Why will my child not settle or switch off at night?

The short answer

Begin by identifying the sleep problem rather than treating every difficult bedtime as the same. Is the child not sleepy at the expected time, unable to enter the bedtime sequence, uncomfortable or worried in bed, repeatedly calling or leaving, waking later, waking very early, or showing unusual movement or breathing? Record sleep and waking across the full day for about two weeks, including naps, medication, pain, illness, school pressure and the bedroom conditions. Make one change at a time: align the routine with a realistic sleep opportunity, use a short predictable descent, make the bed and room physically accessible, and move unresolved conversations out of the final period. Do not promise that screens, exercise or a perfect routine will solve a medical, circadian or anxiety-related problem. Speak to the GP when difficulty is persistent, substantially affects the child or family, or involves pain, severe daytime sleepiness, loud snoring, choking or breathing pauses. Do not start, stop or change melatonin or other medication without the responsible clinician.

• Name the exact sleep problem before choosing a bedtime strategy.
• Record the full sleep-and-wake pattern, not only the moment the light goes out.
• Check physical comfort, breathing, health, medication, anxiety and schedule fit.
• Build a short repeatable descent and change one part at a time.
• Persistent or concerning sleep problems deserve clinical assessment, not endless home experiments.