A mother brings her 7 year old son with Down’s syndrome to clinic complaining of sleep difficulties. He won’t go to sleep alone, frequently wakes in the night, and will not be settled unless transferred to his parents’ bed. His parents are exhausted, and his mother believes his lack ofsleep is also disrupting his daytime behaviour. He has always been difficult to settle and seldom slept through the night without waking. The child is overweight, but not obese, and on enquiry his mother tells you that he does not usually snore, or suffer from nocturnal enuresis (bedwetting), which makes obstructive sleep apnoea an unlikely cause. His mother tells you, “I’m sure he’s just waking up out of stubbornness and not because anything’s wrong, but we’re all worn out. I don’t know what to do.” You wonder if a behavioural treatment programme might be able to help in this situation.