The Relationship Between Ultrasonographic Findings and Sleep Quality in Carpal Tunnel Syndrome

Study Overview
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Brief Summary
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The aim of our study is to determine the relationship between disease severity and sleep quality in CTS patients and to compare the findings with healthy controls.

Detailed Description
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Carpal tunnel syndrome is the most common form of entrapment neuropathies. Anatomically, the roof of the carpal tunnel consists of carpal bones, it is located under the transverse carpal ligament, and there are 9 tendon packs of the forearm flexors and the median nerve. Clinically, sensory (paresthesia and hypoesthesia), motor deficits and pain occur in the distribution of the median nerve secondary to mechanical compression and local ischemia. With the increase in the severity of the disease, entrapment neuropathy, whose symptoms are more pronounced at night, negatively affects the daily life of the person. Waking up at night due to paresthesia is one of the diagnostic criteria for carpal tunnel syndrome. However, the mechanism linking CTS with insomnia is unclear. The aim of our study is to determine the relationship between disease severity and sleep quality in CTS patients.

Official Title
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The Relationship Between Ultrasonographic Findings and Sleep Quality in Patients With Carpal Tunnel Syndrome

Conditions
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Ultrasound, Musculoskeletal Diseases, Median Nerve Disease, Carpal Tunnel Syndrome, Sleep Quality

Intervention / Treatment
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* Other: Assessment of Sleep Quality
* Other: Assessment of Sleep Quality


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients diagnosed with CTS according to the criteria of the American Academy of Neurology Exclusion Criteria: Patients with radiculopathy, brachial plexopathy, thoracic outlet syndrome and traumatic nerve injury that may affect the median nerve History of Carpal tunnel surgery Pregnancy Malignancy Thyroid diseases Amyloidosis Systemic lupus erythematosus, Rheumatoid arthritis, Systemic sclerosis, Gout, Dermatomyositis, Polymyositis Obstructive sleep apnea

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patient Group<br>CTS Patients | Other: Assessment of Sleep Quality<br>* Assessment of Sleep Quality<br>|
| Control Group<br>Healthy Individuals | Other: Assessment of Sleep Quality<br>* Assessment of Sleep Quality<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analog Scale (VAS) | Pain intensity was measured with visual analogue scale for pain (0-10 mm; 0 means no pain, 10 means severe pain) which is used to measure musculoskeletal pain with very good reliability and validity. | 2023.02-2023.05 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) | The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) is a frequently used questionnaire for CTS that includes 2 components. It evaluates for grading under two sub-headings: symptom severity scale (11 questions) and functional status scale (8 questions). Scores range from 0 to 5 for each question; 0 represents no difficulty during the activity, 5 represents extremely severe dysfunction. | 2023.02-2023.05 | 
| Cross-sectional area of the Median Nerve (CSA) | The cross-sectional area (CSA) of the median nerve will be used for analysis by the mean value of 3 measurements made with an electronic caliper at scaphoid-pisiform level. Ultrasonographic evaluations were planned to be performed with the 10-18-MHz linear probe of the MyLab 70 (Esaote, Genova, Italy) device by a physician experienced in US. CSA values increase as clinical findings worsen. | 2023.02-2023.05 | 
| Electrophysiological Evaluation | The patients will be evaluated as mild-moderate-severe CTS according to the criteria of the American Academy of Neurology. | 2023.02-2023.05 | 
| Hand and Finger Grip Strength Assessment | The hand grip strength of the participants will be measured with the Jamar Hand Dynamometer. Measurements will be made with the shoulder in adduction and neutral rotation adjacent to the trunk, elbow 90 degrees flexed, wrist 0-30 degrees dorsiflexion and 0-15 degrees ulnar deviation with thumb up. Finger grip strength will be evaluated with the Jamar Digital Pinchmeter. Patients will be placed in the sitting position with the wrist in 90° flexion and the forearm in the neutral position. Measurements will be made bilaterally in three different positions as lateral, palmar and fingertip grips. Patients will be asked to squeeze with maximum force and each measurement will be made three times, and their averages will be recorded in kg. The dynamometer has a dual scale readout which displays isometric grip force from 0-90 kg. Higher scores means better grip strength. | 2023.02-2023.05 | 
| Pittsburgh Sleep Quality Index (PSQI) | Pittsburgh Sleep Quality Index (PSQI) is a questionnaire that assesses sleep patterns and sleep quality in adults. The measure consists subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping pills, and daytime dysfunction in the past month. The global score of PUKI and each sub-parameter will be calculated and recorded separately. According to the PSQI, good sleepers are defined as a PSQI score = <5 and bad sleepers as PSQI > 5. | 2023.02-2023.05 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Carpal Tunnel Syndrome, Ultrasonographic evaluation, Pittsburgh Sleep Quality Index