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Background: Pediatric sleep problems are strongly linked to future emotional problems. However, research regarding the effect of internet-based cognitive behavior therapy for insomnia (iCBT-I) in early childhood on the outcome of emotion dysregulation is missing. Participants: 200 children (47% female) aged 7 to 63 months (M = 23.13) suffering from behavioral insomnia participated in the Mini-KiSS 6-week online treatment. Methods: A prepost- follow-up design was implemented. Sleep disorders were stated according to ICSD-3 and DSM-5 criteria and emotional dysregulation was assessed with an emotion dysregulation profile for children. Difference scores were calculated, a repeated-measures ANOVA, and stepwise multiple linear regression was performed. Results: After iCBT-I Mini-KiSS for young children, emotion dysregulation significantly declined immediately after the intervention (p = 0.000) and in the follow-up measurement after three months (p = 0.002). Age was associated with the change in emotion dysregulation at follow-up measurement (p = 0.017). Gender or the type of sleep disturbance did not have statistically significant impact on change in emotion dysregulation at any measurement (p ≥ 0.05). Clinically significant improvement of emotional dysregulation was achieved in 14.5% of the children from pre- to post-measurement, and 25.3% improved at follow-up. Conclusions: The findings show that treatment of pediatric insomnia reduce emotion dysregulation of infants and toddlers. Therefore, early sleep intervention might prevent mental disorder in young children. In future, an extended longitudinal design is needed to examine the preventing power of early-improved sleep on later psychopathological disorders. Beyond, future studies should examine underlying mechanisms in more detail.

Study background: Mild to severe sleep problems are reported in 3% to 56% of young children. Behaviourbased treatments are highly effective in improving children´s sleep. The purpose of this work was to examine the efficacy of an Internet-based intervention for young children´s sleep disturbances (Mini-KiSS Online) and to assess the effect of telephone support for parents. Methods: Two intervention conditions (written information with or without additional weekly telephone support) were compared to a waiting-list control condition. N=199 parents with their children (aged 6-63 months) were randomly assigned to one of the study conditions. The treatment consisted of six written information modules based on a cognitive-behavioural approach. One of the treatment groups had additional weekly telephone support. Data of sleep diary, parental behaviour, CBCL 1.5-5 (pre, post, 3-month follow-up) and treatment evaluation were collected. Results: Acceptance of Mini-KiSS Online was high. Children in both treatment conditions showed significant increase in sleep efficacy and reductions in sleep onset latency, duration of night waking, or subjective global ratings while there was no or less change in the control condition. Parents of both treatment conditions reduced their parental presence and physical contact to the child. A benefit of personal assistance was found for treatment evaluation and dropout rates. Conclusion: Mini-KiSS Online is an effective and highly accepted internet-based intervention to reduce sleep problems in young children. Personal telephone assistance counted for higher satisfaction and lower dropouts but not for further improvement of the sleep behaviour of the child.

Objective: Various research has shown that mothers of sleep-disturbed young children experience poorer physical and mental health, show more symptoms of depression or anxiety, and demonstrate a higher level of stress. Coping strategies and self-efficacy might play an important role in this context. In the present study we aimed to investigate psychosocial health, coping, and the sleep-related self-efficacy of parents participating in an Internetbased treatment for sleep-disturbed young children (six months to four years of age). Methods: N=199 mothers and N=197 fathers answered questionnaires regarding psychosocial health, coping, and sleep-related self-efficacy before, immediately after, and three months after treatment. Two intervention conditions (written information only vs. additional telephone support) were compared to a waiting-list control condition. The treatment essentially addressed the child´s sleep situation but also included information on parental coping and psychosocial health. Results: Both parents showed impaired psychosocial health (depression, compulsiveness) and more maladaptive coping (rumination, self-blame) before treatment. Feelings of aggression were reported by mothers only. More psychopathological symptoms in both parents were related to more maladaptive coping strategies and less sleep-related self-efficacy. Adaptive coping was associated with higher sleep-related self-efficacy, while maladaptive coping was related to lower sleep-related self-efficacy in mothers only. Mothers in both treatment conditions improved their psychosocial health (e.g., depression, somatization, anxiety, aggression) and their ability to cope in some scales (increase: relaxation, trivialization; decrease: rumination) after treatment. For fathers, only a few changes were observed. The impaired sleep-related self-efficacy of both parents improved with treatment. Personal telephone support rarely affected the results. Conclusion: Teaching parents to treat their child´s sleep problem can improve impairments in psychosocial health, coping, and self-efficacy predominantly in mothers.