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.