title: Pain, depression and sleep disorders in patients with diabetic and nondiabetic carpal tunnel syndrome: a vicious cycle.
abstract: Carpal tunnel syndrome (CTS) is a condition involving nerve entrapment that often leads to chronic neuropathic pain. We aimed to evaluate sleep quality and related parameters in diabetic and non-diabetic CTS patients.
  
  
  METHODS
  This study included a total of 366 patients with chronic CTS. These patients' sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and depression using the Beck Depression Inventory (BDI). The severity of neuropathic pain was evaluated using the Douleur Neuropathique-4 (DN4) questionnaire and a visual analogue scale (VAS).
  
  
  RESULTS
  In the non-diabetic patient group, the total PSQI score was found to affect BDI and VAS, while in the diabetic patient group, the duration of symptoms affected VAS, BDI and fasting glucose levels.
  
  
  CONCLUSIONS
  For diabetic patients, hyperglycemia depression and chronification of neuropathic pain may lead to deterioration of sleep quality. Therefore, consideration of these parameters in the treatment may break a vicious cycle.
authors.affiliation: Department of Neurology, Bozok University Medical School, Yozgat, Turkey.
authors.forename: Nermin
authors.initials: N
authors.lastname: Tanik
authors.affiliation: Department of Physical Medicine and Rehabilitation, Yozgat State Hospital, Yozgat, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Sarp
authors.affiliation: Department of Physical Medicine and Rehabilitation, Bozok University Medical School, Yozgat, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ucar
authors.affiliation: Department of Neurology, Bozok University Medical School, Yozgat, Turkey.
authors.forename: Asuman
authors.initials: A
authors.lastname: Celikbilek
authors.affiliation: Department of Physical Medicine and Rehabilitation, Bozok University Medical School, Yozgat, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Balbaloglu
authors.affiliation: Department of Neurosurgery, Bozok University Medical School, Yozgat, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ak
authors.affiliation: Department of Neurosurgery, Bozok University Medical School, Yozgat, Turkey.
authors.forename: Tugay
authors.initials: T
authors.lastname: Atalay
authors.affiliation: Department of Orthopedics and Traumatology, Yozgat State Hospital, Yozgat, Turkey.
authors.forename: Hasan Onur
authors.initials: HO
authors.lastname: Arik
authors.affiliation: Department of Psychiatry, Bozok University Medical School, Yozgat, Turkey.
authors.forename: Mehmet Yavuz
authors.initials: MY
authors.lastname: Okyay
authors.affiliation: Department of Neurology, Bozok University Medical School, Yozgat, Turkey.
authors.forename: Levent Ertugrul
authors.initials: LE
authors.lastname: Inan
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000150:complications* / Q000523:psychology; D002908:Chronic Disease; D003866:Depressive Disorder / Q000209:etiology* / Q000523:psychology; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires