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Epidemiologic Associations of Carpal Tunnel Syndrome and Sleep Position: Is There a Case for Causation?

McCabe, S.; Uebele, A.; Pihur, V.; Rosales, R. and Atroshi, Isam LU (2007) In Hand 2(3). p.127-134
Abstract
Abstract Introduction Carpal tunnel syndrome (CTS) is thought to be due to compression of the median nerve in the carpal tunnel. It is known that carpal tunnel pressures are elevated in wrist postures of flexion and extension and in those patients with CTS. Classic symptoms of CTS include night waking with pain, tingling, and numbness. These classic symptoms stimulated our interest in the relationship of sleep to the development of CTS. Method We reviewed the literature surrounding the epidemiology of CTS and the literature regarding sleep disturbances. Through careful distillation of these studies and a process of reasoning, we have developed a hypothesis for a causal mechanism of CTS. Results Epidemiologically, it has been shown that CTS... (More)
Abstract Introduction Carpal tunnel syndrome (CTS) is thought to be due to compression of the median nerve in the carpal tunnel. It is known that carpal tunnel pressures are elevated in wrist postures of flexion and extension and in those patients with CTS. Classic symptoms of CTS include night waking with pain, tingling, and numbness. These classic symptoms stimulated our interest in the relationship of sleep to the development of CTS. Method We reviewed the literature surrounding the epidemiology of CTS and the literature regarding sleep disturbances. Through careful distillation of these studies and a process of reasoning, we have developed a hypothesis for a causal mechanism of CTS. Results Epidemiologically, it has been shown that CTS is associated with age, gender, increased body mass index (BMI), diabetes, pregnancy, and is more common in some populations. The same associations noted above for CTS are strongly associated with sleep disturbances. Sleep disturbances due to age, gender, BMI, pregnancy, and population variations are all associated with sleeping in the lateral position supporting the hypothesis that a common causative mechanism of CTS is sleeping in a lateral position. Discussion We believe that the epidemiologic associations with CTS act through a common causative mechanism, increased sleeping in the lateral position which puts the wrist at increased risk of flexion or extension, compressing the median nerve in the carpal tunnel. This hypothesis is simple and explains the connection between a previously unconnected group of epidemiologic associations. This realization has real clinical significance in that it focuses our attention on the early disorder when it is completely reversible. It clarifies previously confused clinical circumstances, creates research questions that can be tested, and it invites us to change our clinical perspective in this most common form of nerve compression. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Hand
volume
2
issue
3
pages
127 - 134
publisher
Springer
external identifiers
  • scopus:34547586641
ISSN
1558-9447
DOI
10.1007/s11552-007-9035-5
language
English
LU publication?
yes
id
3894dfc4-2bc2-478b-a392-2a828a86a7dd (old id 1298920)
date added to LUP
2009-07-09 15:34:22
date last changed
2017-07-09 04:25:53
@article{3894dfc4-2bc2-478b-a392-2a828a86a7dd,
  abstract     = {Abstract Introduction Carpal tunnel syndrome (CTS) is thought to be due to compression of the median nerve in the carpal tunnel. It is known that carpal tunnel pressures are elevated in wrist postures of flexion and extension and in those patients with CTS. Classic symptoms of CTS include night waking with pain, tingling, and numbness. These classic symptoms stimulated our interest in the relationship of sleep to the development of CTS. Method We reviewed the literature surrounding the epidemiology of CTS and the literature regarding sleep disturbances. Through careful distillation of these studies and a process of reasoning, we have developed a hypothesis for a causal mechanism of CTS. Results Epidemiologically, it has been shown that CTS is associated with age, gender, increased body mass index (BMI), diabetes, pregnancy, and is more common in some populations. The same associations noted above for CTS are strongly associated with sleep disturbances. Sleep disturbances due to age, gender, BMI, pregnancy, and population variations are all associated with sleeping in the lateral position supporting the hypothesis that a common causative mechanism of CTS is sleeping in a lateral position. Discussion We believe that the epidemiologic associations with CTS act through a common causative mechanism, increased sleeping in the lateral position which puts the wrist at increased risk of flexion or extension, compressing the median nerve in the carpal tunnel. This hypothesis is simple and explains the connection between a previously unconnected group of epidemiologic associations. This realization has real clinical significance in that it focuses our attention on the early disorder when it is completely reversible. It clarifies previously confused clinical circumstances, creates research questions that can be tested, and it invites us to change our clinical perspective in this most common form of nerve compression.},
  author       = {McCabe, S. and Uebele, A. and Pihur, V. and Rosales, R. and Atroshi, Isam},
  issn         = {1558-9447},
  language     = {eng},
  number       = {3},
  pages        = {127--134},
  publisher    = {Springer},
  series       = {Hand},
  title        = {Epidemiologic Associations of Carpal Tunnel Syndrome and Sleep Position: Is There a Case for Causation?},
  url          = {http://dx.doi.org/10.1007/s11552-007-9035-5},
  volume       = {2},
  year         = {2007},
}