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

Area of Science:

• Endocrinology
• Surgical Research
• Wearable Technology in Medicine

Background:

• Primary hyperparathyroidism (PHPT) management often includes parathyroidectomy (PTX), particularly for osteoporosis or nephrolithiasis.
• While PTX benefits for nonspecific symptoms are debated, patient-reported outcomes show improved quality of life (QOL).
• Objective evaluation of physical activity and sleep post-PTX using modern technology is lacking.

Purpose of the Study:

• To assess changes in physical activity and sleep patterns following parathyroidectomy (PTX) in patients with primary hyperparathyroidism (PHPT).
• To correlate objective smartwatch data with subjective QOL improvements after PTX.
• To compare sleep and activity data between PHPT patients undergoing PTX and euthyroid controls undergoing thyroidectomy.

Main Methods:

• Prospective study enrolling 45 patients (36 PTX, 9 thyroidectomy controls) from August 2022 to July 2023.
• Patients used smartwatches for continuous physical activity and sleep tracking from 1 month pre-op to 6 months post-op.
• Disease-specific QOL questionnaires were administered at baseline and 6 months; data analyzed using linear mixed effect models.

Main Results:

• Pre-operatively, the PTX group exhibited significantly more light sleep (68% vs. 60%) and less deep sleep (14% vs. 18%) compared to controls.
• Following PTX, patients reported significant QOL improvements, but smartwatch data showed no overall changes in physical activity or sleep patterns.
• Improvements in QOL subcategories for mood and sleep were associated with increased deep sleep and fewer nighttime awakenings.

Conclusions:

• Patients with PHPT present with suboptimal sleep patterns prior to parathyroidectomy.
• Parathyroidectomy leads to significant QOL improvements in PHPT patients, which are objectively associated with enhanced sleep quality metrics.
• Smartwatch technology offers a valuable tool for correlating objective physiological data with subjective patient-reported outcomes after PTX.