For a study, researchers sought to compare automatic and manual inspired oxygen regulation in terms of the frequency and length of extreme low and high SpO2 episodes. A cohort from prospective randomized cross-over experiments that have undergone posthoc analysis. A total of 7 neonatal intensive care units with tertiary care. An automated versus manual oxygen control cross-over trial involved 58 preterm neonates (32 or fewer weeks PMA) receiving respiratory care and supplementary oxygen. Extreme hypoxemia was described as having a SpO2 below 80%, and extreme hyperoxemia as having a SpO2 above 98%. Episode length was divided into 5 categories: less than 5 seconds, between 5 and 30 seconds, between 30 and 60 seconds, between 60 and 120 seconds, and more than 120 seconds. The newborns were essentially getting non-invasive respiratory support and had a median FiO2 of 0.28 (0.25-0.32) at a postmenstrual age of 29 (28-31) weeks (83%). While most episodes were under 30 seconds, lengthier episodes significantly reduced the overall exposure time to extremes. In each of the 3 episodes with the longest-running times (30, 60, and 120 seconds), the timing discrepancies were significantly more minor under automated management than under manual control (P<0.001). The incidents lasting at least 60 seconds showed a reduction in total time spent at the extremes between automated and manual management of nearly two-thirds (3.8 to 2.1% for SpO2 80% and 3.0 to 1.6% for SpO2>98%). This study demonstrated that, regardless of manual or automated control, most SpO2 severe events seen by preterm newborns are brief. However, the infrequent longer episodes not only contribute the most to the overall exposure but also improve with automated control due to their decreased frequency.