apnea vs periodic breathing

Periodic breathing is a physiologic breathing pattern characterized by pauses of 5-10 seconds in breathing followed by rapid, shallow breaths. Without stimulation or intervention, a regular rhythm of breathing resumes after several cycles of periodic breathing, as in this patient.

This benign breathing pattern is thought to be secondary to recurrent central apnea due to immaturity of the nervous system in infants up to age 6 months. There is no associated cyanosis, change in tone, or abnormal limb/eye movements. In addition, signs of respiratory distress, such as retractions, nasal flaring, and persistent tachypnea, are not present in infants with periodic breathing. The irregular breathing pattern and brief pauses in breathing may cause alarm in caregivers; reassurance is indicated.

Apnea of prematurity is characterized by true apnea and pauses in breathing lasting ≥20 seconds; it typically resolves by a corrected gestational age of 37 weeks (ie, at 1 week of life for a 36-week gestation infant). This infant's pauses in breathing are brief (occurring several times per minute), and his age makes apnea of prematurity unlikely.