Visuospatial Ability
In comparison to normative data, multiple studies reported average visuospatial skills in children with SDB.16-18 Reports of average performance remained consistent across multiple tests, including the Beery Visual Motor Integration System,16,42 the NEPSY32Visuospatial domain,17-18 and the McCarthy Perceptual Performance task.16,43 Few studies utilized a control group or investigated differences in visuospatial abilities across SDB severity levels. Biggs et al18 investigated differences in visuospatial ability across SDB severity levels and reported no differences. While the majority of studies on SDB and visual perception are cross-sectional, one study investigated visuospatial skills over time and reported no differences in abilities between children with resolved or unresolved SDB after three years.18
Studies that investigated associations between respiratory indices and cognition in children with SDB reported no relationship between oxygen desaturation or acute respiratory index and visuospatial abilities.18 One longitudinal study indicated that parent report of persistent sleep problems at age five years and age nine years predicted poorer scores on visuospatial tasks at age thirteen years.41 Therefore, it may be beneficial to include variables of sleep duration when investigating associations between SDB and visuospatial abilities. Understanding the impact of SDB on visuospatial skills is limited by a focus on general visuospatial constructs, rather than more detailed components of visual discrimination, form constancy, visual figure-ground, and visual closure. Additional limitations include small sample sizes,36 discrepant criteria for defining SDB and SDB severity levels, and inconsistency in measures of visual perceptual abilities across all studies.