Polanka, Brittanny M.Kundu, SumanSo-Armah, Kaku A.Freiberg, Matthew S.Gupta, Samir K.Zapolski, Tamika C. B.Hirsh, Adam T.Bedimo, Roger J.Budoff, Matthew J.Butt, Adeel A.Chang, Chung-Chou H.Gottlieb, Stephen S.Marconi, Vincent C.Womack, Julie A.Stewart, Jesse C.2022-05-232022-05-232021-02-09Polanka BM, Kundu S, So-Armah KA, et al. Insomnia symptoms and biomarkers of monocyte activation, systemic inflammation, and coagulation in HIV: Veterans Aging Cohort Study. PLoS One. 2021;16(2):e0246073. Published 2021 Feb 9. doi:10.1371/journal.pone.0246073https://hdl.handle.net/1805/29125Background: 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.en-USCC0 1.0 UniversalSleep initiation and maintenance disordersHIV infectionsInterleukin-6Lipopolysaccharide receptorsArticle