When should we speak to the GP about sleep or melatonin?

The short answer

Speak to the GP when a child’s sleep problem persists, changes suddenly or substantially affects health, mood, learning, attendance, safety or family functioning. Arrange prompt assessment for loud habitual snoring, choking, apparent breathing pauses, significant pain, unusual night-time episodes or marked daytime sleepiness. Take a two-week sleep-and-wake record, medication list, relevant health symptoms, what you have tried and the effect on the child and household. Ask what kind of sleep problem the clinician thinks is present, what needs ruling out and what the follow-up plan is. Melatonin is a medicine, not a universal bedtime aid. UK pathways vary, but longer-term prescribing for children and teenagers is usually specialist-led. For autistic children and young people, NICE says it should be considered only when a sleep plan has not been enough and the problem is significantly affecting the child or family, with specialist consultation, non-drug support and regular benefit-risk review. Never use another person’s supply or change the dose, timing, formulation or other prescribed medication yourself.

• Persistent sleep difficulty and meaningful daytime or family impact justify a GP conversation.
• Breathing signs, severe sleepiness, pain and unusual episodes need prompt attention.
• A two-week record helps the clinician see the whole pattern.
• Melatonin’s timing, formulation and purpose must be clear and clinically reviewed.
• Record what improves, what does not and any possible side effects.