{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T15:23:34Z","timestamp":1793892214398,"version":"4.8.0"},"reference-count":62,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL126557"],"award-info":[{"award-number":["R01HL126557"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute on Alcohol Abuse and Alcoholism and Veterans Health Administration Public Health Strategic Health Core Group","award":["U10AA13566"],"award-info":[{"award-number":["U10AA13566"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Insomnia may be a risk factor for cardiovascular disease in HIV (HIV-CVD); however, mechanisms have yet to be elucidated.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>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, \u201cDifficulty falling or staying asleep?,\u201d with the following response options: \u201cI do not have this symptom\u201d or \u201cI have this symptom and\u2026\u201d \u201cit doesn\u2019t bother me,\u201d \u201cit bothers me a little,\u201d \u201cit bothers me,\u201d \u201cit bothers me a lot.\u201d 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 (<jats:italic>CI<\/jats:italic>).<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>We observed no significant associations between insomnia symptoms and sCD14 or IL-6. For D-dimer, veterans in the \u201cBothers a Lot\u201d group had, on average, 17% higher D-dimer than veterans in the \u201cNo Difficulty Falling or Staying Asleep\u201d group in the demographic-adjusted model (exp[b] = 1.17, 95%<jats:italic>CI<\/jats:italic>= 1.01\u20131.37,<jats:italic>p<\/jats:italic>= .04). This association was nonsignificant in the fully-adjusted model (exp[b] = 1.09, 95%<jats:italic>CI<\/jats:italic>= 0.94\u20131.26,<jats:italic>p<\/jats:italic>= .27).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0246073","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T01:24:53Z","timestamp":1612920293000},"page":"e0246073","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Insomnia symptoms and biomarkers of monocyte activation, systemic inflammation, and coagulation in HIV: Veterans Aging Cohort Study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6422-6303","authenticated-orcid":true,"given":"Brittanny M.","family":"Polanka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6305-2559","authenticated-orcid":true,"given":"Suman","family":"Kundu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaku A.","family":"So-Armah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S.","family":"Freiberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir K.","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamika C. 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