Kevin Nguyen,1 Mitch Cadiz,1 Natalie Toma,2 Kendal Nakaoka,3 Emma O’Keefe,3 Tyson Wu,4 Seth Heller,5 Jennifer McQueeny,6 Chathura Siriwardhana,1 Yone-Kawe Lin,1 Matthew Kao,1 Janette Bow-Keola,1 Tyrone John Sumibcay,1 Eonjung Angeline Kim,7 Nicholas Anderson,8 Kore Liow,1,7,8 Enrique Carrazana1
1 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
2 University of Southern California, Los Angeles, CA
3 University of Hawaiʻi at Mānoa, Honolulu, HI
4 American University of the Caribbean School of Medicine, Cupecoy, SXM
5 San Jose State University, San Jose, CA
6 University of Puerto Rico, San Juan, PR
7 Hawaii Headache and Facial Pain Center, Hawaii Pacific Neuroscience, Honolulu, HI
8 Hawaii Sleep and Wake Center, Hawaii Pacific Neuroscience, Honolulu, HI
Background: Native Hawaiian and Other Pacific Islander (NHOPI) populations experience disproportionately high rates of both chronic migraine and sleep disturbances, yet the interplay between these conditions remains underexplored. NHOPI individuals report lower sleep quality and duration compared to other racial groups and are disproportionately affected by sleep apnea and related comorbidities. This study investigates whether insomnia, obstructive sleep apnea (OSA), or poor sleep quality contribute to increased migraine burden among NHOPI patients.
Methods: A retrospective case-control chart review was conducted using Hawaii Pacific Neuroscience medical records from January 2020 to the present. Adult patients diagnosed with chronic migraine (ICD G43.711) were assessed for sleep disorders using ICD G47 codes (e.g., OSA, insomnia) and self-reported disturbances documented in eClinical. Additional variables included BMI and physical activity status. Patients were matched by age, sex, and race. Multivariable regression will control for confounders.
Results: Data analysis is ongoing. Preliminary chart reviews suggest NHOPI patients with chronic migraine experience higher rates of OSA compared to other ethnic groups. Many also report greater sleep disturbances or difficulty sleeping, though average nightly sleep duration was often undocumented. Coexisting risk factors, including obesity and related comorbidities, were frequently observed.
Discussion: This study aims to clarify the contribution of sleep-related conditions to chronic migraine burden in NHOPI patients. Understanding these associations may inform culturally tailored, non-pharmacologic interventions to improve sleep quality, reduce migraine severity, and address neurologic health disparities in this underserved population.
