These are cessation of breathing for 15–20 seconds, often accompanied by bradycardia. Apnoeic attacks are most commonly due to prematurity, but may accompany sepsis, hypoglycaemia, hypoxaemia, hypothermia, hyperthermia.

Clinical Features

  • Apnoea
  • Bradycardia
  • Cyanosis
  • Features of the predisposing condition.


  • Screen for sepsis – full blood count, blood culture
  • Blood glucose levels


  • Re-establish breathing by gentle stimulation. If poor response ventilate using bag and mask.
  • For apnoea of prematurity give caffeine citrate 20mg/kg orally or IV over 30 minutes. If caffeine is not available use IV aminophylline 10mg/kg over 15–30 minute. Maintenance doses should be given at 5mg/kg/day. Avoid rectal
    aminophylline; it may not achieve therapeutic levels. In all cases monitor heart rate.
  • IV fluids according to the daily needs.
  • Avoid oral feeding to prevent aspiration
  • Treat the cause if known.
  • If frequent give continuous oxygen by nasal catheter.
  • In recurrent cases continuous positive airway pressure (CPAP) may be useful. This can be done in a neonatal intensive care unit (NICU)
  • Monitor frequently.