Background: Apnea of prematurity is a common disorder of respiratory control in infants borno34 weeks gestation. Methylxanthines are frequently prescribed for this condition. The Neonatal Cochrane Review Group has produced multiple systematic reviews of xanthine therapy in preterm infants. Objectives: To determine if a broad systematic review of xanthines for apnea of prematurity is needed. Methods: We searched the Cochrane Database of Systematic Reviews for reviews of xanthines in preterm infants. For each review we recorded the (1) total number of included studies; (2) median number of studies per outcome; and (3) total number of included patients. Results: We found eight pertinent reviews. They distinguish between types of xanthines and indications. The number of (1) studies per review, (2) studies per outcome, and (3) patients per review were small (Table). Conclusions: We question the ‘splitting’ approach of the Cochrane reviewers to this topic. The early onset of apnea of prematurity and the near-certainty of its occurrence in very preterm infants make the distinction between prophylactic and therapeutic use of xanthines questionable. Extubation failures are often caused by apnea. The pharmacodynamics of methylxanthines are sufficiently similar to obviate the need for separate reviews for the different types of xanthines. A broad systematic review of methylxanthines for apnea of prematurity is needed and may lead to more precise and clinically meaningful estimates of treatment benefits and risks.