Background Sleep disturbance, often arising from the way parents manage their child’s sleep, affects 40% of children and leads to increased demand on clinical services. Children and young people with significant sleep issues can be treated effectively with a supportive approach but are often prescribed the hormone melatonin because of a lack of available support services.

Aim To understand the effect and clinical implications of a nurse-led sleep support clinic on melatonin prescribing in children and young people.

Method A retrospective case note evaluation was undertaken of a nurse-led sleep support service delivering a bespoke programme and follow-up support to a patient group of 124 children and young people, 104 of whom had co-morbidities.

Results A total of 78 (63%) patients were successfully discharged without melatonin prescriptions after a median of two face-to-face clinic visits and three telephone calls. Eleven out of 12 patients had not restarted melatonin after 12 months.

Conclusion A nurse-led, non-pharmacological approach to sleep support in children and young people can provide an effective, sustainable alternative to melatonin prescribing. The authors recommend that appropriate sleep support should be administered and the response reviewed before melatonin is prescribed. Investment in sleep services to support this approach is important.