ArticleJournal of acquired immune deficiency syndromes (1999)2019
Insomnia as an Independent Predictor of Incident Cardiovascular Disease in HIV: Data From the Veterans Aging Cohort Study.
Article in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Incidence of adverse cardiovascular events in patients with insomnia: A systematic review and meta-analysis of real-world data.PloS one · 2023Pooled it
- Non-pharmacological interventions for improving sleep in people living with HIV: a systematic narrative review.Frontiers in neurology · 2023Pooled it
- Longitudinal Blood Pressure Trajectory and Subclinical Echocardiographic Measures of Cardiovascular Disease in People Living With HIV: A Comparative Prospective Cohort Study.Journal of the American Heart Association · 2026Article
- Shorter total sleep time is associated with lower CD4+/CD8+ T cell ratios in virally suppressed men with HIV.Sleep advances : a journal of the Sleep Research Society · 2024Article
- Cannabis use disorder and adverse cardiovascular outcomes: A population-based retrospective cohort analysis of adults from Alberta, Canada.Addiction (Abingdon, England) · 2024Article
- Delayed circadian rhythms in older Africans living with human immunodeficiency virus (HIV).Journal of pineal research · 2023Article
- Sleep quality, social rhythms, and depression among people living with HIV: a path analysis based on social zeitgeber theory.Frontiers in psychiatry · 2023Article
- Associations of HIV and Depression with Incident Diabetes Mellitus: Veterans Aging Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Impact of obstructive sleep apnea on cardiometabolic health in a random sample of older adults in rural South Africa: building the case for the treatment of sleep disorders in underresourced settings.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Article
- Insomnia symptoms and biomarkers of monocyte activation, systemic inflammation, and coagulation in HIV: Veterans Aging Cohort Study.PloS one · 2021Article
- Associations of Insomnia With Hypertension and Coronary Artery Disease Among Patients With Type 2 Diabetes Mellitus.Frontiers in cardiovascular medicine · 2021Article
- Article
- Natriuretic peptide testing in veterans hospitalized with heart failure: Potential differences by sex.Heart & lung : the journal of critical careArticle
- Negative Lifestyle Factors Specific to Aging Persons Living with HIV and Multimorbidity.Journal of the International Association of Providers of AIDS CareReview
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Authors and funding
13 authors at 11 institutions in 2 countries.
Funding
Abstract
backgroundInsomnia is associated with increased cardiovascular disease (CVD) risk in the general population and is highly prevalent in people with HIV. The CVD risk conferred by insomnia in the HIV population is unknown.
methodsUsing the Veterans Aging Cohort Study Survey Cohort, insomnia symptoms were measured and dummy coded with the item, "Difficulty falling or staying asleep?" (5-point scale from no difficulty to bothers a lot). Incident CVD event ICD-9 codes (acute myocardial infarction, stroke, or coronary artery revascularization) were identified with the Department of Veterans Affairs (VA) and Medicare administrative data and VA fee-for-service data. Those with baseline CVD were excluded.
resultsHIV-infected (N = 3108) veterans had a median follow-up time of 10.8 years, during which 267 CVD events occurred. Compared to HIV-infected veterans with no difficulty falling or staying asleep, HIV-infected veterans bothered a lot by insomnia symptoms had an increased risk of incident CVD after adjusting for demographics [hazard ratio (HR) = 1.64, 95% confidence interval (CI): 1.16 to 2.31, P = 0.005], CVD risk factors (HR = 1.62, 95% CI: 1.14 to 2.30, P = 0.007), additional potential confounders (hepatitis C infection, renal disease, anemia, alcohol use, and cocaine use; HR = 1.70, 95% CI: 1.19 to 2.43, P = 0.003), and HIV-specific factors (HIV-1 RNA, CD4 T-cell count, and antiretroviral therapy; HR = 1.66, 95% CI: 1.16 to 2.37, P = 0.005). Additional adjustment for nonbenzodiazepine sleep medication (HR = 1.62, 95% CI: 1.13 to 2.32, P = 0.009) did not attenuate the association; however, it fell short of significance at P < 0.01 after adjustment for depressive symptoms (HR = 1.51, 95% CI: 0.98 to 2.32, P = 0.060) or antidepressant medication (HR = 1.51, 95% CI: 1.04 to 2.19, P = 0.031).
conclusionsHighly bothersome insomnia symptoms were significantly associated with incident CVD in HIV-infected veterans, suggesting that insomnia may be a novel, modifiable risk factor for CVD in HIV.
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