Sleep disorders and relationship with comorbid anxiety and depression in carpal tunnel syndrome

Yıl 2021, Cilt: 7 Sayı: 4, 368 - 374, 04.07.2021

Şükran Çevik Yurtoğulları , Meral Seferoglu

https://doi.org/10.18621/eurj.745101

Öz

Objectives: In this study, it was aimed to assess relationship of disease severity with sleep quality, depression and anxiety in patients with carpal tunnel syndrome (CTS) and to compare findings with healthy controls.

Methods: The study included 35 patients diagnosed as CTS and 20 healthy individuals. In CTS patients, symptom severity and functional disorders were assessed using Boston Carpal Tunnel Questionnaire (BTCQ). The sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI) in CTS patients and healthy controls. The Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used to evaluate depression and anxiety accompanying to CTS and sleep disorder.

Results: In the assessment of general sleep quality, it was found that PSQI scores were significantly higher in CTS group when compared to healthy controls (p < 0.0001). Again, the BDI and BAI scores were also significantly higher in CTS group than control group (p < 0.0001 and p < 0.003, respectively). There was a strong, positive correlation between BTCQ symptom severity scale (SSS) and PSQI (r = 0.774; p < 0.0001). A significant, positive correlation was observed between Boston SSS and BDI scores (r = 0.666; p < 0.001). When assessed correlation between anxiety scores and Boston SSS and functional state scale (FSS), it was found that anxiety was increased by increasing severity of CTS, indicating a positive, moderate correlation (r=0.469, p < 0.0001 and r=0.464, p < 0.0001).

Conclusions: The pain in patients with CTS can impair sleep quality, which, in turn, may increase risk for depression and anxiety. Thus, comorbid psychiatric symptoms and signs should be considered in the treatment of patients with CTS.

