OK, bit of a weird episode this. At first I felt like I had missed an episode before seeing this one.
There are two storylines juxtaposed in this episode. (Hey, I never get to use the word "juxtaposed" so I'm gonna use it now.)
One story has Sarah check in to a sleep deprivation clinic. (Yes, that's right. An exciting hour of entertainment awaits.) She meets a roommate who has nightmares about being burnt to death as a witch. John visits and alludes to Sarah's nightmares where she is help captive in the back of a van.
A Cute Nurse Lady tells Sarah that she doesn't have a brain tumor responsible for keeping her awake. In another scene Cameron walks past John in her underwear. I'm pointing this out for a storytelling reason, honest!
Each night when Sarah goes to sleep in the clinic she dreams/flashes back to being captured by the guy she shot in the warehouse factory place. He wants to know who she is, who she is working with and what they want. He also implies that he assassinated the Woman With the Deep Manly Voice and the hypnotherapist from the "UFO" episode.
Back in the clinic the roommate burns to death in her bed and Sarah investigates. She and John break into the basement where it appears the Cute Nurse Lady is a terminator and running an experiment on human brain activity for skynet. (Huh?)
Back in the van dream Sarah eventually manages to break free and sticks a syringe her captors eye. (Ew!)
Then, the big twist, Sarah realises that being stuck in the van is real and the clinic is a dream. She eventually shoots her captor in the head. Well, that's what was implied. So after going through the angst of killing someone and then finding out he was alive she kills him again.
OK, if the clinic was a dream does that mean that Sarah is still worried about having a brain tumor? And why did she dream of Cameron in her undies? You see, I told you there was a storytelling reason for mentioning Summer Glau in her undies. It must mean something!
To be honest I sort of saw the "twist" coming. Nothing about the clinic storyline made sense but it makes a lot more sense as a dream.
By the way, the Cute Nurse Lady was played by Julie Ann Emery.