Background: Obstructive sleep apnea (OSA) is characterized by apnea–hypopnea during sleep. Overnight polysomnography (PSG) is usually used to detect the frequency of apneic and hypopneic events. Attention and executive deficits are commonly reported in OSA patients. Previous investigations suggested that cognitive impairments were dependent on attention deficits. However, attention is not a unitary domain and consists of different subdomains such as alertness, sustained attention, focused attention, and executive attention (impulsivity/hyperactivity). Little is known about the attention subdomains affected in OSA. Attention is commonly assessed using continuous performance tests, such as the continuous visual attention test (CVAT). Distinct variables can be derived from the CVAT. Each CVAT variable is associated with a specific attention subdomain.Objective: This study aimed to examine the variables of the CVAT that are affected by OSA and to identify the most reliable CVAT variable that distinguishes OSA from controls via discriminant analysis.Method: Patients scheduled to perform a PSG were invited to participate in this study. Immediately before the PSG, they performed the CVAT. Based on the PSG results, 27 treatment-naïve OSA patients were sampled. The same number of healthy controls were selected to match the two groups by age and gender. Five CVAT variables were examined: commission errors, omission errors, reaction time (RT), variability of reaction time (VRT), and coefficient of variability (VRT/RT).Results: ANCOVAs indicated that RT and VRT were affected by OSA. No difference in accuracy (omission and commission errors) was observed between healthy controls and OSA patients. When the VRT measurements were corrected for their respective RT values (VRT/RT), the mean difference on this coefficient did not reach significance. The discriminant analysis indicated that the two groups could be best differentiated by the RT variable.Conclusions: Attention problems, commonly observed in OSA patients, may reflect a primary problem on the alertness subdomain. The CVAT was able to detect the primary (alertness—RT parameter) and the secondary deficits (sustained attention—VRT parameter) associated with OSA. As there is no learning effect in the condition of retests, the CVAT can be used to assess the cognitive recovery in OSA patients during treatment.

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Auditory parameters in the inattention domain (OE and VRT) can discriminate ADHD from controls. For the hyperactive/impulsive domain (CE), the two modalities are equally important.

Referees and assistant referees are submitted to high physical stress during matches. Pressure to make decisions in front of large crowds is another potential stressor. These two stressors can impair attention executive control, depending on physical fitness and individual vulnerability or resilience to situational pressure. Error percentage for referees and assistants may reach around 14% during a soccer match. Although previous studies have suggested that soccer referees and assistants should take cognitive assessments, they are only required by Fédération Internationale de Football Association (FIFA) to demonstrate knowledge of the rules and pass annually in a fitness test (FIFA-Test). This study aimed to assess attention performance in referees and assistants before and after the mandatory FIFA-Test. It is hypothesized that the high physical demands associated with the pressure to pass the FIFA-Test would interfere with attention performance. The sample included 33 referees and 20 assistants. The Continuous Visual Attention Test (CVAT) consisted of a 15-min Go/No-go task. Performance in the CVAT is based on four variables: omission and commission errors, reaction time, and variability of reaction time (VRT). Failure in the CVAT was defined by a performance below the 5th percentile of the age- and sex-matched normative data in at least one variable of the CVAT. Before the FIFA-Test all participants performed the CVAT. The second CVAT began 3–7 min directly following completion of the FIFA-test. Considering only the officials who passed both the FIFA-Test and the first CVAT (19 referees and 15 assistants), 44% (9 referees and 6 assistants) exhibited a performance decline in the second CVAT. A significant increase in VRT was found after the high intensity exercise. As increase in VRT is thought to reflect executive dysfunctions and lapses of attention, we concluded that physical fitness alone may not be enough to help officials cope with the physical and contextual stresses associated with the FIFA-Test. These data suggest that over 35% of soccer referees and their assistants who were considered physically able to referee matches may not be mentally prepared for the attentional demands of refereeing soccer matches.

The relationship between handedness and attentional performance is poorly understood. Continuous performance tests (CPTs) using visual stimuli are commonly used to assess subjects suffering from attention deficit hyperactivity disorder (ADHD). However, auditory CPTs are considered more useful than visual ones to evaluate classroom attentional problems. A previous study reported that there was a significant effect of handedness on students’ performance on a visual CPT. Here, we examined whether handedness would also affect CPT performance using only auditory stimuli. From an initial sample of 337 students, 11 matched pairs were selected. Repeated ANOVAs showed a significant effect of handedness on attentional performance that was exhibited even in the control group. Left-handers made more commission errors than right-handers. The results were interpreted considering that the association between ADHD and handedness reflects that consistent left-handers are less lateralized and have decreased interhemispheric connections. Auditory attentional data suggest that left-handers have problems in the impulsive/hyperactivity domain. In ADHD, clinical therapeutics and rehabilitation must take handedness into account because consistent sinistrals are more impulsive than dextrals.