 The proposal will address the critical question: is persisting intermittent hypoxia IH in preterm infants associated with biochemical, structural, or functional injury, and is this injury attenuated with extended caffeine treatment? This study will look at the effects of caffeine on IH in 220 preterm infants born at 30 wks gestation. Infants will be enrolled when the clinical care team is planning to stop routine caffeine within the next 5 days. Infants will be started on continuous pulse oximeter recording of O2 saturation and heart rate at enrollment, and will be randomized 110group to extended caffeine treatment or placebo beginning the next day after stopping routine caffeine treatment. Randomized infants will receive 10 mgkgday of caffeine or equal volume placebo prior to 36 wks PMA, and 10 mgkg BID twice-a-day TDD 20 mgkgor equivalent volume beginning at 36 wks PMA. Study drug will be continued until 42 weeks PMA. Pulse oximeter recordings will continue 1 additional week. Two caffeine levels will be obtained, the 1st at 37 wks, and the 2nd at home at 40-41 weeks PMA. Inflammatory biomarkers will be measured at study enrollment and again at 37-38 weeks PMA. Quantitative MRIMRS will be obtained at study enrollment and study completion. 