How to support effective sleep routines

A clear, simple guide for families with children up to around 11 years old.

Why this matters

Sleep isn’t just rest — it is when a huge amount of your child’s development actually happens. During sleep, the brain processes and stores what has been learned that day, the body grows and repairs itself, and emotional regulation resets ready for tomorrow. A child who isn’t sleeping well often shows it in daytime behaviour, mood, attention, and learning, long before anyone thinks to connect it back to sleep itself.

How much sleep does my child actually need?

Age	Sleep needed (including naps)
Newborn (0–4 months)	8–18 hours
Baby (4–12 months)	12–16 hours
Toddler (1–2 years)	11–14 hours
Child (3–5 years)	10–13 hours
Child (6–11 years)	9–12 hours

These are guides, not strict targets — every child is a little different. But if your child is consistently well below their range, it is worth taking a proper look at what is happening.

Why sleep can be harder for some children

Sleep difficulties are much more common in children with additional needs, and there are usually several reasons layered on top of each other. Recognising which of these apply to your child helps you work out where to start.

Body clock differences. Some children produce melatonin — the hormone that signals night-time — later or in smaller amounts, so they simply don’t feel sleepy at bedtime.
Sensory differences. A seam in pyjamas, the hum of a boiler, a light under the door or the feel of a duvet can be genuinely intolerable rather than a minor irritation.
Anxiety and busy thinking. Bedtime is quiet and unstructured, which is often exactly when worries about school or the next day arrive.
Difficulty with transitions. Stopping a preferred activity, moving to a different room and shifting into a different state is a big ask.
Physical discomfort. Constipation, reflux, eczema, pain, hunger and breathing difficulties all disturb sleep — and a child who communicates differently may not be able to tell you.
Medication. Some medicines affect how easily a child falls asleep depending on the timing of the dose. It is worth asking about this at review.
Understanding what’s expected. If a child doesn’t yet understand what bedtime means, resistance is confusion rather than defiance.

Before you change anything: two weeks of logging

It is tempting to jump straight to solutions, but it is worth spending two weeks simply logging what is actually happening first — bedtime, time actually asleep, night wakings, and wake time. Daytime napping needs logging too — not just whether a nap happened, but the actual time it started and how long it lasted. A nap that feels incidental can be exactly what is shifting bedtime later or causing more night wakings, and it is easy to miss that link without writing the times down.

Patterns that feel obvious in the moment (a bad week, a difficult night) often look quite different once they are written down over a fortnight. This also gives you something concrete to share with a health visitor or GP if you do need further support.

We have put together a separate printable two-week sleep diary to make this easy.

A sleep hygiene checklist

A consistent bedtime and wake time, including at weekends.
A calm wind-down routine of around 30 minutes before bed — a bath, a story, quiet time — signalling that sleep is coming.
A dark, cool, quiet room, with a consistent sleep space your child associates with sleeping.
No screens in the hour before bed (more on why below).
No large meals, sugary food, or caffeine close to bedtime.
Consistent comfort associations — the same soft toy, the same song — so the same cues are there every night.

Getting the sleep space right

Small changes to the room often make more difference than anything else, particularly for children who are sensitive to what they can see, hear or feel.

Dark. Blackout blinds make a real difference, especially in summer and for very early waking. If a night light is needed, choose a dim warm or red tone rather than blue or white.
Cool. Around 16–18°C suits most children. Overheating is a common and easily missed cause of night waking.
Consistent sound. Silence can make small noises more noticeable. Steady low sound that runs all night — a fan, white noise, the same quiet track — works better than sound that stops partway through.
Comfortable to the touch. Test fabrics, seams and labels in the daytime rather than at bedtime. Some children need firm, heavy bedding; others can’t tolerate any weight at all.
Kept for sleeping. Where you can, keep the bed for sleep, so it doesn’t become the place where the tablet lives.

A note on weighted blankets

Weighted products help some children and are unsafe for others. Get advice from an occupational therapist before using one. As a general rule, a child must be able to remove it independently, it should never be used with babies or toddlers, and it shouldn’t be used where there are breathing, mobility, circulation or seizure concerns.

Zeitgebers: what actually sets the body clock

“Zeitgeber” means “time-giver” — the environmental cues that tell the body when it is day and when it is night, keeping the internal body clock (circadian rhythm) in sync. Light is the strongest zeitgeber by far, alongside things like meal timing and activity.

This is exactly why blue light matters. Light from screens — phones, tablets, TVs — suppresses melatonin, the hormone that signals to the body that it is time to sleep. A child watching a screen right before bed isn’t just staying stimulated by the content; their body is genuinely being told it is still daytime. Getting good natural light in the morning, and reducing blue light in the hour before bed, helps the body clock do its job properly.

