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Distractibility and inattention have been implicated as potential contributors to fibrofog, but the role of environmental distractions has not been explored. In this study, ambulatory assessment methods were used to examine whether <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> is related to more environmental distractions and to examine the impact of distractions on subjective and objective cognitive functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty people with <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> and 50 age\u2010, sex\u2010, and education\u2010matched controls without <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> completed 8 consecutive days of ambulatory assessments. Five times per day, participants reported perceived cognitive functioning and environmental distractions and completed validated tests of processing speed and working memory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> group reported distractions in a higher proportion of the ambulatory cognitive testing sessions (40.5%) compared with the group without <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> (29.8%; <jats:italic>P<\/jats:italic> &lt; 0.001) and more often reported multiple simultaneous distractions. For both groups, sound was the most common distraction. The group with <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> reported more distractions caused by light, and the group without <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> reported more social distractions. Group differences in subjective and objective cognitive functioning were not augmented during distraction relative to during periods of no distraction. There were no group differences in within\u2010person changes in cognitive functioning as a function of distraction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The group with <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> reported more distractions than the group without <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content>; both groups reported poorer processing speed when distracted, and the effects of distraction on test performance did not differ significantly by group. Findings suggest that sensitivity to environmental distractions may play a role in the experience of cognitive dysfunction in <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11130","type":"journal-article","created":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T08:38:09Z","timestamp":1585730289000},"page":"214-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Role of Environmental Distractions in the Experience of Fibrofog in Real\u2010World Settings"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3664-3898","authenticated-orcid":false,"given":"Anna L.","family":"Kratz","sequence":"first","affiliation":[{"name":"University of Michigan Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Whibley","sequence":"additional","affiliation":[{"name":"University of 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