Reply: neonatal caffeine therapy and sleep: important findings to guide new approaches and reduce concerns.

Abstract

From the Author: We thank Dr. Araujo and colleagues for their interest in our study (1). Polysomnography involves the measurement of many physiological signals, and much can be learned about pathophysiology by studying the more subtle aspects of these signals. However, the direct clinical relevance of some of these sophisticated analyses is not clear. Hence, the American Academy of Sleep Medicine and other academic associations have defined the most relevant clinical polysomnographic parameters to be reported. The current study was designed to look for clinically meaningful differences in sleep between participants randomized to the two conditions (caffeine vs. placebo), and none were found. In addition, it should be noted that the participants had undergone detailed neurodevelopmental evaluations as part of the parent Caffeine for Apnea of Prematurity study (2, 3); these studies have shown improved function in the caffeine group, making it unlikely that subtle unmeasured abnormalities in sleep due to caffeine exposure are having significant effects on development or cortical maturation. However, further neurodevelopmental evaluations are being performed as these children become older, and if deficits are seen in the caffeine group, then further studies would be warranted.