There are many questions on here asking about sleepless children but my wife and I are starting to come to our wits-end and none of the advice we've found (here or otherwise) seems to fit our situation or no longer works.
I think this is because as our four and a half year old daughter is getting older her will and determination is getting stronger. She is a rather stubborn child and, to be fair, she gets that that from both parents. We've read most common advice and tried it all.
Here is how this plays out. My wife and I follow our normal night-time routine, starting at 7:00 PM. We sit down and read to both of our children* and they get a final, small snack while we read. After corporate reading and snack, we head to potty-time, brush teeth, and put both kids to bed. For our daughter, this involves reading a short book, singing a song with the lights out and walking out of the room. My wife and I rotate who takes which child every other night.
This has been a mostly-successful routine but, progressively as our daughter has gotten older and smarter, she's found ways to try to get out of bed and come out of her room. I'll spare the stories but she's smart enough to discern potential parental "loopholes" and will try to exploit them. After a round of two of sending her back to bed, she resolves to laying in bed from 15 minutes to an hour and then cuts on the lights to read.
Let me be clear-- the 7:00 PM bed time routine is very-well crafted. Wait until 7:30 PM and, based off of behavioral observation, you've waited to long and she'll be over tired. On those nights you know the task of getting her to bed is going to be a struggle involving tears of at least 2, if not 3, individuals in our household.
We've tried to follow the advice of other's and just ignore her behavior that happens in her room. Usually she quiet and not causing problems. We have no clue how often she does this throughout the night, but on multiple occasions we've found the light on in the middle of the night, and she's surrounded by books or toys. Also, she will wake up early in the morning if she hear's me getting ready. I leave the house at 5:30 AM, and she's often up with lights on, some times clothed and ready to start her day!
This wouldn't be a problem but all of this sleep deprivation is starting to dramatically effect her attitude. After a couple of good AM hours, the tiredness starts to kick in and she becomes cranky and hard to deal with, and understandably so. She's exhausted!
We've long given up on a nap time because that became a fight over a year and a half ago. Instead, it's a "rest time" where she has to be quite and in her bedroom for an hour where we encourage her to read on her bed. About once every 2 weeks she will nap (and nap hard.) Those become good evenings because she get's some of the catch-up sleep she desperately needs and we'll often put her to bed closer to 8:00 PM because we don't want her to go to bed and not be tired.
Sorry for the rather long post but the bottom-line is that our child is refusing to rest at night time if she can prevent it. When we catch her awake, we try to cut off the lights, and reset the room to a sleep-time state. This always results in an angry toddler, who often ends up crashing, usually within 10-15 minutes of us cleaning up her room and cutting off the lights.
My wife and I are fit to be tied. Our rather well behaved & good daughter is stealthy and hates sleep. However, this comes at the expense of my daughter (and wife's) day-time sanity.
What should we do? Is there a point when we should see a doctor about this? IMHO, this is completely behavioral stubbornness but you can't force a child to sleep. This is an issue of control and the kid just won't sleep, and no amount of consistency, routine, loving reassurance, or autonomy seems to help her help herself and GO TO BED.
*Our other child is a 2 year old boy. We have no problems with him and his sleep routine. He doesn't sleep as much as the average child his age but he does handle our routine well and sleeps when he should sleep.