Both comparative and single-race studies suggest that sleep disorders are at least as prevalent among American Indians (AIs) as they are in the all-races population, but no extensive investigation has examined the epidemiology of sleep problems in a representative sample of AIs. We propose an innovative mixed-methods study that will allow for population estimation of the prevalence of sleep problems and their associations with specific cardiovascular and metabolic risk factors, as well as the qualitative characterization of cultural factors related to sleep health. This will be the largest epidemiological examination of sleep health and cardiovascular and metabolic risk to date.