When to start making changes

Once you have a real picture from your two weeks of logging, a few things are worth thinking about before you begin:

It sometimes gets worse before it gets better. When you change your approach, it is common for a child to push back harder for a few days — testing whether the old pattern will come back if they try hard enough. This is a normal part of learning a new routine, not a sign it isn’t working. Hold steady; it does settle.
Start when there’s no other disruption on the horizon. A house move, a new sibling, starting a new setting — trying to change sleep at the same time as anything else major makes it much harder for everyone.
Start when you’re in a place to be genuinely consistent — for your own sake too. Agree your approach with everyone involved before you begin, and only start when you feel steady enough to keep it up. A new approach applied for three nights and then dropped often makes things harder than not changing anything at all. There will still be moments you feel frustrated — that is completely normal — and if you ever feel yourself about to react in a way you’ll regret, it is always fine to make sure your child is safe and step away for a moment.
Change one thing at a time, and give it two weeks. If you change five things at once and sleep improves, you won’t know which one to keep. Two weeks is usually long enough to tell whether something is working.
Communicate in a way your child actually understands. Use whatever method works for your child — an Object of Reference or Picture of Reference for “bedtime” or “sleep”, alongside the words, so the routine is something they can genuinely predict and understand, not just something that happens to them.

Common difficulties, and what often helps

Approaches need to be matched to the particular difficulty rather than applied across the board. These are starting points — adapt them to your child’s understanding, communication and sensory needs.

What you’re seeing	What often helps
Won’t settle without you in the room	Gradual retreat. Stay where you are now, then move your chair a little further towards the door every few nights. Move on only when the current step is settled. Slow turns out to be faster than it looks.
Repeated call-outs and requests	Build them into the routine — a set number of drinks, a last toilet trip, a final cuddle — then keep any further responses brief, quiet and boring. A fixed number of bedtime passes can help older children.
Waking in the night and needing you to get back to sleep	Whatever helps your child fall asleep at bedtime is what they will look for at 2am. If that is you, changing the bedtime routine is what changes the night. Keep night responses low-light, low-talk and predictable.
Waking very early	Check light and noise first, then consider an OK-to-wake clock. Moving bedtime slightly later can help — an over-tired child often wakes earlier, not later.
Anxiety at bedtime, or fear of the dark	Deal with worries earlier in the evening rather than at lights-out. A social story about what happens at night, a comfort object, a dim light, and a check-in you actually keep doing — “I’ll look in on you in ten minutes” — until they’re asleep.
Sleep is fine, then falls apart after a change	Expect some regression after illness, holidays, transitions and house moves. Return to the routine you know works rather than inventing a new one; most children settle again within a fortnight.

When to seek medical advice

Some sleep problems have a physical cause that no routine will fix. Speak to your health visitor or GP if you notice any of the following:

Snoring most nights, pauses in breathing, gasping, or habitual mouth breathing — these can indicate obstructive sleep apnoea, which is treatable.
Unusual movements, stiffening, or repeated events at night that could be seizures.
Significant daytime sleepiness despite an apparently reasonable night.
Uncomfortable, restless legs in the evening, or a strong urge to move them.
Signs of pain, reflux, constipation, itching or eczema disturbing sleep.
Sleep problems that are affecting your child’s health, learning or mood — or your own wellbeing as a parent or carer.

If melatonin comes up

In the UK melatonin is a prescription-only medicine for children. It is normally started by a specialist such as a community paediatrician, rather than bought online, and availability varies between areas.

It is intended to be used alongside a sleep routine rather than instead of one — prescribers will expect to see that sleep hygiene has been tried first, often with a diary as evidence. It generally helps more with falling asleep than with staying asleep, and should be reviewed regularly rather than continued indefinitely.

Sleep, school and support

Poor sleep affects attention, memory, emotional regulation and behaviour, and a tired child at 9am is not the same child at 9am after a good night. It is worth recording sleep in the same way you would record any other need:

Share your diary with your child’s setting. It helps staff understand a difficult morning, and can prompt reasonable adjustments such as a soft start.
If your child has an EHC plan, sleep and its impact can be described within health needs and provision, and revisited at the annual review.
Sleep deprivation across the household is relevant to a carer’s assessment and to short breaks. Ask your local authority about both — details are on your council’s Local Offer.

A note for families

If sleep difficulties are affecting your child’s health, development, or your family’s wellbeing more broadly, it is always worth speaking to your health visitor or GP — some sleep difficulties do need a bit more support than a routine change alone can offer.

And be honest with them about your own sleep too. Long-term broken nights affect your patience, your mood and your health as much as your child’s, and that is worth saying out loud rather than absorbing.

This guide is one of a series produced by SEND Experts at Hand to help families support their child with confidence. For advice about your own child’s sleep, speak to your health visitor, school nurse or GP. For advice tailored to your family, book a 1:1 advice session.