ABSTRACTThis application is in response to NOT-MD-19-023 which calls for proposals for expanding recruitment ofprojects to include Native Hawaiians / Other Pacific Islanders (NH/OPIs). Sleep disturbances including shortsleep duration sleep apnea and insomnia disorder are highly prevalent among adults in the US and areassociated with an increased risk for mental and physical health consequences including cardiometabolicdisease. Comparative research studies indicate that sleep disparities are present in some minority populations;however the extent to which sleep disparities exist across different racial/ethnic groups is not well known. BothMexican-Americans and individuals from Native Hawaiian/Other Pacific Islander (NH/OPI) populations are at anincreased risk for adverse sleep and corresponding cardiometabolic health outcomes yet the role of potentialmechanisms linking such deficiencies in these comparative minority groups is understudied. Factors that impactsleep functioning in one population may differentially impact another population. The overall goal of this projectis to support and strengthen two aims of the parent grant by specifically including NH/OPI into the NogalesCardiometabolic Health and Sleep study to further evaluate how acculturation psychosocial stressors and othersocial environmental and behavioral factors impact relationships between sleep disturbances andcardiometabolic disease risk similarly and uniquely as compared to Mexican-Americans at the US/Mexicoborder. This project aims to determine how acculturation economic hardship psychosocial stress and unhealthybehaviors (diet exercise alcohol and smoking) are related to sleep disturbance by type in NH/OPI and incomparison to these relationships in Mexican-Americans. The second goal of this project is to determine howsleep and/or social-behavioral factors predict cardiometabolic disease risk among NH/OPI as well as determinehow these same factors are different in NH/OPI when compared to Mexican-Americans at the US/Mexico border.To accomplish these goals this project will partner with researchers at the University of Hawaii to recruit andenroll N=100 NH/OPI to complete a battery of assessments from a clinic visit (questionnaires interviews examfor anthropometry collection of biomarkers) a 1-night home sleep apnea assessment a 24-hour ambulatoryblood pressure recording and a 2-week home monitoring period with sleep diary and actigraphy. Inclusion ofNH/OPI into the larger dataset will facilitate a better understanding of sleep disturbances and the impact offactors that regulate sleep including duration insomnia symptoms and obstructive sleep apnea in relation tocardiometabolic disease risk within this population and in comparison to Mexican-Americans. The analytic planwill utilize a machine-learning analytic approach which will be used to evaluate the complex relationships amongall of these variables. This project will further address efforts at reducing sleep-cardiometabolic health disparitiesin minority populations by identifying potentially modifiable areas associated with community-based interventionprograms.