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Introduction Sleep disturbances/diagnoses are acknowledged complications across diverse chronic diseases but are rarely systematically assessed or treated. We set out to develop a low-impact, simple decentralised digital pathway to define the proportion of patients with multiple long-term cardiometabolic conditions affected by sleep disturbance and pilot a remote diagnostic/monitoring assessment pathway in a subset of patients with pulmonary hypertension (PH).Methods Patients in an ongoing open primary-care registry with a coded diagnosis of any cardiometabolic disease (>18 yrs) were prospectively consented through the uMed AccessCMD registry and undertook a set of digital patient-related outcome measures (ePROMs) that included the Jenkins Sleep Evaluation Questionnaire (JSEQ); a short, simple 4 domain questionnaire. A cohort of patients with pulmonary hypertension in the UK National Cohort Study (UKNCS) undertook ePROMs and additional paper validation and cross-comparison with longer-form questionnaires- Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and wearable assessment (GarminVenu2). Patients with a previously-defined JSEQ threshold score of >5 were put through a remote diagnostic pathway to investigate common causes of sleep disturbance with guideline-approved treatment options including insomnia, sleep apnoea (obstructive and central), restless legs syndrome (RLS) and menopause.Results Provisional results from the AccessCMD registry demonstrate that 2057 (74%, n= 2758) had a JSEQ of >5, 61% in the UKNCS (n=44). JSEQ scores highly correlated with ISS (r=0.84 p=2.89e-11) and moderately with ESS (r=0.44 p=4.38e-03). Wearable data demonstrated the highest correlation between JSEQ and REM sleep variation (r=0.6 p=0.00151). To date, 24 participants (54.5%) have been diagnosed with a sleep disturbance; RLS (n=9, 20.45%), insomnia (n=9, 20.5%), menopause (n=4, 9.1%), OSA (n=4, 9.1%) and CSA (n=1, 2.3%).Abstract P50 Figure 1Conclusion A high proportion of patients with cardiometabolic disease report sleep disturbance and a remote diagnostic pathway in a pilot cohort of patients with PH identified potentially treatable causes in >50% of participants.