Background <p>Sleep disorders in children with Smith-Magenis Syndrome (SMS) are common. They affect not only the child but also the entire family. Disturbed sleep in SMS is caused by a sleep-wake rhythm dysfunction. SMS patients mostly have an inverted melatonin secretion rhythm with a peak in melatonin levels during the day. Therefore, children with SMS are often awake at night and sleepy during the day, followed by extremely severe behavioral problems. There are many recent scientific studies with treatment recommendations.</p> Purpose <p>Since SMS is a rare disorder, many doctors are not familiar with it and parents of children with SMS are often left alone without medical support. The aim of this article is to summarize and explain the current state of knowledge about diagnostic and therapeutic pathways for sleep disorders in children with SMS. For parental counseling, there is an appendix with recommendations that physicians can use to provide parents with specific advice.</p> Conclusion <p>This may lead to opportunities to develop personalized behavioral and treatment concepts.</p>