Sleep and pain negatively impact each other. Children in pain often have difficulty going to sleep and sustaining sleep. Anxiety often develops within this negative cycle. Hypnotherapy has been noted as an effective intervention for pain, sleep and anxiety. The case presented illustrates the use of hypnotherapy in contrast to cognitive behavioural therapy (CBT) to resolve an 11-year-old girl's cycle of persistent anxiety, abdominal pain and sleep interruption. Utilizing the child's favourite activity of baking a cake, a metaphor for successful sleep was developed. The hypnotherapeutic use of surprise and dissonance promoted a rapid resolution of this pre-teen's difficulties. An explication of this process is provided. Copyright © 2009 British Society of Experimental & Clinical Hypnosis. Published by John Wiley & Sons, Ltd.