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Interviews were audio-recorded and transcribed verbatim. Interview transcripts were coded and analyzed to explore themes related to pain and sleep disturbance, and relationships among those themes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Pain was a prominent driver of sleep disturbance; 12 participants with RA (80%) and 14 with axSpA (93%) reported that pain impacted their ability to fall asleep, while all 15 with RA (100%) and 14 with axSpA (93%) reported that pain impacted their ability to stay asleep. Two-thirds of participants with RA (67%) or axSpA (60%) described a bi-directional relationship, whereby pain worsened sleep disturbance and sleep disturbance further aggravated pain. Factors other than pain, such as fatigue and emotional health, were also reported as important contributors to sleep disturbance (RA: <jats:italic>n<\/jats:italic>\u2009=\u200912\/15, 80%; axSpA: <jats:italic>n<\/jats:italic>\u2009=\u200914\/15, 93%). Participants with RA or axSpA described complex interconnections between fatigue, emotional health, pain, and sleep, often labeling these relationships as \u201c<jats:italic>vicious cycles<\/jats:italic>\u201d. Notably, half of all participants reported sleep disturbance occurring without pain or other understood causes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>These perspectives collected from people with RA or axSpA suggest that reducing sleep disruption directly may offer clinically relevant benefits.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11136-023-03524-9","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T12:02:20Z","timestamp":1698408140000},"page":"373-385","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A concept elicitation study to understand the relationship between sleep and pain in rheumatoid arthritis and axial spondyloarthritis"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9096-9269","authenticated-orcid":false,"given":"Kimberly","family":"Raymond","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-9709","authenticated-orcid":false,"given":"Wen-Hung","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9423-6097","authenticated-orcid":false,"given":"Marguerite","family":"Bracher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9663-7510","authenticated-orcid":false,"given":"April","family":"Foster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9118-0673","authenticated-orcid":false,"given":"Andrew","family":"Lovley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0420-6458","authenticated-orcid":false,"given":"Cory","family":"Saucier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0081-5165","authenticated-orcid":false,"given":"Kristi","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6302-4171","authenticated-orcid":false,"given":"Eleanor J.","family":"McDermott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"issue":"3","key":"3524_CR1","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1080\/13548506.2020.1764597","volume":"26","author":"L Zhang","year":"2021","unstructured":"Zhang, L., Shen, B., & Liu, S. 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