THE RELATIONSHIP BETWEEN MEDIAN NERVE COMPRESSION IN THE CARPAL TUNNEL AND SLEEPING POSITION: A SYSTEMATIC REVIEW

Abstract

Median nerve compression is reported to be the most common nerve compression in the upper extremity, especially in the carpal tunnel. Carpal tunnel syndrome (CTS) is a condition where the median nerve is entrapped in the narrow passageway that is covered by carpal bones and ligaments which is called the carpal tunnel. Despite the common symptoms such as numbness and tingling sensation in the median nerve distribution, many studies have agreed to characterize nocturnal paresthesia as one of the CTS symptoms. These symptoms have been frequently reported to cause a sleep disturbance to the patients at night. According to recent research, sleeping position is reported to be the provocative factor to the symptoms, while some studies reported that alteration in sleeping position can reduce the symptoms. Hence, this study objectively aims to identify the relationships between median nerve compression in the carpal tunnel and sleeping position through a systematic review. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) as the main guideline. This study retrieved all selected articles from online databases such as PubMed, Scopus and ScienceDirect and from other sources such as Google Scholar that were published from 2010 to 2022. The articles were screened through the titles and abstract and were further reviewed and evaluated for eligibility. Only four articles that meet the inclusion criteria were included in this study. The included articles were then assessed for the risk of bias by using Crowe Critical Appraisal Tools (CCAT). The data from the selected articles were then analyzed and extracted for the results. Our assessment suggests that lateral side sleeping is the most preferred sleeping position in CTS patients that increased the symptoms at night. This study has a limitation where least research articles were published that are concerned about the association between nerve compression and sleeping position despite the frequent complaint of the symptoms at night. It is suggested for the future researchers to include the possible associations such as pain intensity, BMI, nature of work, the use of night splint and preferred hand position during sleeping in their study.