Assessment of the problem

Obtain a good account of the problem - what happens when the child is unable to settle at night. Why is the lack of settling such a problem with the parents eg lack of privacy, tiredness.

Establish what the child's sleep pattern is. This may lead to the identification of a possible solution immediately. However often the account of the child's sleep pattern given by the parents is not clear and a parent should be asked to keep a sleep diary over the following week. This diary should include:

• the time when the child wakes up in the morning. Did the child have to be roused?
• what was the child's mood on wakening?
• details concerning times and durations of naps during the day
• the time that the child is told he must go to sleep
• the time at which the child is known to have gone to sleep
• details of any waking in the night - the time, duration and parental reaction

The sleep diary can be drawn up on a sheet of paper with the points listed proving columns of a table and the days in the week providing rows.