Impact of Clinical and Electrophysiological Features of Carpal Tunnel Syndrome on Sleep Disturbances
Year 2025,
Volume: 15 Issue: EK-1, 40 - 45, 20.10.2025
Halil Can Alaydın
,
Gül Melisa Bozdoğan Yılmaz
Rümeysa Paltacı
,
Zülfikar Arlıer
,
Halit Fidancı
Abstract
Aim: This study investigates the relationship between clinical and electrophysiological severity of carpal tunnel syndrome (CTS) and sleep disturbances. While CTS is known to cause nocturnal symptoms, the extent to which these disturbances correlate with clinical and electrophysiological findings remains unclear.
Material and Method: This retrospective analysis was conducted on 48 patients with electrophysiologically confirmed CTS. Clinical severity was classified into five stages, and electrophysiological severity was determined through nerve conduction studies. Sleep disturbances were assessed using the Jenkins Sleep Scale (JSS). The Kruskal-Wallis and Mann-Whitney U tests were used to compare JSS scores across severity groups, while Spearman’s correlation analysis evaluated associations between JSS scores and other parameters.
Results: JSS scores significantly correlated with clinical severity of CTS (Spearman’s rho=0.46, p=0.001). Pairwise comparisons showed that patients with moderate (p=0.03) and severe (p=0.031) CTS symptoms had significantly higher JSS scores compared to those with very mild symptoms. However, no significant correlation was found between JSS scores and electrophysiological parameters (p >0.05).
Conclusion: Our findings indicate that sleep disturbances in CTS are more closely related to clinical symptom severity, particularly in patients with moderate to severe clinical findings. In contrast, electrophysiological parameters do not appear to correlate with sleep impairment, suggesting that central sensitization, pain perception, and nocturnal symptom fluctuations may play a more prominent role in sleep disturbances among CTS patients.
References
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7. Patel A, Culbertson MD, Patel A, et al. The Negative Effect of Carpal Tunnel Syndrome on Sleep Quality. Sleep Disord. 2014;2014:1–7.
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8. Karatas G, Kutluk O, Akyuz M, Karaahmet O, Yalcin E. The effects of carpal tunnel syndrome on sleep quality. Ann Med Res. 2020;27(1):381.
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9. Aydin E, Turan Y, Kurt Omurlu I. Evaluation of Sleep Quality in Patients with Carpal Tunnel Syndrome. Adnan Menderes Üniversitesi Tıp Fakültesi/Journal Adnan Menderes Univ Med Fac. 2015;15(3):96–98.
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10. Akçay İH, Demirdel E. Karpal Tünel Sendromlu Kadınlarda Elektrodiagnostik Test Sonuçlarına Göre Klinik Değerlendirme, Ağrı, Fonksiyonel Durum ve Uyku Kalitesi Sonuçlarının İncelenmesi: Pilot Çalışma. İstanbul Gelişim Üniversitesi Sağlık Bilim Derg. 2022;17(17):526–539.
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11. Tanık N. Carpal tunnel syndrome: An evaluation clinical and sociodemographic characteristics of 350 patients. Dicle Med J/ Dicle Tip Derg. 2014;41(3):538–541.
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12. Padua L, Padua R, LoMonaco M, Romanini E, Tonali P. Italian multicentre study of carpal tunnel syndrome: study design. Italian CTS Study Group. Ital J Neurol Sci. 1998;19(5):285289.
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13. Padua L, Padua R, Lo Monaco M, Aprile I, Tonali P. Multiperspective assessment of carpal tunnel syndrome: a multicenter study. Italian CTS Study Group. Neurology. 1999;53(8):1654–1659.
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14. Chen S, Andary M, Buschbacher R, et al. Electrodiagnostic reference values for upper and lower limb nerve conduction studies in adult populations. Muscle Nerve. 2016;54(3):371Kafkas J Med Sci 2025.
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15. Fidanci H, Öztürk I, Köylüoğlu AC, Yildiz M, Buturak Ş, Arlier Z. The needle electromyography findings in the neurophysiological classification of ulnar neuropathy at the elbow. Turkish J Med Sci. 2020;50(4):804–810.
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16. Buturak Ş, Fidancı H, Yıldız M, Arlıer Z. Relationship between Gravidity, Parity, and Neurophysiological Features in Carpal Tunnel Syndrome (CTS) Patients with a History of Pregnancy. Niger J Clin Pract. 2024;27(3):345–351.
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17. Buturak Ş, Fidancı H, Köylüoğlu AC, Yıldız M, Arlıer Z. T he relationship between fatigue, neuropathic pain, and neurophysiological features in carpal tunnel syndrome. J Contemp Med. 2022;12(6):907–911.
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18. Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve. 2011;44(4):597–607.
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19. Jenkins CD, Stanton BA, Niemcryk SJ, Rose RM. A scale for the estimation of sleep problems in clinical research. J Clin Epidemiol. 1988;41(4):313–321.
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20. Jerlock M, Gaston-Johansson F, Kjellgren KI, Welin C. Coping strategies, stress, physical activity and sleep in patients with unexplained chest pain. BMC Nurs. 2006;5:7.
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21. Duruöz MT, Ünal Ç, Ulutatar F, Sanal Toprak C, Gündüz OH. T he validity and reliability of Turkish version of the Jenkins sleep evaluation scale in rheumatoid arthritis. Arch Rheumatol. 2018;33(2):160–167.
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22. Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010;9(8):807–819.
