Sleep-disordered breathing is a risk factor for hypertension, cardiovascular disease and accidents in the general population, but little is known about this correlation among professional truck drivers. To examine the relationships of sleep-disordered breathing with blood pressure levels and excessive daytime sleepiness among truck drivers, we conducted a population-based cross-sectional study of 1,313 subjects aged 20-69 years registered in the Japanese Trucking Association. The 3% oxygen desaturation index was selected as an indicator of sleep-disordered breathing, representing the number of desaturation events per hour of recording time in which blood oxygen fell by > or = 3% by overnight pulse oximetry. The Epworth Sleepiness Scale was used to estimate excessive daytime sleepiness. There were significant positive associations between the 3% oxygen desaturation index levels and both diastolic blood pressure levels and Epworth Sleepiness Scale scores. The multivariate odds ratio of hypertension was 2.0 (1.1-3.6) for a 3% oxygen desaturation index of > or = 15 in reference with a 3% oxygen desaturation index of <5. This association was more evident among those aged > or = 40 years and overweight subjects. Further, the multivariate odds ratio of an Epworth Sleepiness Scale of > or = 11 was 2.3 (1.1-4.9) for a 3% oxygen desaturation index of > or =15 in reference with a 3% oxygen desaturation index of <5. This association was more evident among those aged > or =40 years. The associations of sleep-disordered breathing severity with diastolic blood pressure levels and excessive daytime sleepiness suggest the need for sleep-disordered breathing screening among truck drivers for prevention of hypertension and potential traffic accidents.