Assessing Changes in Nonspecific Symptoms After Parathyroidectomy for Primary Hyperparathyroidism Using a Smartwatch

Objective: Parathyroidectomy (PTX) is indicated in primary hyperparathyroidism (PHPT) with osteoporosis or nephrolithiasis. There is not a uniform consensus on the benefit of PTX for nonspecific symptoms, but patient-reported questionnaires have demonstrated improved quality of life (QOL) afterward. This study aimed to evaluate physical activity and sleep after PTX using smartwatch technology.

Methods: A prospective study of consecutive patients undergoing PTX for PHPT from August 2022 to July 2023 was conducted. Each patient received a smartwatch to continuously track physical activity and sleep, starting 1 month before to 6 months postoperatively. Euthyroid patients undergoing thyroidectomy served as controls. A disease-specific QOL questionnaire was completed at baseline and 6 months. Data were compared within and between groups using linear mixed effect models.

Results: Forty-five patients were enrolled (PTX = 36, thyroidectomy = 9). The PTX group showed higher proportion of light sleep (68% vs 60%, P = .006), and a lower proportion of deep sleep (14% vs 18%, P < .001) when compared with the thyroidectomy group before surgery. After patients with PTX showed improvement in the QOL questionnaire (-16.0, P < .001) but there were no significant changes seen in the overall smartwatch physical activity or sleep patterns. However, improvements in the mood and sleep subcategory of the QOL questionnaire were associated with more deep sleep and lower number of nighttime awakenings.

Conclusion: Patients with PHPT seem to have worse sleeping patterns at baseline. Significant improvement after PTX can be seen using QOL questionnaires that are associated with sleep smartwatch data.