"From Insomnia to Restful Sleep"
Xiao M · London · 6 sessions · 3 months
📋Background
Xiao M is a Chinese master's student in finance studying in London. When she came to me, she had been suffering from insomnia for over two months.
Her insomnia began around midterm exams — during that period of intense academic pressure, she could barely fall asleep until 3-4 AM, and regularly woke up at 2 AM and couldn't fall back asleep.
"I lie in bed and my mind races: I haven't finished tomorrow's essay, there's an exam next week, my family's money didn't come from nowhere, what if I can't graduate..."
Insomnia brought a chain reaction: inability to concentrate during the day, declining memory, couldn't understand teachers in class. A vicious cycle began — the more she worried about sleeping, the less she slept.
During assessment, I found that Xiao M's problem was not just "poor sleep," but anxiety-driven insomnia. Her "sleep beliefs" also had issues: she believed "you must sleep 8 hours every night to be normal," and the moment she couldn't sleep, she became anxious, which in turn caused even more sleeplessness.
🔄Process
Over six sessions, we used Cognitive Behavioral Therapy for Insomnia (CBT-I, a specialised form of CBT for insomnia) as the core framework.
Sessions 1-2: Sleep Diary and Cognitive Restructuring
I asked Xiao M to keep a sleep diary for two weeks. The diary revealed an important discovery: her actual average sleep time was longer than she "felt" — she felt like she "didn't sleep all night," but in reality she had 5-6 hours of sleep, just fragmented by multiple awakenings.
The goal of cognitive restructuring was to change her catastrophising thoughts: - From "if I can't sleep, I'm finished" → "not sleeping well makes me uncomfortable but won't cause serious consequences" - From "I must sleep 8 hours" → "sleep quality matters more than duration; as long as it averages out, that's enough"
Sessions 3-4: Sleep Restriction and Stimulus Control
The core of sleep restriction therapy: reduce "ineffective time in bed" (lying awake unable to sleep), and strengthen the association between bed and "falling asleep."
Specific approach: - Fixed wake-up time every day (even if you slept poorly) - Only go to bed when truly sleepy - If you can't fall asleep within 20 minutes, get up and do a relaxing activity in another room, return to bed only when sleepy
This phase was very difficult. Xiao M said once she got up at 2 AM and sat in the living room until 5 AM before going back to sleep. But she persevered.
Sessions 5-6: Mindfulness and Body Relaxation
I introduced body scan exercises to help her "let go" of the day's fatigue and worries before sleep. Breathing exercises were used to cope with anxiety when waking up in the middle of the night.
✨Outcomes
At the end of six sessions, Xiao M's sleep had improved significantly:
- Time to fall asleep: reduced from an average of 2 hours to under 30 minutes - Nighttime awakenings: reduced from 3-4 times per night to 0-1 times - Bedtime: essentially stabilised around 11:30 PM - Daytime energy and mood: noticeably improved
More importantly, her "sleep beliefs" underwent a fundamental shift — she no longer treated sleep as a "task to be accomplished," but allowed it to happen naturally.
💬Counsellor's Note
Insomnia is rarely just a "sleep" problem — it is often the body and brain saying: "I need to be cared for."
Xiao M's story showed me that behind many international students' insomnia is actually deep-seated anxiety about academic pressure, family expectations, and sense of self-worth. When we focus only on "sleep" itself, we rarely address the root cause.
CBT-I is a失眠 treatment with strong research evidence, but its most fundamental principle is actually simple: **embrace sleep's natural rhythm, and release the "control" over sleep.**
Note: All case studies are published with written consent from clients. Identifying information has been anonymised. This article is for educational purposes only and does not constitute medical or psychological counselling advice.
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