Anahtar Kelimeler

Carpal tunnel syndrome, depression, anxiety, sleep disorder

Kaynakça

• 1. Keith AB, Jeffrey JB. Hand Disorders. In: DeLisa JA, Gans BM, Walsh NE (Editors): Physical Medicine and Rehabilitation, 4th ed. Philadelphia, 2005:pp 843-54.
• 2. Şenel K. El ve El Bileği Ağrısı. Beyazova M, Gokce-Kutsal Y (Editorler). Fiziksel Tıp ve Rehabilitasyon. Ankara: Güneş Kitabevi, 2000, s.1455-64.
• 3. Graham B, Regehr G, Naglie G, Wright JG. Development and validation of diagnostic criteria for carpal tunnel syndrome. J Hand Surg Am 2006;31:919-24.
• 4. Wainner RS, Fritz JM, Irrgang JJ, Delitto A, Allison S, Boninger ML. Development of a clinical prediction rule for the diagnosis of carpal tunnel syndrome. Arch Phys Med Rehabil 2005;86:609-18.
• 5. Katz JN, Larson MG, Sabra A, Krarup C, Stirrat CR, Sethi R, et al. The carpal tunnel syndrome: diagnostic utility of the history and physical examination findings. Ann Intern Med 1990;112:321-7.
• 6. Gomes I, Becker J, Ehlers JA, Nora DB. Prediction of the neurophysiological diagnosis of carpal tunnel syndrome from the demographic and clinical data. Clin Neurophysiol 2006;117:964-71.
• 7. Katz JN, Larson MG, Sabra A, Krarup C, Stirrat CR, Sethi R, et al. The carpal tunnel syndrome: diagnostic utility of the history and physical examination findings. Ann Intern Med 1990;112:321-7.
• 8. Nora DB, Becker J, Ehlers JA, Gomes I. What symptoms are truly caused by median nerve compression in carpal tunnel syndrome? Clin Neurophysiol 2005;116:275-83.
• 9. Bigatti SM, Hernandez AM, Cronan TA, Rand KL. Sleep disturbances in fibromyalgia syndrome: relationship to pain and depression. Arthritis Rheum 2008;59:961-7.
• 10. Marty M, Rozenberg S, Duplan B, Thomas P, Duguesnoy B, Allaert F, Section Rachis de la Societe Francaise de Rhumatologie. Quality of sleep in patients with chronic low back pain: a case-control study. Eur Spine J 2008;17:839-44.
• 11. Jablecki CK, Andary MT, Floeter MK, Miller RG, Quartly CA, Vennix MJ, 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 andRehabilitation. Neurology 2002;58:1589-92.
• 12. Stevens JC. AAEM minimonograph 26: The electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine. Muscle Nerve 1997;20:1477-86.
• 13. Sezgin M, Incel NA, Serhan S, Camdeviren H, As I, Erdogan C. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the BostonQuestionnaire. Disabil Rehabil 2006;28:1281-5.
• 14. Heybeli N, Özerdemoglu RA, Aksoy OG, Mumcu EF. [Functional and symptomatic scoring used for the assessment of outcome in carpal tunnel release]. Acta Orthop Traumatol Turc 2001;35:147-51. [Article in Turkish]
• 15. Ağargun MY, Kara H, Anlar O. [The Validity and Reliability of the Pittsburgh Sleep Quality Index]. Turk Psikiyatri Dergisi 1996;7(2). [Article in Turkish]
• 16. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
• 17. Beck AT. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571.20.
• 18. Hisli N. Beck depresyon envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Türk Psikoloji Dergisi 1988;6:3-13.
• 19. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893-7.
• 20. Ulusoy M. Beck Anksiyete Envanteri: Geçerlik ve güvenirlik çalışması. Yayınlanmamış uzmanlık tezi. Bakırköy Ruh ve Sinir Hastalıkları Hastanesi, İstanbul. 1993.
• 21. Ertekin C. Santral ve Periferik EMG Anatomi-Fizyoloji-Klinik. Izmir: Meta Basim Matbacilik Hizmetleri, 2006:403-27.
• 22. Patel JN, McCabe SJ, Myers J. Characteristics of sleep disturbance in patients with carpal tunnel syndrome. Hand (N Y) 2012 7:55-8.
• 23. Lehtinen I, Kirjavainen T, Hurme M, Lauerma H, Martikainen K, Raulaha E. Sleep related disorders in carpal tunnel syndrome. Acta Neurol Scand 1996;93:360-5.
• 24. Annagür BB, Uguz F, Apiliogullari S, Kara I, Gunduz S. Psychiatric disorders and association with quality of sleep and quality of life in patients with chronic pain: A SCID-Based Study. Pain Med 2014;15:772-8.
• 25. Alsaadi SM, McAuley JH, Hush JM, Bartlett DJ, McKeough ZM, Grunstein RR et al. Assessing sleep disturbance in low back pain: the validity of portable instruments. PLoS One 2014;9:e95824.
• 26. Stewart WFRJ, Chee E, Brandenberg N. Work related costs of diabetic neuropathic (DPN) Pain in the US: results from the american productivity audit. In: 24th Annual Scientific Meeting of the American Pain Society, Boston, Mass. 2014.
• 27. Geoghegan JM, Clark DI, Bainbridge LC, Smith C, Hubbard R. Risk factors in carpal tunnel syndrome. J Hand Surg Br 2004;29:315-20.
• 28. Nicholson B, Verma S. Comorbidities in chronic neuropathic pain. Pain Med 2004;5(Suppl s1):S9-27.
• 29. Beleckas CM, Wright M, Prather H, Chamberlain A, Guattery J, Calfee RP. Relative prevalence of anxiety and depression in patients with upper extremity conditions. J Hand Surg Am 2018;43:571.e1-571.e8.)
• 30. Moghadam-Ahmadi A, Bidaki R, Sarhadi TS, Vakilian A, Razavi AS. Prevalence of depression and anxiety in patients with carpal tunnel syndrome, Rafsanjan, Iran 2014. J Mazandaran Univ Med Sci 2017;27:64-73.
• 31. McCallum LM, Damms NA, Sarrigiannis PG, Zis P. Anxiety and depression in patients with suspected carpal tunnel syndrome – A case controlled study. Brain Behav 2019;9:e01342.
• 32. Radat F, Margot-Duclot A, Attal N. Psychiatric co-morbidities in patients with chronic peripheral neuropathic pain: a multicentre cohort study. Eur J Pain 2013;17:154-7.
• 33. Cameron LD, Leventhal H, Love RR. Trait anxiety, symptom perceptions, and illness‐related responses among women with breast cancer in remission during a tamoxifen clinical trial. Health Psychol 1998;7:459-69.
• 34. Hazard RG, Bendix A, Fenwick JW. Disability exaggeration as a predictor of functional restoration outcomes for patients with chronic low‐back pain. Spine (Phila Pa 1976) 1991;16:1062-7.
• 35. Howren MB, Suls J. The symptom perception hypothesis revised: depression and anxiety play different roles in concurrent and retrospective physical symptom reporting. J Pers Soc Psychol 2011;100:182-95.