CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2023; 12(01): 059-063
DOI: 10.1055/s-0041-1741406
Original Article

Improvement of Sleep Quality after Surgical Decompression in Carpal Tunnel Syndrome

Nguyen Le Trung Hieu
1   Department of Neurology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh city, Vietnam
2   Department of Neurology, Children's Hospital No. 2, Ho Chi Minh city, Vietnam
Nguyen Anh Sang
3   Department of Upper Limb Surgery, Military Hospital 175, Ho Chi Minh city, Vietnam
4   Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh city, Vietnam
› Author Affiliations


Background Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy which can cause severe sleep disturbance. Carpal tunnel release (CTR) is a choice for severe cases, which has shown to improve sleep quality, but the available evidence is limited. This study aimed to investigate the impact of CTR on sleep quality and hand symptoms and functions in patients with CTS.

Methods This was a prospective study in 2019–2020 on patients with CTS and poor sleep quality undergoing CTR. Patients were evaluated before and at 1, 3, and 12 months after CTR by the Pittsburgh sleep quality index (PSQI) and Boston carpal tunnel syndrome questionnaires.

Results There were 33 patients with 27 females (82%) and a median age of 51 years. The median time of CTS diagnosis and having sleep disorder before CTR were 12 and 6 months, respectively. The outcomes significantly improved after CTR, with the median PSQI and Boston symptom and function scores reduced from 12, 33, and 23 before CTR to 9, 14, and 11 at 1 month; 7, 13, and 9 at 3 months; and 1, 11, and 8 at 12 months postoperatively, respectively. The correlations between the PSQI and Boston symptom and function scores were > 0.6 at all time-points.

Conclusions Surgical decompression significantly improves sleep quality and the hand symptoms and functions in patients with CTS. Long-term evaluations are lacking and thus are required in future studies.

Publication History

Article published online:
30 December 2021

© 2021. Neurological Surgeons' Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Paget J. The first description of carpal tunnel syndrome. J Hand Surg Eur Vol 2007; 32 (02) 195-197
  • 2 Padua L, Coraci D, Erra C. et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016; 15 (12) 1273-1284
  • 3 Patel JN, McCabe SJ, Myers J. Characteristics of sleep disturbance in patients with carpal tunnel syndrome. Hand (N Y) 2012; 7 (01) 55-58
  • 4 Gaspar MP, Kane PM, Jacoby SM, Gaspar PS, Osterman AL. Evaluation and management of sleep disorders in the hand surgery patient. J Hand Surg Am 2016; 41 (10) 1019-1026
  • 5 Lehtinen I, Kirjavainen T, Hurme M, Lauerma H, Martikainen K, Rauhala E. Sleep-related disorders in carpal tunnel syndrome. Acta Neurol Scand 1996; 93 (05) 360-365
  • 6 Patel A, Culbertson MD, Patel A. et al. The negative effect of carpal tunnel syndrome on sleep quality. Sleep Disord 2014; 2014: 962746
  • 7 Graham B, Regehr G, Naglie G, Wright JG. Development and validation of diagnostic criteria for carpal tunnel syndrome. J Hand Surg Am 2006; 31 (06) 919-924
  • 8 Tulipan JE, Kim N, Abboudi J. et al. Prospective evaluation of sleep improvement following carpal tunnel release surgery. J Hand Surg Am 2017; 42 (05) 390.e1-390.e6
  • 9 Rubin G, Orbach H, Rinott M, Rozen N. The effectiveness of splinting and surgery on sleep disturbance in carpal tunnel syndrome. J Hand Surg Eur Vol 2018; 43 (03) 286-289
  • 10 Erickson J, Polatsch D, Beldner S, Melamed E. An assessment of sleep disturbance in patients before and after carpal tunnel release. J Hand Surg Asian Pac Vol 2019; 24 (02) 144-146
  • 11 Gaspar MP, Osterman MN, Shin EK, Osterman AL, Kane PM. Sleep disturbance and response to surgical decompression in patients with carpal tunnel syndrome: a prospective randomized pilot comparison of open versus endoscopic release. Acta Biomed 2019; 90 (01) 92-96
  • 12 Okkesim CE, Serbest S, Tiftikçi U, Çirpar M. Prospective evaluation of preoperative and postoperative sleep quality in carpal tunnel release. J Hand Surg Eur Vol 2019; 44 (03) 278-282
  • 13 Niedermeier SR, Pettit RJ, Frantz TL, Colvell K. M Awan H. Early postoperative improvement in sleep and pain after carpal tunnel release. Hand (N Y) 2020; 15 (03) 311-314
  • 14 Keith MW, Masear V, Chung K. et al. Diagnosis of carpal tunnel syndrome. J Am Acad Orthop Surg 2009; 17 (06) 389-396
  • 15 Graham B, Peljovich AE, Afra R. et al. The American Academy of Orthopaedic Surgeons Evidence-Based Clinical Practice Guideline on: Management of Carpal Tunnel Syndrome. J Bone Joint Surg Am 2016; 98 (20) 1750-1754
  • 16 Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28 (02) 193-213
  • 17 Levine DW, Simmons BP, Koris MJ. et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993; 75 (11) 1585-1592
  • 18 Trouw AG, Patel A, Yang A, Jauregui J, Caligiuri D, Choueka J. Improvement in sleep quality after carpal tunnel release. J Long Term Eff Med Implants 2018; 28 (01) 55-61
  • 19 Bilgin Topçuoğlu Ö, Oruç Ö, Saraç S, Çetintaş Afşar G, Uluç K. Carpal tunnel syndrome in obstructive sleep apnea patients. Noro Psikiyatri Arsivi 2017; 54 (04) 307-311