Erickson John, Polatsch Daniel, Beldner Steven, Melamed Eitan
* Department of Orthopedic Surgery, Division of Hand Surgery, Hand and Upper Extremity Fellow of NYU Langone Orthopedic Hospital (formerly the Hospital for Joint Diseases), New York, NY, USA.
† The New York Hand and Wrist Center at Lenox Hill, New York, NY, USA.
J Hand Surg Asian Pac Vol. 2019 Jun;24(2):144-146. doi: 10.1142/S2424835519500188.
Night time numbness is a key characteristic of CTS and relief of night time symptoms is one of the outcomes most important to patients. This study tested the null hypothesis that there is no difference between sleep quality and night symptoms before and after carpal tunnel release (CTR). Forty-four, English-speaking adult patients requesting open CTR for electrodiagnostically confirmed carpal tunnel syndrome completed questionnaires before and after surgery. Average age was 59, 24 patients were men and 20 were women. Patient with a primary or secondary sleep disorder were excluded. Before surgery, patients completed the Pittsburg Sleep Quality index (PSQI). At an average of 3 months after surgery, participants completed PSQI questionnaires. Onset of sleep quality improvement was specifically addressed. Differences between preoperative and postoperative sleep quality were evaluated using the paired t-test. Spearman correlations were used to assess the relationship between continuous variables. Of the 44 patients, 32 (72%) were classified as poor sleepers (PSQI > 5.5) prior to surgery. At 3 months follow up, there was a significant improvement PSQI global scores (7.8 ± 5.1 vs 4 ± 3.5, < 0.001) as well as subdivisions. Daytime dysfunction (0.2 ± 0.4, < 0.001) and medication use (1.0 ± 1.2 vs 0.9 ± 1.2, < 0.045) secondary to sleep disturbance and was improved as well. In all patients, onset of improvement was within 24 hours of surgery. CTR is associated with improvement in sleep quality at 3 months follow-up. CTR improves daytime dysfunction related to the sleep disturbance. The onset of sleep improvement is 24 hours after surgery in most cases.
夜间麻木是腕管综合征的一个关键特征，而缓解夜间症状是对患者来说最重要的结果之一。本研究检验了零假设，即腕管松解术（CTR）前后睡眠质量和夜间症状之间没有差异。44名因电诊断确诊为腕管综合征而要求进行开放性CTR的成年英语患者在手术前后完成了问卷调查。平均年龄为59岁，24名患者为男性，20名患者为女性。患有原发性或继发性睡眠障碍的患者被排除在外。手术前，患者完成了匹兹堡睡眠质量指数（PSQI）。平均术后3个月，参与者完成了PSQI问卷。特别探讨了睡眠质量改善的开始时间。使用配对t检验评估术前和术后睡眠质量之间的差异。使用Spearman相关性来评估连续变量之间的关系。在44名患者中，32名（72%）在手术前被归类为睡眠质量差（PSQI>5.5）。在3个月的随访中，PSQI全球评分（7.8±5.1对4±3.5，<0.001）以及各亚组均有显著改善。睡眠障碍继发的日间功能障碍（0.2±0.4，<0.001）和药物使用（1.0±1.2对0.9±1.2，<0.045）也得到了改善。在所有患者中，改善均在手术后24小时内开始。CTR与3个月随访时睡眠质量的改善相关。CTR改善了与睡眠障碍相关的日间功能障碍。在大多数情况下，睡眠改善在手术后24小时开始。
