They're common in children but stick... | Georgia Telehealth Therapy

Imagine getting out of bed, uh, walking down a flight of stairs, unlocking your front door, and just wandering out into the cold street. Oh, wow. Yeah. And doing all of that while your brain is entirely profoundly fast asleep. Like there is no dream guiding you, right? No internal movie playing. Exactly. There is no narrative in your head. It's just an autopilot physical body executing these highly complex commands in the dark while the conscious mind is completely switched off, which is such a wild concept to wrap your head around. It really is. Okay, let's unpack this because when we typically think of someone sleepwalking, pop culture gives us this very specific almost, you know, comical image.

Oh, totally. The zombie walk. Yes. We picture a zombie with their arms outstretched in front of them, eyes glazed over, acting out whatever bizarre movie happens to be playing in their imagination, like they're trapped in a dream, right? Like they're trying to navigate the physical world based on a hallucination. But today, we are going to completely dismantle that pop culture myth. I love this because it's so misunderstood. It really is. So we are diving deep into some clinical insights from coping and healing counseling to explore the uh the fascinating biological reality of what is actually happening to the human body when the lights go out. And it is definitely not what people think. No, not

at all. And then we are going to look at how modern clinical therapy actually steps in to help the practical side of it. So whether you are a learner trying to, you know, optimize your own sleep hygiene or you're just trying to understand a family member's terrifying night tears without panicking, this deep dive is for you. It's going to be incredibly relevant for so many people. Absolutely. So let's start with that whole acting out of dream misconception. Yeah, it is funny how sticky that classic movie trope really is. is I mean the sleepwalker is always uh fighting an imaginary dragon or serving an invisible customer or something right completely detached from the room they are

actually in. Exactly. But the clinical reality of what is happening in the brain and the body during these episodes is well it's far more complex. To really understand it we have to tear that myth down right to the studs. Clinically speaking these events are classified as nonrem sleep arousal disorders. Okay. Nonrem. Yeah. And understanding that non-REM part is literally the absolute key to everything. Right. Because REM sleep, rapid eye movement sleep, that's where the vivid hallucinatory dreaming actually happens. Right. Precisely. That's the dream stage. So if these disorders are nonrem, they are completely bypassing the dream stage entirely. Spot on. Sleepwalking and sleep terrors, they occur during deep slowwave nonrem sleep. Okay? And this is

a profound dreamless stage of the sleep cycle. The brain is not generating vivid narratives or you know colorful landscapes. It is essentially a void just totally blank. Completely blank. And this dreamless state is the exact reason why the person experiencing the episode usually remembers absolutely nothing the next morning because there's nothing to remember. Exactly. There is no dream to remember because there was no dream happening in the first place. Man, I am struggling to wrap my head around this. I mean, I'm looking at my own hands right now. It's weird to think about, right? It really is. Wait, if the brain isn't dreaming and painting a picture of reality, what exactly is driving the physical

body to get up and navigate a room? That is the million-dollar question, right? Like, if my conscious brain isn't awake to send a signal saying, "Lift the left leg, now the right leg." How on earth does my nervous system coordinate balance or spatial awareness or fine motor skills like turning a doornob? How do I not trip over the coffee table? Well, what's fascinating here is the profound disconnect between the sleeping mind and the active body. A disconnect. Okay. Yeah. During one of these arousal disorders, the part of the brain responsible for complex learned motor functions like the machinery that stores muscle memory and allows you to walk or open doors, that part is essentially awake

and highly active. Oh wow. But the conscious memory making centers of the brain, the parts that provide self-awareness, they remain in a state of deep paralyzed slumber. So it's like the engine is running but literally nobody is behind the wheel. That is exactly it. The physical body is capable of executing complex previously learned behaviors on complete autopilot. That is terrifying. It requires zero conscious direction or dream state hallucination to guide it. It is a pure physiological activation in the absence of consciousness. Unbelievable. And that is why the amnesia is so complete the next day. The memory recording function of the brain was never even turned on to capture the event. That just blows my mind.

And you know, it is not always someone taking a two-mile stroll down the block. Oh, definitely not. There's a whole spectrum of how this autopilot behavior manifests physically. Like sometimes it starts incredibly small, right? Yeah. Very subtle things. A person might just, I don't know, sit up in bed, look around the room with a completely blank stare, and then quietly lie back down. Exactly. But then it scales up. It does scale up, and it can be incredibly unsettling to witness. I mean, clinicians often hear terrified parents describe finding their child just standing in the dark kitchen staring at a wall. Oh, that sounds like a horror movie. It really does. And it can escalate to

walking around the bedroom, roaming the hallways, or in extreme cases, the person might actually unlock complex deadbolts and leave the house entirely all while asleep. All while remaining entrenched in this deep, dreamless sleep. Wow. And then there are sleep terrors, which according to the source fall under this exact same umbrella of nonrem disorders. Yes, they do. which is wild to me because you would naturally assume a night terror is just a really really bad nightmare, right? That's what everyone thinks, but it isn't. This is sudden panicked screaming. The person's heart is racing. They're sweating profusely. Their pupils are dilated and they look absolutely terrified. Pure physiological panic. Exactly. But again, there is no bad dream

they are reacting to. Just pure physical panic. Here's where it gets really interesting. Okay, lay it on me. I was trying to visualize this blank hard to wake state and it feels perfectly analogous to a computer that is stuck in sleep mode. Oh, I like that. You know, when your monitor is completely black like the system looks totally shut down, but you can hear the internal cooling fan in the hard drive just inexplicably worring at top speed. Yes. Doing god knows what in the background. Exactly. Yeah. The hardware is working overtime, but the software, the interface you actually interact with is completely offline. The hardware software disconnect is honestly the perfect way to conceptualize it.

Makes so much sense. It really does because the racing heart, the panicked screaming in asleep terror, the act of walking down a flight of stairs, that is all the physiological hardware responding, physical machinery, right? The autonomic nervous system is firing on all cylinders, releasing adrenaline, moving muscles, reacting to some kind of internal misfire. Wow. But the conscious software, the part of the brain that says, "I am awake. I am safe. I am making choices is completely shut down." So no one's clicking the mouse, right? There is no software input telling the hardware to do these things. It's just a pure hardware glitch happening in the dark. Okay. So who exactly is experiencing these massive hardware

glitches? Because we usually associate sleepwalking with kids. We do. Yeah. Which makes logical sense. I mean kids brains are still developing. Their neural pathways are literally under construction. So a few glitches in the system are bound to happen. Sure. You expect a few bugs in a new system, right? But these disorders absolutely can and do continue into adulthood or they even pop up for the very first time in adults, which is crazy. It happens more than you'd think. There is a very persistent misconception that sleepwalking is strictly a childhood phase you just outgrow. Right? But for many it persists and understanding the adult triggers is absolutely crucial here. Okay. So what are they? When we

look at the clinical data the primary culprits triggering these episodes in adults are stress, sleep deprivation and certain medications. Wait, if stress and sleep deprivation are the primary triggers, aren't we basically creating a perfect storm for adult sleepwalking in our modern burnedout society? You're hitting the nail on the head. I mean, who isn't chronically stressed and sleepd deprived right now. If we connect this to the bigger picture, you are hitting on a major public health dynamic. It's everywhere. It really is. We live in a culture that consistently glorifies burnout. We willingly trade hours of necessary restorative sleep for more time working or answering emails or just doom scrolling on our phones. Guilty is charged, right?

We all do it. But what the clinical data tells us is that this daytime lifestyle doesn't just make you tired. It fundamentally disrupts the underlying architecture of your sleep. It breaks the system. Exactly. When you are chronically stressed during the day, your cortisol levels stay artificially elevated. Your sympathetic nervous system, your fightor-flight response is constantly humming in the background. So you are basically carrying that hyperaroused hum right into bed with you every night. Exactly. And that creates a pressure cooker effect in the brain. Oh man. The body is so sleepd deprived that it's desperate for deep sleep, but the nervous system is too agitated to maintain it smoothly, right? Because of the cortisol, right? So

the transitions between the different sleep stages become highly fragmented and unstable. Imagine trying to smoothly shift gears in a manual transmission car while someone else is randomly slamming their foot on the gas pedal. That's a great visual. A very jerky ride. Very jerky. That instability is the fertile ground where these non-REM arousal glitches happen. The brain tries to transition out of deep sleep, but the hyperaroused nervous system misfires and suddenly your physical body is up and walking while your consciousness remains entirely asleep. So by ignoring our stress and anxiety during the day, we are quite literally programming our bodies to glitch out and roam the halls at night. Pretty much. Yeah, that is incredibly daunting.

