Effects of an online treatment for pediatric sleep problems on emotion dysregulation in young children

F. Lollies, Faculty for Psychology, I. Brandhorst, A. Schlarb
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Abstract

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.
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儿童睡眠问题在线治疗对幼儿情绪失调的影响
背景:儿童睡眠问题与未来的情绪问题密切相关。然而,关于基于互联网的儿童早期失眠症认知行为治疗(iCBT-I)对情绪失调结局的影响的研究尚缺乏。参与者:200名7 - 63月龄儿童(女性占47%)(M = 23.13)参加了Mini-KiSS 6周在线治疗。方法:采用前后随访设计。根据ICSD-3和DSM-5标准陈述睡眠障碍,并使用儿童情绪失调档案评估情绪失调。计算差异评分,进行重复测量方差分析,并进行逐步多元线性回归。结果:幼儿iCBT-I Mini-KiSS干预后,情绪失调在干预后立即(p = 0.000)和3个月后随访测量中显著下降(p = 0.002)。在随访测量中,年龄与情绪失调的变化相关(p = 0.017)。性别或睡眠障碍类型对情绪失调变化的影响均无统计学意义(p≥0.05)。从测量前到测量后,14.5%的儿童的情绪失调得到临床显著改善,25.3%的儿童在随访中得到改善。结论:小儿失眠治疗可减少婴幼儿情绪失调。因此,早期睡眠干预可能会预防幼儿精神障碍。未来,需要一个扩展的纵向设计来检验早期改善睡眠对后期精神病理障碍的预防能力。此外,未来的研究应该更详细地检查潜在的机制。
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