0775 Polysomnography Characteristics of Infants Presenting with BRUE: A Single Center Experience

Abstract Introduction Brief resolved unexplained events (BRUE) commonly seen in infants, is not a specific diagnosis but a description of a sudden, brief, and now resolved episode. It includes one or more of the following presenting features: Cyanosis or pallor; absent, decreased, or irregular breathing, marked change in tone or altered level of responsiveness. Polysomnograms (PSG) are often performed as part of workup for infants presenting with BRUE. But the utility of PSGs in BRUE workup algorithm has not been well studied. Methods In this single center retrospective study, we reviewed clinical data from 100 consecutive infants (0-1 years) presenting with BRUE, of which 32 infants had PSG performed as part of workup. Results Age ranged from 12 days to 7 months: median age being 3 months. 23 out of 32 infants presented with apnea while 6 infants presented with change in color. 24 infants had obstructive sleep apnea (OSA); 3 infants had mixed sleep apnea; 3 infants had central sleep apnea (CSA) and 2 were normal. 10 infants had severe OSA, 9 had moderate OSA while 5 had mild OSA. Most common clinical diagnoses in our cohort were gastro-esophageal reflux disease (GERD) (17 infants) and laryngomalacia (8 infants). In our cohort, infants with GERD and laryngomalacia had higher AHI overall. Conclusion Though BRUE is a transient event, it is frightening to the observer leading to significant anxiety to parents. Because of the diverse presentations, causes, and prognoses of infants presenting with acute events, evaluation and management should be individualized. The clinical challenge is to identify the infants who may benefit from further testing and prolonged observation, while avoiding unnecessary testing. In our cohort, most of the infants presenting with BRUE did not undergo PSG. But among those who had PSG, it showed significant findings in infants which led to further intervention. PSG can be a useful non-invasive tool in the workup of selected infants with BRUE combined with clinical judgement. A normal PSG can also allay anxiety and be extremely reassuring for parents. Support (if any)