Caffeine has emerged as preferred pharmacological treatment for AOP and is widely used in neonatal intensive care units. It has shown to reduce the duration of mechanical ventilation, lower risk of bronchopulmonary dysplasia, and improve neurodevelopment outcomes. Despite its efficacy, there is lack of consensus regarding optimal duration of caffeine therapy.

Clinical practises vary regarding when to discontinue caffeine therapy. Some units advocate for extended use until infants reach 34-35 weeks post menstrual age (PMA) or beyond, while others opt for early discontinuation after seven consecutive apnea-free days. The decision to stop caffeine is often based on decreasing risk of AOP as PMA increases.

Extending caffeine therapy may reduce the risk of apnea recurrence however, prolonged use comes with challenges such as tachycardia, feed intolerance, and reduced weight gain. Additionally, keeping infants on caffeine until a certain PMA threshold may prolong hospital stays and increase care costs.

Conversely, a shorter course of caffeine therapy may heighten the risk of apnea recurrence, necessitating a balance between the benefits and potential drawbacks of continued caffeine use. Existing literature on duration of caffeine therapy and its impact on AOP recurrences limited, with few controlled trials addressing this issue.

Our study aims to address this gap by comparing the recurrence of AOP between two groups : Group 1, where caffeine is discontinued at 32 weeks PMA, and group 2 where caffeine is continued till fixed period of 34 week sand stopped. This research will contribute to a better understanding of optimal caffeine management in preterm infants and guide clinical decision making regarding AOP treatment duration.