Objective To explore the current practices and challenges in night‐time care for people with dementia living in care homes in the UK. Methods Focus group discussions (FGD) were held with care staff and family carers from five care homes in South London. To supplement the FGD data, an online survey was circulated to family carers (n = 16), and informal interviews were conducted with night‐time care staff and nurses (n = 19). The questions for the online survey were designed to specifically explore the themes that emerged from the FGD. Results Thematic analysis revealed eight key themes in the management of sleep disturbance in people with dementia living in care homes: current night‐time care practices, dissonance in perceived causes of sleep disturbances, inconsistencies in treatment options, insufficient staffing levels, working relationships between shifts, nurse burden and responsibility, communication as a critical challenge, connecting with residents and one overarching theme of balance. Conclusions The findings of this study highlight the need for an evidence‐based sleep disturbance management programme designed for use in care homes and informed by stakeholders. The key themes identified represent the major barriers to good quality care and areas which future programmes will need to address to improve the quality of night‐time care in care homes. There are clearly opportunities for future examination of non‐pharmacological night‐time care management programmes for use in the population. Copyright © 2017 John Wiley & Sons, Ltd.