Brittanny M Polanka1, Suman Kundu2, Kaku A So-Armah3, Matthew S Freiberg2, Samir K Gupta4, Tamika C B Zapolski5, Adam T Hirsh5, Roger J Bedimo6, Matthew J Budoff7, Adeel A Butt8,9,10, Chung-Chou H Chang11, Stephen S Gottlieb12, Vincent C Marconi13,14,15, Julie A Womack16,17, Jesse C Stewart5. 1. Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America. 2. Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America. 3. Division of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America. 4. Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America. 5. Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, United States of America. 6. Division of Infectious Diseases, VA North Texas Healthcare System, Dallas, Texas, United States of America. 7. Lundquist Institute, Torrance, California, United States of America. 8. VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States of America. 9. Weill Cornell Medical College, Doha, Qatar, and New York City, New York, United States of America. 10. Hamad Medical Corp, Doha, Qatar. 11. Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America. 12. Department of Medicine, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, Maryland, United States of America. 13. Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America. 14. Atlanta VA Medical Center, Atlanta, Georgia, United States of America. 15. Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, Unites States of America. 16. VA Connecticut Healthcare System, West Haven, Connecticut, United States of America. 17. Yale University School of Nursing, West Haven, Connecticut, United States of America.
Abstract
BACKGROUND: Insomnia may be a risk factor for cardiovascular disease in HIV (HIV-CVD); however, mechanisms have yet to be elucidated. METHODS: We examined cross-sectional associations of insomnia symptoms with biological mechanisms of HIV-CVD (immune activation, systemic inflammation, and coagulation) among 1,542 people with HIV from the Veterans Aging Cohort Study (VACS) Biomarker Cohort. Past-month insomnia symptoms were assessed by the item, "Difficulty falling or staying asleep?," with the following response options: "I do not have this symptom" or "I have this symptom and…" "it doesn't bother me," "it bothers me a little," "it bothers me," "it bothers me a lot." Circulating levels of the monocyte activation marker soluble CD14 (sCD14), inflammatory marker interleukin-6 (IL-6), and coagulation marker D-dimer were determined from blood specimens. Demographic- and fully-adjusted (CVD risk factors, potential confounders, HIV-related factors) regression models were constructed, with log-transformed biomarker variables as the outcomes. We present the exponentiated regression coefficient (exp[b]) and its 95% confidence interval (CI). RESULTS: We observed no significant associations between insomnia symptoms and sCD14 or IL-6. For D-dimer, veterans in the "Bothers a Lot" group had, on average, 17% higher D-dimer than veterans in the "No Difficulty Falling or Staying Asleep" group in the demographic-adjusted model (exp[b] = 1.17, 95%CI = 1.01-1.37, p = .04). This association was nonsignificant in the fully-adjusted model (exp[b] = 1.09, 95%CI = 0.94-1.26, p = .27). CONCLUSION: We observed little evidence of relationships between insomnia symptoms and markers of biological mechanisms of HIV-CVD. Other mechanisms may be responsible for the insomnia-CVD relationship in HIV; however, future studies with comprehensive assessments of insomnia symptoms are warranted.
