Is this a sleep habit problem or something more?

The short answer

Do not try to diagnose the cause from one difficult bedtime. Record what happens across two weeks and separate sleep onset, night waking, early waking, breathing or unusual events, and daytime sleepiness. A pattern may be maintained by timing, cues, adult responses or an activity that repeatedly continues, but those observations do not rule out pain, reflux, constipation, eczema, anxiety, medication effects, delayed body clock, restless movement or sleep-disordered breathing. Look for a sudden change, distress or pain, loud habitual snoring, choking or breathing pauses, marked daytime sleepiness, unusual movements, loss of functioning or a pattern that persists despite a reasonable accessible sleep plan. Take concrete observations and the medication list to the GP. Do not delay medical advice while attempting perfect sleep hygiene, and do not start supplements or change prescribed medication yourself.

• “Habit” describes a repeated pattern; it does not establish choice or exclude illness.
• Separate sleep onset, waking, early waking, unusual events and daytime effects.
• Compare conditions without using a good night to dismiss a persistent concern.
• Breathing signs, pain, marked sleepiness or sudden change need prompt clinical attention.
• Take a concise record and medication information to the GP.