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Periodic Breathing

Periodic Breathing is a topic covered in the 5-Minute Pediatric Consult.

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  • A respiratory pattern consisting of regular oscillations in breathing amplitude
  • Typically, a respiratory pattern in which ≥3 apneas lasting ≥3 seconds occur, separated by <20 seconds of respiration
Don’t confuse periodic breathing with obstructive and/or central apnea.


  • Usually absent in the first 48 hours of life
  • More frequent during rapid eye movement (REM or active) sleep versus non-REM (quiet) sleep
  • Less common in prone versus supine position
  • In full-term infants
    • Amount of periodic breathing usually <4% of total sleep time
    • Amount gradually decreases through the 1st year of life.
    • By 1 year of age, the mean amount of periodic breathing is <1% of total sleep time.
  • In premature infants
    • Amount of periodic breathing is higher than in full-term infants.
    • Amount correlates inversely with gestational age.


  • No common pathologic finding
  • Abnormalities, when they exist, are related to the underlying disorder causing the periodic breathing.


  • Periodic breathing can be seen in healthy infants, children, and adults.
  • Abnormalities, in any component of the breathing control system, may result in an increased amount of periodic breathing.
  • Possible etiologies
    • A delay in detecting changes in blood gas values by the chemoreceptors
    • Increased chemoreceptor gain

Commonly Associated Conditions

  • Periodic breathing in infants is associated with the following:
    • Apnea of prematurity or infancy
    • Familial history of sudden infant death syndrome (SIDS)
    • Anemia of prematurity
    • Hypoxemia
    • Hypochloremic alkalosis
  • Periodic breathing with adults is associated with the following:
    • Cardiac abnormalities (especially congestive heart failure [CHF])
    • Neurologic dysfunction (meningitis, encephalitis, brainstem dysfunction)
    • Exposure to high altitudes

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Cabana, Michael D., editor. "Periodic Breathing." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617344/all/Periodic_Breathing.
Periodic Breathing. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617344/all/Periodic_Breathing. Accessed April 26, 2019.
Periodic Breathing. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617344/all/Periodic_Breathing
Periodic Breathing [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 26]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617344/all/Periodic_Breathing.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Periodic Breathing ID - 617344 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617344/all/Periodic_Breathing PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -