It is very satisfying seeing a child with a sleep disorder because, so often, it is fairly easy to put right. Lots of children go through a period of not sleeping, and although it is sometimes the result of some awful happening, more often it is just a tiny hiccup in life. And I never forget the time I spent ages on the psychological aspects of a particular child only to find that she had been kept awake by the street light outside her room, and slept like a top as soon as the room was made dark enough. Hannah looked tired at the first appointment, though perhaps her mother seemed tireder. She is the oldest of three children and has never been a good sleeper, even when she was a baby. She is 6 now and goes to bed at about 8 o’clock but often isn’t asleep when her parents go up at 11, and usually wakes at about 4 to come into their bed. Luckily the other two children sleep well.  Hannah plays while I talk to her mum. Hannah is the first child of both parents. She was much wanted and is much loved. As a baby she was sensitive to cows milk and later had a touch of eczema but is otherwise well. She has never been seriously ill, they live quite close to grand-parents who love her a lot; she enjoys school, has friends there and is a bright girl near the top of her class. Father has a good job and there are no money problems; Mother doesn’t work.  While we are talking, I am observing Hannah too. She is a pretty, very blond little girl and very active. She moves from the dolls house to the box of toys to the puppets. She looks at her Mummy quite often but doesn’t interrupt us. She seems curious about me and has been told that she is coming here so that I can help her sleep properly, but, frankly, she doesn’t seem that bothered. Hannah is happy to talk with me and tells me that she goes up to her bedroom and then her mummy or daddy puts her to bed and reads her a story. She likes stories very much. She used to watch videos in her bedroom till she went to sleep but her parents have now taken the television out. Now she reads her books for a bit and sometimes plays with her dolls or other toys till she feels sleepy. Her Mother adds that Hannah always has a bath before she goes to bed and that she’s very cuddly at bedtime.  Hannah doesn’t know why she wakes up in the night, she doesn’t remember having bad dreams, and says she isn’t worried when she wakes up. She likes to go in to her Mummy’s bed, and says she sleeps best with her Mummy and Daddy and doesn’t wake up until they get up in the morning.  It is clear that Hannah is quite happy with the situation. She doesn’t wake up every night but has no motivation to change a situation where she has the chance to sleep with her parents. She is the only one of the three children at school full-time and perhaps feels a bit left out in terms of parental attention. We need to determine how much of a problem this is and for whom. If Hannah is happy with the way things are, and then we have to work out either a]whether the parents would prefer to cope with things as they are for a little longer, until Hannah is more motivated, Or b] whether they feel the need to sleep now, in which case things might become a little sticky for a while.

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