title: Prospective Evaluation of Sleep Improvement Following Carpal Tunnel Release Surgery.
abstract: OBJECTIVE
  Sleep disturbance due to nighttime awakening is a well-documented symptom of carpal tunnel syndrome. While relief of nighttime waking following carpal tunnel release (CTR) has been demonstrated, the effect of CTR on overall sleep quality has not been fully investigated. We hypothesized that CTR would result in significant improvement in overall sleep quality as well as patients' overall satisfaction with their sleep habits.
  
  
  METHODS
  Cases of carpal tunnel syndrome with positive nerve studies, and treated with CTR, were prospectively enrolled. Demographic data, electromyography (EMG) severity, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, and Insomnia Severity Index (ISI) scale data were collected.
  
  
  RESULTS
  A total of 398 patients were enrolled, with 99% available at 2 weeks and 64% available at 3-month final follow-up. At final follow-up, average Quick Disabilities of the Arm, Shoulder, and Hand score improved significantly from the preoperative value. Average ISI score on all 7 sleep categories on the survey improved significantly from before surgery to the first postoperative visit. However, the total ISI score did not further improve significantly between the 2-week and the 3-month postoperative visits. The ISI score improvements did not correlate with EMG severity.
  
  
  CONCLUSIONS
  Patients undergoing CTR demonstrated significant improvement in mean scores for 7 aspects of sleep quality. Sleep improvement was unrelated to preoperative EMG severity and was experienced within 2 weeks of surgery.
  
  
  METHODS
  Therapeutic II.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA. Electronic address: Jacob.tulipan@gmail.com.
authors.forename: Jacob E
authors.initials: JE
authors.lastname: Tulipan
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Jack
authors.initials: J
authors.lastname: Abboudi
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Jones
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Frederic
authors.initials: F
authors.lastname: Liss
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: William
authors.initials: W
authors.lastname: Kirkpatrick
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Jonas
authors.initials: J
authors.lastname: Matzon
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Michael
authors.initials: M
authors.lastname: Rivlin
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wang
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Asif M
authors.initials: AM
authors.lastname: Ilyas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000150:complications* / Q000601:surgery*; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Carpal tunnel release; carpal tunnel syndrome; electromyography; insomnia; sleep disturbance