PurposeBehavioral sleep problems are highly common in early childhood. These sleep problems have a high tendency to persist, and they may have deleterious effects on early brain development, attention, and mood regulation. Furthermore, secondary effects on parents and their relationship are documented. Negative parental cognition and behavior have been found to be important influencing factors of a child’s behavioral sleep problems. Therefore, in the current study we examined the acceptance and efficacy of a newly developed Internet-based intervention program called Mini-KiSS Online for sleep disturbances for children aged 6 months to 4 years and their parents.Patients and methodsFifty-five children (54.54% female; aged 8–57 months) suffering from psychophysiological insomnia or behavioral insomnia participated in the 6-week online treatment. Sleep problems and treatment acceptance were examined with a sleep diary, anamnestic questionnaires, a child behavior checklist (the Child Behavior Checklist 1.5–5), and treatment evaluation questionnaires.ResultsThe evaluation questionnaires showed a high acceptance of Mini-KiSS Online. Parents would recommend the treatment to other families, were glad to participate, and reported that they were able to deal with sleep-related problems of their child after Mini-KiSS Online. Parental behavior strategies changed with a reduction of dysfunctional strategies, such as staying or soothing the child until they fell asleep, allowing the child to get up again and play or watch TV, or reading them another bedtime story. Frequency and duration of night waking decreased as well as the need for external help to start or maintain sleep. All parameters changed significantly, not only in the questionnaires but also in the sleep diary.ConclusionMini-KiSS Online is shown to be a highly accepted and effective treatment to change parental behavior and reduce behavioral sleep problems in early childhood.

This pilot study shows a high acceptance and good feasibility of the multimodal short-time parent-training program Mini-KiSS. Sleep problems were significantly reduced.

Zusammenfassung. Einleitung: Internetbezogene Störungen (IBS) bei Jugendlichen und jungen Erwachsenen sind eng mit Familienfaktoren verknüpft. Dennoch beziehen wenige Forschungs- und Übersichtsarbeiten die Familie mit ein. Methodik: Die vorliegende Arbeit gibt einen Überblick zu Elternfaktoren, die bei der Entstehung, Aufrechterhaltung und Reduktion einer Symptomatik beteiligt sein können. Hierfür wurden N = 87 wissenschaftliche Arbeiten in die Literaturübersicht integriert. Ergebnisse: Klare Zusammenhänge finden sich in der Literatur zwischen der Eltern-Kind-Beziehung und IBS bei Jugendlichen und jungen Erwachsenen. Die Qualität der Eltern-Kind-Kommunikation erscheint ein vielversprechender Ansatz zu sein, um eine IBS-Symptomatik zu beeinflussen. Es gibt Hinweise, dass zumindest für manche Familien die Förderung der gemeinsam verbrachten Zeit hilfreich sein könnte. In Bezug auf erzieherische Aspekte sollte zwischen verschiedenen Bereichen unterschieden werden. Elterliches Wissen und Kontrolle der Internetnutzung scheinen Schutzfaktoren zu sein, der Effekt von Regeln und Restriktionen ist jedoch ungeklärt. Schlussfolgerungen: Um eine IBS-Symptomatik zu verändern, ist es sinnvoll, die Eltern-Kind-Beziehung zu verbessern. Die Wege dorthin sind jedoch kaum erforscht. Empfehlungen in Bezug auf Erziehungsstrategien (z. B. Regeln und Restriktionen) sollten sehr vorsichtig formuliert werden, da die Effekte noch unklar sind. Die Integration der Eltern in Prävention und Intervention wird von vielen Forscher_innen befürwortet, es gibt jedoch nur einzelne Studien, die Eltern im Rahmen von Interventionen berücksichtigen.

Journal of Psychiatry AbstractStudy 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.