Please select the eligibility criteria that correspond to the clinical trial below.
Title: Pilot Study on the Effect of Parathyroidectomy on Sleep
Brief Summary: Primary hyperparathyroidism (PHPT) is an endocrine disorder that disrupts calcium metabolism and has a broad range of clinical manifestations. With respect to the nonclassic, subjective symptoms that have been reported to be associated with PHPT, such as sleep disturbance, neurocognitive dysfunction, mood disturbance, fatigue, and decreased quality of life, there is a lack of objective data on the extent to which these symptoms are affected by parathyroidectomy.

There have been reports of improvements in sleep in patients following parathyroidectomy, but these have been based solely on subjective sleep surveys. To date, there are no published studies on objective sleep evaluations of patients with PHPT. The overall goals of this protocol are to ascertain the feasibility of performing sleep studies on patients with PHPT, and to obtain pilot data on the effects of parathyroidectomy on those sleep studies.

It is hypothesized that it will be feasible to evaluate sleep parameters in patients with PHPT in the M. D. Anderson Sleep Center. Towards testing this hypothesis, the specific aims are:

Specific Aim 1: To assess the feasibility of using nocturnal polysomnography (PSG) to evaluate the primary outcome measure of total sleep time.

Specific Aim 2: To assess the feasibility of using nocturnal polysomnography (PSG) to evaluate the secondary outcome measures of sleep architecture, arousal index, sleep efficiency, wake after sleep onset, and sleep onset latency in patients with PHPT.

Specific Aim 3: To assess the feasibility of evaluating the secondary outcome measures of subjective sleepiness as tested with the Epworth Sleepiness Scale (ESS), and of sleep quality as tested with the Brief Sleep Disturbance Scale (BSDS) in patients with PHPT.

Specific Aim 4: To assess the feasibility using a randomized "wait-list"-control design to assess the effects of parathyroidectomy on sleep measures obtained with nocturnal PSG.


Options:
A: Inclusion Criteria:

* Primary hyperparathyroidism
* Referred to Aarhus University Hospital with the diagnose; primary hyperparathyroidism
* Participant is over 18 years old, able to understand and sign consent form

Exclusion Criteria:

* Familial hypocalciuric hypercalcaemia
* Multiple endocrine neoplasia (MEN)
* Parathyroid cancer
* Renal disease - GFR \< 60 ml/min
* Major heart surgery
* Known coronary heart disease
* NYHA III-IV
* Known with pacemaker
* Arrhythmia e.g. atrial fibrillations or flutter, Second- and third-degree atrioventricular block, sinoatrial depolarization of \< 40 or \> 160 beats per minute.
* Ongoing treatment with beta-blockers
* Severe manifest osteoporosis with multiple fractures
* Severe hypercalcemia: p-ionised calcium \> 1.70 mmol/L
B: Inclusion Criteria:

* Primary hyperparathyroidism subjected to parathyroid surgery

Exclusion Criteria:

* Renal insufficiency
* Severe osteoporosis
* Pregnancy
C: Inclusion Criteria:

1. Be diagnosed with PHPT (inappropriate PTH level in the setting of a high or high-normal serum calcium level greater than or equal to 10.0 mg/dL).
2. Have at least one of the following symptoms affecting sleep: a) not feeling refreshed on awakening b) difficulty falling asleep c) waking up during the night d) have difficulty falling back asleep at night after awakening e) waking up too early in the morning f) excessive sleepiness during the day
3. Be considered an appropriate surgical candidate.
4. Be older than 21 years of age.
5. Female participants of childbearing potential must have a negative pregnancy test (urinary or serum beta-HCG).

Exclusion Criteria:

1. Have a known major sleep disorder documented by prior diagnosis, such as: a) sleep disordered breathing b) narcolepsy c) periodic limb movement disorder d) parasomnias
2. Have any other functional tumors if they have familial Multiple Endocrine Neoplasia Syndrome 1 or 2 (MEN 1 or MEN 2).
3. Patients with a calcium level greater than 13mg/dL.
4. Patients with recent history of kidney stones.
5. Patients with recent history of pancreatitis
D: Inclusion Criteria:

* Untreated, asymptomatic pHPT
* 2.60\>S-Ca\<2.85 mmol/liter
* Age between 50 and 80 yr
* No medications interfering with Ca-metabolism
* Informed consent

Exclusion Criteria:

* Hyperparathyroid bone disease
* Previous operation in the neck
* Impaired kidney function
* Kidney stones
* Complicating medical conditions
* Psychiatric disorders
* Multiple endocrine neoplasia,
* Familial hypocalcuric hypercalcemia
* Familial HPT

Answer: C