I Almost Died Driving Home From the Hospital
The road divider came out of nowhere.
One second, I was driving my Myvi home after a 30-hour shift at the hospital. The next, I heard the crash. Metal scraping concrete. My left side mirror shattering.
My heart pounded so hard I thought it would burst through my chest. My hands shook on the steering wheel as I yanked the car back onto the road. The shock ran from my head to my toes — half terror, half relief that I was still breathing.
I was five minutes from home. Five minutes from finally collapsing into bed after 30 hours of back-to-back ward admissions. And I’d almost killed myself because I couldn’t stay awake.
This wasn’t the first time I’d microsleep behind the wheel that day. I’d already bought coffee. I’d pinched my thigh raw trying to keep my eyes open. But exhaustion doesn’t negotiate. Eventually, my brain just shut down — even though I was driving 80 km/h on the road.
That was my rock bottom moment during first-year housemanship. And looking back now as a psychiatrist who specializes in CBT-I and insomnia treatment, I realize something painful:
I suffered for months because I didn’t know my brain could be retrained.
The Hell of Medical Training: When Your Brain Forgets How to Sleep
Let me paint you a picture of what insomnia actually looks like when you’re a first-year houseman in Malaysia.
You wake up at 5am. You drag yourself to the hospital by 6am. You do morning rounds, clerk new admissions, examine patients, carry out treatment plans, handle emergencies. Then you’re on call — which means no sleep, just more admissions throughout the night. Back-to-back clerking. Back-to-back decision-making when your brain is running on fumes.
By the time you hand over to your colleague the next afternoon (if you’re lucky — sometimes you don’t finish until 5pm), you’ve been awake for over 30 hours straight.
You’d think going home means instant sleep, right?
Wrong.
Because here’s what actually happens when you finally lie down in bed:
- Did I complete all the tasks?
- Did I miss anything?
- What if I made a mistake and the patient deteriorates?
- What if my senior calls me and I can’t answer?
Your mind races. Your heart pounds. Your body is exhausted, but your brain will not shut down.
You lie there for hours. Anxious. Wired. Frustrated.
And the worst part? You wake up the next morning feeling like you never slept at all — but you still have to show up at 6am and do it all over again.
This was my life for months. One to two on-call nights per week. Racing thoughts every single night, even when I wasn’t on call. Stress eating to cope. Feeling like I wanted to quit medicine entirely.
The car crash was just the breaking point. But the real damage? That was happening every single night in my bed.
Why “Just Push Through” Doesn’t Fix Insomnia
After the crash, I did what every overworked houseman does: I pushed through.
I told myself, “This is just part of training. Everyone goes through this. You’ll adjust eventually.”
And you know what? I did adjust. Sort of.
As I gained more confidence in my clinical skills — after a few postings, after learning the routines, after proving to myself I could handle the work — my sleep gradually improved. The anxiety lessened. I stopped lying awake for hours every night.
But here’s the thing I didn’t realize at the time:
My brain didn’t heal. It just… adapted.
I was still sleeping poorly compared to before medical school. I was still waking up tired. I was still anxious about bedtime. I just got used to functioning on less sleep.
And I thought that was normal. I thought that was just what being a doctor meant.
I was wrong.
The Discovery That Changed Everything: CBT-I (Cognitive Behavioral Therapy for Insomnia)
Years later, when I was training in psychiatry, I stumbled across something that stopped me in my tracks.
It was called Cognitive Behavioral Therapy for Insomnia (CBT-I).
At first, I was skeptical. It sounded too simple. “You’re telling me I can retrain my brain to sleep just by changing some behaviors and thoughts? That’s it?”
But the more I read, the more it clicked:
Insomnia Isn’t Just Stress — It’s a Learned Pattern (Conditioned Insomnia)
Every night you lie in bed anxious, frustrated, and wide awake — that’s a training session. Your brain is learning: “Bed = battlefield. Bed = where I struggle. Bed = where I fail.”
Over time, this pattern becomes automatic. Even when the original stress (like housemanship) is gone, your brain still treats bed as a place of anxiety instead of rest.
This is called conditioned insomnia. And it’s why “sleep hygiene tips” don’t work. It’s why melatonin doesn’t work. It’s why just “relaxing more” doesn’t work.
Because you’re not addressing the root problem: your brain has been trained wrong.
How CBT-I Fixed My Insomnia (Two Key Techniques)
Once I understood the science, I tried CBT-I techniques on myself. I focused on two main strategies:
1. Stimulus Control
This means: your bed is ONLY for sleep. Not for scrolling TikTok. Not for worrying about work. Not for lying awake frustrated.
If you’re in bed and not asleep within 15–20 minutes, you get up and do something else until you feel sleepy again. Then you return to bed.
This sounds counterintuitive (and honestly, annoying), but it works. You’re retraining your brain: “Bed = sleep. That’s it.”
2. Cognitive Restructuring
This means: challenging the anxious thoughts that keep you awake.
Instead of “If I don’t sleep tonight, I’ll mess up at work tomorrow,” you learn to think: “My body will get the sleep it needs. I’ve functioned on less sleep before. Worrying about sleep makes it worse.”
