Navigate Up

Heart Center - A-Z Index


Print This Page

Apnea of prematurity

Apnea is breathing that slows down or stops from any cause. Apnea of prematurity refers to short episodes of stopped breathing in babies who were born before they were due.

Alternative Names

Apnea - newborns; AOP; As and Bs; Blue spell - newborns; Dusky spell - newborns; Spell - newborns


There are several reasons why newborns, in particular those who were born early, may have apnea, including:

  • Their brain is not fully developed
  • The muscles that keep the airway open are weak

Other stresses in a sick or premature baby may worsen apnea, including:

  • Anemia
  • Feeding problems
  • Heart or lung problems
  • Infection
  • Low oxygen levels
  • Overstimulation
  • Temperature problems


Newborns, especially preemies, often have an irregular breathing pattern.

These babies will have short episodes (5 - 10 seconds) of either shallow breathing or stopped breathing (apnea). These episodes are followed by periods of normal breathing.

When there is very shallow or no breathing (apnea), the baby may also have a drop in heart rate. This heart rate drop is called bradycardia.

Some babies may also have poor color and an ill-looking appearance. Apnea episodes that last longer than 20 seconds are considered serious.

Exams and Tests

Most preterm and some sick full-term babies have some degree of apnea so, these babies are hooked up to monitors in the hospital. The monitors keep track of their breathing, heart rate, and oxygen levels. Apnea or a drop in heart rate can set off the alarms on these monitors.


How apnea is treated depends on the cause, how often the breathing stops, and the severity of spells. Babies who appear to be otherwise healthy and have few spells per day are simply watched. They can be gently stimulated during periods when breathing stops.

Babies who are well, but who have many episodes in which they stop breathing, may be given a caffeine preparation to help stimulate their breathing. Sometimes the nurse will suction children with apnea, change their position, or use a bag and mask to help them breathe.

Proper positioning, slower feeding time, oxygen, and (in extreme cases) a breathing machine may be needed to assist in breathing.

Studies have not been able to show a benefit to putting babies on home monitors, so these monitors are not used very often anymore.

Outlook (Prognosis)

Apnea is common in premature babies. Most babies have normal outcomes. Although mild apnea is not thought to have long-term effects. However, most doctors feel that preventing multiple or severe episodes is better for the baby over the long-term.

Apnea episodes that began after the second week of life or that last longer than 20 seconds are considered more serious.

Apnea of prematurity usually goes away by the baby's 36th week.


Miller MJ, Martin MJ. Pathophysiology of apnea of prematurity. In: Polin RA, Fox WW, Abman SH. eds. Fetal and Neonatal Physiology. 4th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 91.

Carlo WA. Apnea. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 95.2.

Updated: 12/4/2013

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

¬©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

Pittsburgh, PA, USA