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Browsing by Subject "Sleep initiation and maintenance disorders"
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Item Insomnia symptoms and biomarkers of monocyte activation, systemic inflammation, and coagulation in HIV: Veterans Aging Cohort Study(PLOS, 2021-02-09) Polanka, Brittanny M.; Kundu, Suman; So-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.; Medicine, School of MedicineBackground: 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.Item Mothers’ sleep deficits and cognitive performance: Moderation by stress and age(Public Library of Science, 2021-01-07) Deater-Deckard, Kirby; Chary, Mamatha; McQuillan, Maureen E.; Staples, Angela D.; Bates, John E.; Pediatrics, School of MedicineThere are well-known associations between stress, poor sleep, and cognitive deficits, but little is known about their interactive effects, which the present study explored in a sample of mothers of toddlers. Since certain types of cognitive decline start during the 20s and continue into later ages, we also explored whether mothers' age interacted with stress and sleep in the prediction of cognitive functioning. We hypothesized that poorer sleep [measured using one week of 24-hour wrist actigraphy data] and having more chronic stressors [e.g., life events, household chaos, work/family role conflict] would be linked with poorer cognitive performance [both executive function and standardized cognitive ability tasks], and that the interactive combination of poorer sleep and more stressors would account for the effect. We also explored whether this process operated differently for younger versus older women. In a socioeconomically and geographically diverse community sample of 227 women with toddler-age children [age, M = 32.73 yrs, SD = 5.15 yrs], poorer cognitive performance was predicted by greater activity during the sleep period, shorter sleep duration, and lower night-to-night consistency in sleep; it was not associated with higher levels of stress. The interactive effects hypothesis was supported for sleep activity [fragmented sleep] and sleep timing [when mothers went to bed]. The combination of more exposure to stressors and frequent night waking was particularly deleterious for older women's performance. For younger women, going to bed late was associated with poorer performance if they were experiencing high levels of stress; for those experiencing low levels of stress, going to bed late was associated with better performance.