Tottenham Hotspur have dominated possession at the Stadium of Light but find themselves behind to a John O'Shea strike at the interval.
Sunderland were on the defensive from the outset, with Gareth Bale looking dangerous in the opening stages.
Emmanuel Adebayor was guilty of missing a pair of gilt-edged chances for the visitors, most notably hitting the bar from close range after a mistake from Carlos Cuellar.
Against the run of the play the Mackems took the lead just before the break when they took full advantage of an inviting set piece.
Spurs failed to clear a curling free kick from Sebastian Larsson, which fell to Steven Fletcher. The Scot had his shot well saved by Hugo Lloris but the rebound fell to O'Shea, who was on hand to slot home the opening goal.
Bale looked to orchestrate a quick response but Sunderland held firm and head into the break with a slender advantage.