Concordance Between Subjective Sleep and PSQI/ISI in Carpal Tunnel Syndrome Patients: A Comparative Study Before and...

Carpal tunnel syndrome (CTS) is frequently associated with sleep disturbances that considerably impair quality of life. Most studies have focused on either subjective sleep or standardized patient-reported (SPR) measures, but the concordance between these measures before and after surgery remains unclear. We aimed to determine the rates of concordance and discordance, along with the associated factors, ultimately proposing strategies to enhance the assessment process and postoperative care for these patients.

We conducted a single-center observational study including 104 adult CTS patients who underwent carpal tunnel release, divided into retrospective (n = 71) and prospective (n = 33) cohorts. Subjective sleep quality was assessed by patient self-report, whereas SPR included the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Assessments were performed before surgery and at 1, 3, and 12 months after surgery. Concordance between subjective and SPR results was determined at each time point.

Before surgery, 100% of patients reported poor sleep, with all having PSQI > 5 and ISI > 7 (full concordance). After surgery, both subjective and SPR sleep quality improved significantly. At 12 months, 95.77% of patients self-reported good sleep; 95.77% had PSQI ≤ 5, and 91.55% had ISI ≤ 7. Concordance between subjective and SPR assessments increased over time, but a minority of patients continued to exhibit discordance, with self-perceived improvement preceding SPR normalization in some cases. Strong positive correlations were found between PSQI and ISI at all time points.

Carpal tunnel release leads to substantial improvements in both subjective and SPR sleep quality in CTS patients, with increasing concordance over time. However, persistent discordance in some individuals underscores the need for multidimensional assessment and individualized management.

Therapeutic IIb.