What typically triggers episodes of apnea in premature infants?

Episodes of apnea in premature infants are most commonly triggered by breathing irregularities during REM sleep. During this sleep phase, infants experience fluctuations in their breathing patterns, which can lead to pauses in respiration. Premature infants, due to immature central nervous system development, often have an underdeveloped ability to regulate their breathing rhythm. These irregularities can result in a cessation of breathing for more than 20 seconds or shorter pauses accompanied by bradycardia or oxygen desaturation.

While physical activity and excessive coughing can influence breathing in infants, they are not typical triggers for apnea. Volume overload, particularly in relation to fluid management, can lead to respiratory distress or other complications but is less directly associated with apnea episodes itself compared to the impact of REM sleep breathing irregularities.