Advances in Health and Behavior

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.

The recent pandemic seriously affected national health systems worldwide. The focus of the 2021 edition of the European Patients’ Rights Day was on patient organizations’ concrete reactions to it, offering answers to people and actions that should be put in place in order to have more resilient healthcare systems, starting from the 14 rights stated in the European Charter of Patients’ Rights. From their experiences emerged the great reforming force of civic organizations and Patient Advocacy Groups, capable of responding promptly to new needs by managing services, building alliances, quickly signalling necessary normative or procedural changes, mobilizing resources (both human and economic), introducing and promoting practices from which it will not be necessary to go back when everything is over. We still perceive the urgent need to better address the consequences of the Covid-19 pandemic. Evidence collected during the crisis show that Covid-19 has had a significant impact – for instance - on Non-Communicable Diseases. Indeed, oncological and chronic patients have been left almost alone for several months. Rather than recalling the impact of Covid, the 15^th European Patients’ Rights Day wanted to highlight actions and reactions that have civic & patients' organizations as protagonists: actions realized despite the pandemic and reactions put in place to mitigate its impact.