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Although sleep problems are recognised as important contributors to fibromyalgia symptoms, the mechanisms linking sleep disturbances, psychological factors and functional impairment remain insufficiently understood. This study investigated the direct and indirect relationships among sleep disturbances, pain catastrophising, depression, bodily pain and functional impairment using path analysis. Data were drawn from 253 women diagnosed with fibromyalgia. Poor sleep quality was directly associated with elevated levels of pain catastrophising and depression, and both psychological factors were, in turn, significantly related to greater functional impairment. Together, these variables accounted for 32.5% of the variance in functional impairment. No significant indirect effects were observed between sleep disturbances and functional impairment through bodily pain, and pain severity was not significantly associated with functional outcomes. These findings underscore the critical role of poor sleep quality in functional impairment among individuals with fibromyalgia. Implementing interventions that target and improve sleep may, in turn, alleviate related psychological distress, reduce disability and enhance quality of life in this population.<\/jats:p>","DOI":"10.1111\/jsr.70199","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T03:05:16Z","timestamp":1758164716000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["In the End: Associations Between Sleep Disturbance and Functional Impairment in Fibromyalgia\u2014A Path Analysis Study"],"prefix":"10.1111","volume":"35","author":[{"given":"Kristoffer","family":"Bothelius","sequence":"first","affiliation":[{"name":"Clinical Pain Research, Department of Surgical Sciences Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Kosek","sequence":"additional","affiliation":[{"name":"Clinical Pain Research, Department of Surgical Sciences Uppsala University  Uppsala Sweden"},{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2059-1621","authenticated-orcid":false,"given":"Markus","family":"Jansson\u2010Fr\u00f6jmark","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience Karolinska Institutet, &amp; Stockholm Health Care Services, Region Stockholm  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2018.09.018"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359105317751615"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002334"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.20.2433"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.20982\/tqmp.15.1.p038"},{"issue":"5","key":"e_1_2_9_7_1","first-page":"S154","article-title":"The Fibromyalgia Impact Questionnaire (FIQ): A Review of Its Development, Current Version, Operating Characteristics and Uses","volume":"23","author":"Bennett R.","year":"2005","journal-title":"Clinical and Experimental Rheumatology"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23828"},{"issue":"5","key":"e_1_2_9_9_1","first-page":"728","article-title":"The Fibromyalgia Impact Questionnaire: Development and Validation","volume":"18","author":"Burckhardt C. 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