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HomePreventative MedicineCorporate bosses risk cardio-metabolic health from lack of sleep – UCT study

Corporate bosses risk cardio-metabolic health from lack of sleep – UCT study

A recent study has confirmed that four years of consistently inadequate sleep for corporate executives was associated with adverse cardio-metabolic health.

The research, led by Paula Pienaar, a PhD candidate at the University of Cape Town, and Vrije Universiteit Amsterdam in The Netherlands, analysed annual health risk assessment data of more than 1 500 senior managers and executive directors of South African companies collected over four years.

“Corporate executives are exposed to a particularly competitive, high-pressured work environment,” said Pienaar.

“Under constant pressure to perform, sleep is one area of their lives that is often compromised. This is somewhat ironic since daytime fatigue resulting from poor sleep strongly influences employees’ work quality and productivity.

“We now know that sleeping less than the recommended seven to nine hours increases risk for lifestyle diseases, including obesity, cardiovascular disease and the metabolic condition of type 2 diabetes – known collectively as cardio-metabolic diseases.”

For the study, which was published in Preventive Medicine journal, clinical measurements were obtained during annual corporate health risk assessments, including body mass index (BMI), waist circumference, blood pressure, fasting blood glucose and lipid measures.

These health indicators were also used to calculate a global cardio-metabolic disease risk score, such that a higher score indicated a less favourable cardio-metabolic disease profile.

The study also accounted for potential confounding factors such as hours worked weekly, daily commuting time, absenteeism, depression, anxiety, stress, physical activity, smoking and alcohol consumption.

The paper found that one in four executives had central obesity, one in five had raised blood glucose levels, and 42% had elevated blood pressure.

Based on these findings, said Pienaar, the need to better understand their risk for lifestyle-related diseases is warranted.

“Moreover, with an average sleep duration of seven hours, and statistics revealing that at least one in five of these executives reported less than seven hours of sleep, it was clear that investigating the impact of their sleep on health outcomes could address the current gaps existing in the field of corporate sleep research and provide the opportunity to make a significant contribution to workplace health promotion programmes in South Africa and abroad,” Pienaar said.

The main findings of the study revealed that consistently reporting shorter sleep durations over a four-year period was associated with two important risk factors for cardio-metabolic disease – BMI (a marker of obesity) and waist circumference (a measure of central obesity).

Intriguingly, this relationship differed between men and women. For male executives, shorter sleep was consistently associated with a higher risk for obesity (as evidenced by higher BMI and waist circumference values) as well as higher global cardio-metabolic disease risk scores.

While female executives reporting a shorter sleep duration appeared to be more vulnerable to obesity (higher BMI), this association disappeared when lifestyle factors were taken into account.

This suggested lifestyle factors like physical activity, smoking and alcohol consumption, might have a more significant impact on obesity risk among female corporates than sleep duration alone.

Taking a closer look at the work life of the study participants, Pienaar said it became apparent that extended working hours (defined as more than 60 hours per week) emerged as the key occupational factor connecting insufficient sleep duration to an elevated risk of cardio-metabolic disease.

She said it was plausible that the corporate work culture, particularly the attitude towards sleep health, had many executives feeling compelled to work long hours to demonstrate commitment and dedication. This, in turn, resulted in compromised sleep duration.

The study authors advocated for organisations to foster discussions promoting a healthier workplace culture and attitude toward sleep.

“Our findings emphasise the significance of adequate sleep in preventing future cardio-metabolic disease, ultimately maintaining the health and well-being of corporate executives. In a demanding work environment, ensuring that employees have sufficient high-quality sleep is crucial for both individual health and workplace productivity.”

Study details

Longitudinal associations between self-reported sleep duration and cardio-metabolic disease risk in corporate executives

Paula Pienaar, Laura Roden, Cécile Boot, Willem van Mechelen, Jos Twisk, Estelle Lambert, Dale Rae.

Published in Preventive Medicine in October 2023.


This study aimed to determine the longitudinal associations between self-reported sleep duration and cardio-metabolic disease (CMD) risk in corporate executives.

Self-reported sleep duration and lifestyle, occupational, psychological, and anthropometrical, blood pressure and blood marker variables were obtained from 1512 employees at annual health risk assessments in South Africa between 2016 and 2019. Gender-stratified linear mixed models, adjusting for age, lifestyle, occupational and psychological covariates were used to explore these longitudinal associations.

Among women, shorter sleep duration was associated with higher body mass index (BMI) co-varying for age only (ß with 95% confidence intervals: −0.19 [−0.36, −0.03]), age and occupational factors (−0.20 [−0.36, −0.03]) and age and psychological factors (−0.20 [−0.37, −0.03]). Among men, shorter sleep was associated with both BMI and waist circumference (WC) covarying for age only (BMI: −0.15 [−0.22; −0.08]; WC: −0.62 [−0.88; −0.37]); age and lifestyle factors (BMI: −0.12 [−0.21; −0.04]); WC: −0.016 [−0.92; −0.29], age and occupational factors (BMI: −0.20 [−0.22; 0.08]; WC: −0.62 [−0.88; −0.36]), and age and psychological factors (BMI: −0.15 [−0.22; −0.07]; WC: −0.59 [−0.86; −0.33]). Among men, shorter sleep was also longitudinally associated with higher CMD risk scores in models adjusted for age and lifestyle factors (CMD: −0.12 [−0.20; −0.04]) and age and psychological factors (CMD: −0.08 [−0.15; −0.01]).

Corporate executives who report shorter sleep durations may present with poorer CMD risk profiles, independent of age, lifestyle, occupational and psychological factors. Addressing sleep health in workplace health programmes may help mitigate the development of CMD in such employees.


Preventive Medicine article – Longitudinal associations between self-reported sleep duration and cardio-metabolic disease risk in corporate executives (Creative Commons Licence)


See more from MedicalBrief archives:


Not enough night-time sleep linked to clogged arteries – Swedish study


Sleep health problems significantly increase heart disease risk – South Florida University


Work stress and impaired sleep linked to 3x higher CVD risk










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