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23. Dahlin LB. Aspects on pathophysiology of nerve entrapments and nerve compression injuries. Neurosurg Clin N Am. 1991;2(1):21–29.
-
24. Rempel D, Dahlin L, Lundborg G. Pathophysiology of nerve compression syndromes: response of peripheral nerves to loading. J Bone Joint Surg Am. 1999;81(11):1600–1610
Year 2025,
Volume: 15 Issue: EK-1, 40 - 45, 20.10.2025
Halil Can Alaydın
,
Gül Melisa Bozdoğan Yılmaz
Rümeysa Paltacı
,
Zülfikar Arlıer
,
Halit Fidancı
References
-
1. Padua L, Coraci D, Erra C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273–1284.
-
2. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153–158.
-
3. Bland JDP. Carpal 2007;335(7615):343–346. tunnel syndrome. BMJ.
-
4. Kimura J. Electrodiagnosis in Diseases of Nerve and Muscle: Principles and Practice. Published online September 1, 2013.
-
5. Jablecki CK, Andary MT, Floeter MK, et al. Practice parameter: Electrodiagnostic studies in carpal tunnel syndrome. Report of the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2002;58(11):1589–1592.
-
6. Chan L, Turner JA, Comstock BA, et al. The relationship between electrodiagnostic findings and patient symptoms and function in carpal tunnel syndrome. Arch Phys Med Rehabil. 2007;88(1):19–24.
-
7. Patel A, Culbertson MD, Patel A, et al. The Negative Effect of Carpal Tunnel Syndrome on Sleep Quality. Sleep Disord. 2014;2014:1–7.
-
8. Karatas G, Kutluk O, Akyuz M, Karaahmet O, Yalcin E. The effects of carpal tunnel syndrome on sleep quality. Ann Med Res. 2020;27(1):381.
-
9. Aydin E, Turan Y, Kurt Omurlu I. Evaluation of Sleep Quality in Patients with Carpal Tunnel Syndrome. Adnan Menderes Üniversitesi Tıp Fakültesi/Journal Adnan Menderes Univ Med Fac. 2015;15(3):96–98.
-
10. Akçay İH, Demirdel E. Karpal Tünel Sendromlu Kadınlarda Elektrodiagnostik Test Sonuçlarına Göre Klinik Değerlendirme, Ağrı, Fonksiyonel Durum ve Uyku Kalitesi Sonuçlarının İncelenmesi: Pilot Çalışma. İstanbul Gelişim Üniversitesi Sağlık Bilim Derg. 2022;17(17):526–539.
-
11. Tanık N. Carpal tunnel syndrome: An evaluation clinical and sociodemographic characteristics of 350 patients. Dicle Med J/ Dicle Tip Derg. 2014;41(3):538–541.
-
12. Padua L, Padua R, LoMonaco M, Romanini E, Tonali P. Italian multicentre study of carpal tunnel syndrome: study design. Italian CTS Study Group. Ital J Neurol Sci. 1998;19(5):285289.
-
13. Padua L, Padua R, Lo Monaco M, Aprile I, Tonali P. Multiperspective assessment of carpal tunnel syndrome: a multicenter study. Italian CTS Study Group. Neurology. 1999;53(8):1654–1659.
-
14. Chen S, Andary M, Buschbacher R, et al. Electrodiagnostic reference values for upper and lower limb nerve conduction studies in adult populations. Muscle Nerve. 2016;54(3):371Kafkas J Med Sci 2025.
-
15. Fidanci H, Öztürk I, Köylüoğlu AC, Yildiz M, Buturak Ş, Arlier Z. The needle electromyography findings in the neurophysiological classification of ulnar neuropathy at the elbow. Turkish J Med Sci. 2020;50(4):804–810.
-
16. Buturak Ş, Fidancı H, Yıldız M, Arlıer Z. Relationship between Gravidity, Parity, and Neurophysiological Features in Carpal Tunnel Syndrome (CTS) Patients with a History of Pregnancy. Niger J Clin Pract. 2024;27(3):345–351.
-
17. Buturak Ş, Fidancı H, Köylüoğlu AC, Yıldız M, Arlıer Z. T he relationship between fatigue, neuropathic pain, and neurophysiological features in carpal tunnel syndrome. J Contemp Med. 2022;12(6):907–911.
-
18. Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve. 2011;44(4):597–607.
-
19. Jenkins CD, Stanton BA, Niemcryk SJ, Rose RM. A scale for the estimation of sleep problems in clinical research. J Clin Epidemiol. 1988;41(4):313–321.
-
20. Jerlock M, Gaston-Johansson F, Kjellgren KI, Welin C. Coping strategies, stress, physical activity and sleep in patients with unexplained chest pain. BMC Nurs. 2006;5:7.
-
21. Duruöz MT, Ünal Ç, Ulutatar F, Sanal Toprak C, Gündüz OH. T he validity and reliability of Turkish version of the Jenkins sleep evaluation scale in rheumatoid arthritis. Arch Rheumatol. 2018;33(2):160–167.
-
22. Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010;9(8):807–819.
-
23. Dahlin LB. Aspects on pathophysiology of nerve entrapments and nerve compression injuries. Neurosurg Clin N Am. 1991;2(1):21–29.
-
24. Rempel D, Dahlin L, Lundborg G. Pathophysiology of nerve compression syndromes: response of peripheral nerves to loading. J Bone Joint Surg Am. 1999;81(11):1600–1610