Insomnia symptoms and biomarkers of monocyte activation, systemic inflammation, and coagulation in HIV: Veterans Aging Cohort Study

Brittanny M. Polanka, Suman Kundu, Kaku A. So-Armah, Matthew S. Freiberg, Samir K. Gupta, Tamika C.B. Zapolski, Adam T. Hirsh, Roger J. Bedimo, Matthew J. Budoff, Adeel A. Butt, Chung Chou H. Chang, Stephen S. Gottlieb, Vincent C. Marconi, Julie A. Womack, Jesse C. Stewart

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


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 demographicadjusted 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.

Original languageEnglish (US)
Article numbere0246073
JournalPloS one
Issue number2 February
StatePublished - Feb 2021
Externally publishedYes

ASJC Scopus subject areas

  • General


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