Final structural equation model for the relationship between hoarding, sleep disturbance, and adverse health outcomes. The model depicts standardized estimates for latent class factor loadings (all p < .0001) and significant (p < .0029 after Bonferroni adjustment) pathways between latent class variables. Mental health factor loadings: self-reported 1) substance use disorder (SUD) or alcohol use disorder (AUD), 2) major depressive disorder (MDD), and 3) anxiety disorder (ANX). Physical health factor loadings: self-reported 1) stroke, 2) heart disease, 3) high cholesterol (High Choles), 4) high blood pressure (HBP), 5) diabetes, and 6) obesity. Objective cognition factor loadings: Detection Test reaction time (Time_DET), Identification Test reaction time (Time_IDN), One Card Learning Test reaction time (Time_OCL), One Back Test reaction time (Time_ODN), One Card Learning Test accuracy (ACC_OCL), and One Back Test accuracy (ACC_ONB). Subjective cognition factor loadings: compromised performance on Everyday Cognition subdomains, including 1) memory, 2) language, 3) planning, 4) organization, 5) divided attention, and 6) visuospatial abilities (Visual). Quality-of-life (QoL) factor loadings: 36-item Short-Form Health Survey score for 1) physical functioning (PhysFunc), 2) role limitations owing to physical health (LimitPhys), 3) role limitations owing to emotional health (LimitEmo), 4) energy, 5) emotional well-being (Emotion), 6) social functioning (Social), 7) pain, and 8) general health. CFI, comparative fit index; RMSEA, root-mean-square error of approximation; TLI, Tucker-Lewis index.