[Usefulness of the Brouillette index in the diagnosis of obstructive sleep apnea syndrome in children]

Abstract

Aim: Polygraphy enables differentiation between primary snoring and obstructive sleep apnea syndrome (OSAS). A clinical score (Brouillette Index) has been proposed that could be useful in classifying children suspected of suffering from this disorder and in reducing the number of polysomnographic studies.

Patients and methods: We evaluated 192 consecutive children with adenoton-sillar hypertrophy and with no craniofacial abnormalities or other associated diseases referred to our pediatric respiratory clinic for suspected OSAS. The Brouillette Index (BI) was used to classify the patients into a) non-OSAS (BI < neg 1), b) uncertain OSAS (BI between neg 1 and 3.5 and c) OSAS (BI > 3.5). For the polygraphic diagnosis we analyzed two different criteria for differentiating between OSAS and primary snoring: a respiratory distress index (RDI) >= 3 or >= 5.

Results: The BI correctly classified only 23% of the patients with suspected OSAS. In the great majority of the children, polysomnographic monitoring was needed to differentiate between OSAS and primary snoring. In one group of children (10.9% or 6.4% depending on the diagnostic criteria), the BI would have led to incorrect classification.

Conclusions: The BI is not an efficient tool for discriminating between primary snoring and OSAS in an outpatient pediatric respiratory clinic.