It’s not about “positive thinking.” It’s about breaking the catastrophic thought loops that trigger hyperarousal.
The Results
Within a few weeks, I started waking up feeling actually refreshed. My brain felt clear. I could fall asleep within 10 minutes instead of lying awake for hours.
For the first time in years, I actually enjoyed going to bed instead of dreading it.
That was over five years ago. And I’ve been sleeping well ever since — even during stressful periods. (Though I’ll be honest: when I get really excited about a project, like building this website, my brain sometimes races at night. The difference is, I now know how to reset it within a week or two instead of suffering for months.)
The Painful Realization: I Suffered Needlessly
Here’s what still frustrates me:
I could have avoided months of suffering during housemanship if I’d known about CBT-I back then.
I didn’t need to push through. I didn’t need to white-knuckle my way to “adjustment.” I didn’t need to risk my life driving home after 30-hour shifts.
I needed to retrain my brain. That’s it.
And here’s the part that breaks my heart as a psychiatrist now: Most Malaysians have no idea this solution exists.
Why I’m Building the 30-Day Sleep Reset Program
In my clinical practice today, 80% of my patients come to me with insomnia.
Not as their main complaint — usually they’re seeking help for depression or anxiety. But when I dig deeper, I find out they haven’t been sleeping well for months. Sometimes years.
And you know what? Their insomnia often came first. It was the precipitating factor that tipped them into depression or worsened their anxiety.
This is preventable.
Insomnia doesn’t have to become a chronic condition. It doesn’t have to lead to mental health crises. It doesn’t have to mean years of suffering.
But here’s the problem: most people don’t seek help until their condition is already severe. They wait until they’re so desperate, so burned out, so deep in the hole that climbing out takes months of treatment — and sometimes medication.
We don’t want that. We want to prevent that.
That’s why I’m creating the 30-Day Sleep Reset Program. Not to replace psychiatric consultations (some people genuinely need that level of care), but to make evidence-based sleep education accessible to Malaysians before they reach crisis point.
Because if I’d known about CBT-I during housemanship — if I’d had access to a structured program that taught me how to retrain my brain — I would never have crashed my car. I would never have spent months lying awake in anxiety. I would never have thought quitting medicine was my only option.
You shouldn’t have to suffer for years before someone teaches you how sleep actually works.
Here’s What I Want You to Know
If you’re reading this and recognizing yourself — if you’re lying awake at night with a racing mind, if you’re exhausted but can’t sleep, if you’ve tried “sleep hygiene” and it didn’t work — I need you to understand something:
Your brain isn’t broken. It’s just been trained wrong.
And just like any other learned behavior, it can be unlearned.
You don’t need to push through for months hoping it gets better. You don’t need to wait until you’re so desperate that you’re considering medication. You don’t need to accept poor sleep as your “new normal.”
You need to retrain your brain. And the good news? Most people start seeing changes within 2–3 weeks when they use the right techniques.
What Happens Next
I’m building The 30-Day Sleep Reset Program specifically for Malaysians like you — people who are exhausted, frustrated, and ready to fix this problem properly instead of just managing it.
It’s not a bunch of generic “sleep tips” you can find on Google. It’s not another article telling you to “avoid blue light and keep your room dark.”
It’s the same brain retraining system I used on myself. The same evidence-based CBT-I techniques I use with my patients. Adapted for Malaysian life — our work culture, our schedules, our challenges.
Because you deserve to sleep well. You deserve to wake up refreshed. You deserve to enjoy bedtime instead of dreading it.
And you definitely deserve better than nearly crashing your car because your brain forgot how to rest.
Ready to retrain your brain? Follow @psychiatristtalk on Instagram or visit moodie.my for more evidence-based sleep education. I’ll be sharing the same techniques that saved my sleep — and my career — during medical training.
Because nobody should have to learn this the hard way like I did.
References
- Trauer JM, et al. Cognitive behavioral therapy for chronic insomnia: A systematic review. Annals of Internal Medicine. 2015;163(3):191-204.
- Perlis ML, et al. Etiology and pathophysiology of insomnia. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Elsevier; 2017:769-784.
- Belleville G, et al. Meta-analytic review of the impact of cognitive-behavior therapy for insomnia on concomitant anxiety. Clinical Psychology Review. 2011;31(4):638-652.
- Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatric Clinics of North America. 1987;10(4):541-553.
- Harvey AG. Treating sleep and circadian problems to promote mental health. Sleep. 2022;45(4):zsac026.
- Miller CB, et al. Physiological markers of arousal change with psychological treatment for insomnia. PLoS One. 2015;10(12):e0145317.
- Henry AL, et al. Insomnia as a mediating therapeutic target for depressive symptoms. Journal of Sleep Research. 2021;30(1):e13140.
- Espie CA, Henry AL. Disseminating cognitive behavioural therapy (CBT) for insomnia at scale. Journal of Sleep Research. 2023;32(6):e14025.
Dr. Lee Wen Pei 笔
Psychiatrist & CBT-I Certified
Moodie 解忧处方笺