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Original research
Relationship between sleep disorders, HIV status and cardiovascular risk: cross-sectional study of long-haul truck drivers from Southern Africa
  1. Johanna Roche1,
  2. Alinda G Vos2,3,
  3. Samanta T Lalla-Edward3,
  4. W D Francois Venter3,
  5. Karine Scheuermaier1
  1. 1Wits Sleep Lab, Brain Function Research Group, School of Physiology, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
  2. 2Julius Global Health, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
  3. 3Ezintsha, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
  1. Correspondence to Dr Johanna Roche, Wits Sleep Lab, Brain Function Research Group, School of Physiology, University of the Witwatersrand Faculty of Health Sciences, Johannesburg 2193, South Africa; johanna.roche{at}


Objectives Long-haul truck drivers (TDs) may have lifestyles that promote cardiovascular disease (CVD), including diet, sleep and activity issues. Most studies conducted among truckers investigated the relationship between poor sleep and cardiometabolic health, but none assessed whether suspected obstructive sleep apnoea (OSA) and shortened sleep were associated with markers of cardiometabolic risk. We determined whether sleep disorders and circadian misalignment were associated with chronic inflammation and CVD risk in TDs from Southern Africa.

Methods Participants were recruited at roadside wellness centres in Gauteng and Free State Provinces, South Africa. OSA risk was assessed using the Berlin Questionnaire, while sleep duration and sleep quality were assessed using items from the Pittsburgh Sleep Quality Index. Clinical information, neck circumference (NC), metabolic profile, elevated BP, HIV status and C-reactive protein (CRP) were collected. CVD risk was assessed using the Framingham Risk Score (FRS).

Results Out of 575 participants aged on average 37.7 years, 17.2% were at OSA risk, 72.0% had elevated BP, 9.4% had HIV and 28.0% were obese. Mean sleep duration was 7.4±1.8 hours, and 49.6% reported working night shift at least once a week. Shortened sleep, OSA risk, age, body mass index, NC and years as full-time TD were associated with greater FRS independently of HIV status and night shift. Working night shift was associated with higher CRP levels in HIV+ compared with HIV− participants.

Conclusions Circadian misalignment in HIV, and OSA and short sleep duration in all truckers were associated with increased CVD risk. Truckers should be given careful attention in terms of health management and sleep education.

  • occupational health
  • sleep
  • shift work schedule
  • transportation
  • ethnic groups

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  • Twitter @Roche_Johanna, @Lalla-Edward

  • Contributors Conceptualisation: all authors; data curation and analyses: JR and KS; funding acquisition: WDFV, AGV and STL-E; investigation: WDFV, AGV and STL-E; project administration: AGV and STL-E; writing – original draft: JR; writing – review and editing: all authors.

  • Funding This work was funded by North Star Alliance through a research and implementation grant received from the Ministry of Foreign Affairs of the Netherlands, managed by the Royal Dutch Embassy of Mozambique. The Amsterdam Institute for Global Health and Development (AIGHD) and Wits Reproductive Health and HIV Institute (WRHI) held separate contracts with North Star Alliance (AIGHD’s grant reference: 0068 North Star Alliance – North South Corridor Demonstration Project (NSCDP); WRHI’s grant number: D1404070). JR received a postdoctoral research fellowship from the University Research Council of the University of the Witwatersrand, Johannesburg, South Africa.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Research Ethics Committee of the University of the Witwatersrand (reference number M160760).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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