CTS has been previously studied, there is a paucity of literature describing the severity of this phenomenon in relation to other symptoms of common hand/wrist ailments, as measured by verified patient-reported outcome questionnaires. This study specifically aimed to compare preoperative sleep ratings between the conditions above and explore whether these values correlate with other patient-reported assessments of pain, quality of life, and function. We anticipated no significant variation in reported sleep disturbance between the diagnoses, and that overall severity of sleep disturbance correlates to commensurate reported pain and overall dysfunction.

Materials & Methods: Patients with CTS, de Quervain's tenosynovitis, CMC arthritis, and TF with planned surgical intervention were prospectively assessed over an 8-month period using validated questionnaires, including the PROMIS Sleep Disturbance Questionnaire; the Pain Visual Analog Scale (Pain VAS); the PROMIS Pain Interference Questionnaire; the Emory Quality of Life Questionnaire (EQ5D); and the Single Assessment Numeric Evaluation (SANE) rating of the affected extremity. Statistical analysis of the results was performed, with p values reported.

Results: A total of 88 patients (19.6% males, 80.4% females, average age 55.6) were included. There were 41 patients with CTS, 9 with de Quervain's tenosynovitis, 11 with CMC arthritis, and 27 with TF. Those with CTS, de Quervain's, CMC arthritis, and TF had average preoperative sleep disturbance scores of 53.9 +/- 8.5; 57.3 +/- 6.0; 52.34 +/- 8.2; and 56.7 +/- 7.1, respectively. There was no significance to differences between these scores (p=0.258). Across all conditions, reported sleep disturbance showed moderately positive correlation with pain interference t scores and correlated negatively with reported quality of life.

Conclusions: Patient-reported sleep disturbance was not found to be significantly different among common hand and wrist conditions (CTS, de Quervain's tenosynovitis, CMC arthritis, and TF). Sleep disturbance scores across all conditions increased with those reporting more pain interference and worse quality of life.

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