BACKGROUND: Insomnia may be a risk factor for cardiovascular disease in HIV (HIV-CVD); however, mechanisms have yet to be elucidated. METHODS: We examined cross-sectional associations of insomnia symptoms with biological mechanisms of HIV-CVD (immune activation, systemic inflammation, and coagulation) among 1,542 people with HIV from the Veterans Aging Cohort Study (VACS) Biomarker Cohort. Past-month insomnia symptoms were assessed by the item, "Difficulty falling or staying asleep?," with the following response options: "I do not have this symptom" or "I have this symptom and…" "it doesn't bother me," "it bothers me a little," "it bothers me," "it bothers me a lot." Circulating levels of the monocyte activation marker soluble CD14 (sCD14), inflammatory marker interleukin-6 (IL-6), and coagulation marker D-dimer were determined from blood specimens. Demographic- and fully-adjusted (CVD risk factors, potential confounders, HIV-related factors) regression models were constructed, with log-transformed biomarker variables as the outcomes. We present the exponentiated regression coefficient (exp[b]) and its 95% confidence interval (CI). RESULTS: We observed no significant associations between insomnia symptoms and sCD14 or IL-6. For D-dimer, veterans in the "Bothers a Lot" group had, on average, 17% higher D-dimer than veterans in the "No Difficulty Falling or Staying Asleep" group in the demographic-adjusted model (exp[b] = 1.17, 95%CI = 1.01-1.37, p = .04). This association was nonsignificant in the fully-adjusted model (exp[b] = 1.09, 95%CI = 0.94-1.26, p = .27). CONCLUSION: We observed little evidence of relationships between insomnia symptoms and markers of biological mechanisms of HIV-CVD. Other mechanisms may be responsible for the insomnia-CVD relationship in HIV; however, future studies with comprehensive assessments of insomnia symptoms are warranted.
Authors: Hazel Everitt; Lisa McDermott; Geraldine Leydon; Harvey Yules; David Baldwin; Paul Little Journal: Br J Gen Pract Date: 2014-02 Impact factor: 5.386
Authors: Karen A Matthews; Huiyong Zheng; Howard M Kravitz; MaryFran Sowers; Joyce T Bromberger; Daniel J Buysse; Jane F Owens; Mark Sanders; Martica Hall Journal: Sleep Date: 2010-12 Impact factor: 5.849
Authors: Shia T Kent; Greer A Burkholder; Gabriel S Tajeu; E Turner Overton; Paul Muntner Journal: Curr Hypertens Rep Date: 2015-11 Impact factor: 5.369
Authors: Matthew S Freiberg; Chung-Chou H Chang; Lewis H Kuller; Melissa Skanderson; Elliott Lowy; Kevin L Kraemer; Adeel A Butt; Matthew Bidwell Goetz; David Leaf; Kris Ann Oursler; David Rimland; Maria Rodriguez Barradas; Sheldon Brown; Cynthia Gibert; Kathy McGinnis; Kristina Crothers; Jason Sico; Heidi Crane; Alberta Warner; Stephen Gottlieb; John Gottdiener; Russell P Tracy; Matthew Budoff; Courtney Watson; Kaku A Armah; Donna Doebler; Kendall Bryant; Amy C Justice Journal: JAMA Intern Med Date: 2013-04-22 Impact factor: 21.873
Authors: Daniel J Taylor; Allison K Wilkerson; Kristi E Pruiksma; Jacob M Williams; Camilo J Ruggero; Willie Hale; Jim Mintz; Katherine Marczyk Organek; Karin L Nicholson; Brett T Litz; Stacey Young-McCaughan; Katherine A Dondanville; Elisa V Borah; Antoinette Brundige; Alan L Peterson Journal: J Clin Sleep Med Date: 2018-03-15 Impact factor: 4.062
Authors: Adam Trickey; Margaret T May; Janne Vehreschild; Niels Obel; Michael John Gill; Heidi Crane; Christoph Boesecke; Hasina Samji; Sophie Grabar; Charles Cazanave; Matthias Cavassini; Leah Shepherd; Antonella d'Arminio Monforte; Colette Smit; Michael Saag; Fiona Lampe; Vicky Hernando; Marta Montero; Robert Zangerle; Amy C Justice; Timothy Sterling; Jose Miro; Suzanne Ingle; Jonathan A C Sterne Journal: PLoS One Date: 2016-08-15 Impact factor: 3.240
Authors: Leonard Ngarka; Joseph Nelson Siewe Fodjo; Esraa Aly; Willias Masocha; Alfred K Njamnshi Journal: Front Immunol Date: 2022-01-13 Impact factor: 8.786