Attention
Attention is broken down into components of selective attention, which reflects our ability to focus on particular events, divided attention, which refers to our ability to attend to two stimuli simultaneously, and sustained attention, which refers to our ability to focus on activities for a long period of time.44 In comparison to normative data, studies reported average simple attention16,41 and below average sustained attention9,16,20 for children with SDB. Studies that measured sustained attention with continuous performance tasks reported borderline impaired overall performance19 and 30% more errors of commission.20 Studies that differentiated between auditory and visual attention reported below average scores in auditory attention20 and low average20 to average11,17 scores in visual attention. Limited research has investigated SDB severity level on simple and sustained attention. Hunter et al11reported no attentional differences among snoring children, children with mild SDB, or children with moderate to severe SDB. More research is required to explore the effects of SDB severity on attentional capacities, both globally and more specifically.
There has been limited research on the association between respiratory characteristics and attention. Chervin45 reported no associations between attention problems and SDB status or PSG assessment characteristics. In contrast, Christiansz et al46reported significant associations between attention and respiratory parameters, such as slow wave activity (SWA), which is a sensitive indicator of sleep disruption. Higher levels of SWA were associated with an increase in percentage of sustained attention errors.46
Discrepancies in the research on attention and SDB are likely influenced by small sample sizes,16,20 lack of control groups,16,20 differences in definitions of SDB and SDB severity level, and variations between community based11,17,19 and clinic based6,20,46 referrals. In addition, different measures of attention were implemented across the majority of studies, making it difficult to effectively compare results.