Department of Endocrine Surgery, Helios University Hospital Wuppertal, University of Witten-Herdecke and Heinrich-Heine University Düsseldorf, Wuppertal, Germany.
Department of Pneumology, Allergology, Sleep and Respiratory Medicine, Helios University Hospital Wuppertal, University of Witten-Herdecke, Heusnerstr, Wuppertal, Germany.
Adv Exp Med Biol. 2021;1335:121-127. doi: 10.1007/5584_2021_628.
We investigated the impact of parathyroidectomy on sleep quality in patients with primary hyperparathyroidism (pHPT). Thirty consecutive patients with pHPT were enrolled in the study within 1 year. pHPT was diagnosed by typical symptoms accompanied by an elevated level of parathormone. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of sleep 1 day before and 6 months after parathyroidectomy. The mean total PSQI score was elevated to 6.8 ± 0.6 points before surgery, which was in the pathological cut-off of greater than ≥5, indicating impaired sleep quality. After parathyroidectomy, the total score declined insignificantly, amounting to 5.6 ± 0.4 (p > 0.05). Nevertheless, the number of patients with a score of ≥5 before surgery decreased from 21 (70%) to 16 (53%) after surgery. There also was a significant improvement in sleep latency (p = 0.05) and sleep efficiency (p = 0.02) domains of PSQI. We conclude that 70% of patients with untreated pHPT suffered from sleep disorders that improved after parathyroidectomy. The clinical consequence is that patients with pHPT should be questioned about having sleep disorders, which might influence the decision-making concerning parathyroidectomy. With the relation reversed, patients without pHPT but suffering from sleep disturbance should be tested for pHPT.
我们研究了甲状旁腺切除术对原发性甲状旁腺功能亢进症（pHPT）患者睡眠质量的影响。在 1 年内，我们连续招募了 30 例 pHPT 患者。pHPT 通过典型症状伴甲状旁腺激素水平升高诊断。匹兹堡睡眠质量指数（PSQI）用于评估甲状旁腺切除术前 1 天和术后 6 个月的睡眠情况。术前平均 PSQI 总分升高至 6.8±0.6 分，大于≥5 的病理性截止值，表明睡眠质量受损。甲状旁腺切除术后，总分无显著下降，为 5.6±0.4（p>0.05）。然而，术前 PSQI 评分≥5 的患者人数从 21 例（70%）减少至术后 16 例（53%）。PSQI 的入睡潜伏期和睡眠效率两个领域也有显著改善（p=0.05 和 p=0.02）。我们得出结论，未经治疗的 pHPT 患者中有 70%患有睡眠障碍，甲状旁腺切除术后得到改善。其临床意义在于，pHPT 患者应被询问是否存在睡眠障碍，这可能会影响甲状旁腺切除术的决策。反之，如果患者没有 pHPT，但有睡眠障碍，应测试其是否有 pHPT。
