Sleep Occupation Quality and Occupation-based Hand Function in Carpal Tunnel Syndrome

Sleep disturbance is considered a health crisis by Centers for Disease Control and Prevention (2013). It is not uncommon for clients with carpal tunnel syndrome (CTS) to also have poor sleep (Patel et al., 2014). The purpose of this study was to investigate the impact of sleep quality on hand function, while controlling for pain level and CTS diagnostic electromyography severity in CTS clients at a Southern Arizona orthopedic practice. This study tested the following hypothesis: Sleep quality is positively associated with hand function above and beyond the association of pain and CTS severity to occupation-based hand function in CTS clients. This study included 53 adults who were diagnosed at an orthopedic outpatient practice inSouthern Arizona, with CTS. The measures used in this study were Manual Ability Measure-20 (MAM-20), Pittsburgh Sleep Quality Index (PSQI), and Visual Analogue Scale (VAS) for pain.Electromyography (EMG) was used to determine CTS diagnosis and CTS severity level. The SPSS 23 program was used to produce descriptive statistics for variables. The sample was predominantly middle-aged with significantly more female than male participants. The mean Rasch-derived manual ability was 62.76, the mean pain level as assessed by visual-analog scale was 5.96, and the mean PSQI score of 10.15 was above the cutoff score of 5 for detecting disturbed sleep. Participants reported an average of just under six hours of sleep per night in the past month. The findings of this study supported the hypothesis. In a multiple regression analysis, sleep quality was significantly associated with manual ability after controlling for CTS severity and pain. Scores on the PSQI accounted for a unique 12.7% of the variance in manual ability. Findings from this study support public health and work place initiatives that include the promotion of sleep quality for CTS. Occupational science and occupational therapy practice are informed by the findings of this study highlighting that CTS care should include evaluation and treatment of sleep quality for the promotion of hand function outcomes and client-centered outcomes