You said that your child has problems falling asleep at bedtime. You may also notice that your child wakes up at night and has a hard time going back to sleep. You also said that your child is starting to have trouble at home or preschool/school or other places because of these sleep problems. Sometimes stressful things make it hard for children to fall asleep. Some examples are:
Your child may have problems falling asleep because you have a hard time setting limits. Your child may "stall" and try to avoid going to bed. S/he may do things like ask for more hugs/kisses, a drink of water, or an extra book/song. Sometimes children do this because they are feeling stressed or worried. Your child may fall asleep okay, but then sleep restlessly. You may also notice that your child tosses or turns a lot while sleeping or sleepwalks. You may notice that your child wants to take more naps during the day since s/he is having so much trouble sleeping at night.
Warning signs that things are getting worse
If you think these problems are getting worse talk to your child's doctor, even if you have discussed these things before.
Adapted in part from the American Academy of Pediatrics (AAP) Diagnostic and Statistical Manual for Primary Care (DSM-PC) (1996).