© 2019 The Author(s). Background: Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger. Methods: The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8-12 years, with normal reported sleep duration of 8-11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1-2 h per night. Discussion: Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12618001671257. Registered 10 October 2018.

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For over forty years, Bellevue Hospital's Therapeutic Nursery Program has been addressing the emotional problems of New York City preschoolers, aged two to five years, with the help of their families and other caregivers. Typical psychiatric disorders treated in the Therapeutic Nursery Program include anxiety disorders (separation anxiety, generalized anxiety and posttraumatic stress disorder), disruptive behavior disorders (attention deficit hyperactivity disorder and oppositional defiant disorder), mood disorders, adjustment disorders and attachment disorders.We have found that group psychotherapy provides a safe and secure place where, through psychodynamic intervention, children can repair dysfunctional relationships, identify and express a full range of emotions, resolve cultural differences and develop age appropriate skills.Our Therapeutic Nursery Program employs a wide range of additional treatment modalities in order to reach the treatment goals. Individual or family sessions, as well as meetings with teachers and social service workers, are scheduled to address issues.We have also found that dyadic or sibling work is often needed to stop or reverse the development of inappropriate family relationships.One of our indications of a successful intervention is that either during or after their participation in the Therapeutic Nursery, children return to community-based daycare centers and preschools. We have also found that via participation in the Therapeutic Nursery program, families have opportunities to strengthen their ability to nurture their children, share successful parenting with other families and build pleasurable experiences with their children.