But thankfully, there are evidence-based clinical solutions for this. Yes, there is hope, right? First and foremost, a licensed clinician must make the diagnosis. Yeah, you cannot just WebMD your way out of a complex sleep disorder. Please don't try to. Self-dagnosing sleep disorders is highly dangerous. I can imagine because there are other serious neurological conditions like nocturnal seizures or REM sleep behavior disorder that need to be completely ruled out by a professional. Right. You need an expert to look at the hardware. Exactly. But once a clinician definitively diagnoses a nonrem sleep arisal disorder, the interventions become highly targeted and effective. Well, one intervention that comes up frequently in the text is safety planning, which makes total

sense practically. It's usually step one. If someone is prone to leaving the house, you need to secure the environment. You know, put bells on the doors, move trip hazards out of the hallways, that sort of thing. Basic physical safety, right? But the intervention that really caught my eye was something called scheduled awakenings. Ah, so what does this all mean? How does waking someone up actually help them sleep better? It feels totally counterintuitive. It does sound backwards, doesn't it? Totally. But as I processed it, I thought back to the glitchy Wi-Fi router. Okay, let's hear it. You know how a router always seems to crash at the exact same time every day or under the exact

same heavy load? Yes. Always right in the middle of a meeting. Exactly. So, right before it is about to hit that breaking point and crash, you walk over and hit the reset button. You interrupt the bad cycle before the glitch can fully manifest, forcing the whole system to start a fresh, clean cycle. I love that. And just like that router, your sleep cycle has highly predictable points where it is most likely to crash. Really predictable points. Yes. These arousal episodes typically occur in the first third of the night during the specific transition out of the deepest slowwave sleep stages. Okay. So, by gently waking the person, and I mean just enough to lightly rouse them,

not fully wake them up and start a conversation. Just a little nudge, right? just a nudge about 15 to 30 minutes before the episode typically occurs, you are effectively hitting that reset button on their sleep cycle. You alter the sleep architecture just enough to bypass that unstable, glitchy transition phase. It is a fascinating clinical tool, especially for children suffering from severe nightly sleep terrors. That is incredible. Just bypassing the glitch entirely before it even happens. It is a great management tool. But you know, while scheduled awakenings and safety planning manage the immediate symptoms, the ultimate goal of clinical care is treating whatever underlying issue is driving the poor sleep in the first place. Right. Treating

the root cause. Exactly. If chronic stress, anxiety, or trauma is the gasoline fueling these nighttime episodes, you cannot just put a lock on the bedroom door and call it a day. You're just masking the problem, right? You have to treat the daytime psychological load. That is where interventions like cognitive behavioral therapy for insomnia or CBTI come in. Wait, I need to challenge that a bit. Go for it. If CBT is essentially a form of talk therapy, how does that fix a deeply physical neurological sleep disorder? Like what is the actual mechanism there? It is a great question and it comes back to downregulating that hyperaroused nervous system we discussed earlier. A fight orflight hum. Exactly.

H CBT isn't just venting about your day. It actively helps you identify and restructure the thought patterns and behaviors that keep your daytime cortisol levels elevated. Okay. So, it lowers the stress hormone. Yes. By addressing the root anxiety or trauma during the day and reassociating the bed with actual rest rather than worry, you are literally creating a more stable chemical environment in your brain. Oh wow. When night falls, your nervous system isn't stuck in fight orflight mode. Cortisol drops naturally, sleep pressure builds properly, and your brain can finally transition smoothly between sleep stages without the hardware misfiring. So, it is not just talking. It is literally rewiring the chemical state of the brain so the

system doesn't crash at 3:00 a.m. That's exactly what it is doing. Which brings up a very practical problem, which is knowing that you need to get to the root cause of your stress and anxiety is one thing, but actually finding a licensed clinician to help you do that can be incredibly overwhelming. Oh, absolutely. a huge barrier and that is where accessible teleaalth models like coping and healing counseling or CHC come into play as a realworld application for getting this help. Looking at how practices like CHC operate provides an excellent blueprint for what accessible root cause clinical care actually looks like in practice. Definitely I mean they have a deep edge of professionals. The team includes

licensed clinical social workers, licensed professional counselors and licensed marriage and family therapists. a very multid-disciplinary team, right? Essentially, whatever flavor of specialized care you need, whether you need someone deeply trained in family dynamics or someone specializing in individual behavioral therapy, they have someone credentialed to provide it. And they have over 15 licensed therapists, right? Yes. 15 plus. And it is a diverse, culturally competent team serving all 159 counties in Georgia. That statewide reach is huge. It's so crucial, especially when you're asking people to unpack their deepest, most vulnerable stressors because the therapeutic alliance, that critical level of trust and mutual understanding between a client and a clinician is the absolute foundation of effective treatment. You

have to trust them. Exactly. Having a diverse, culturally competent team means a much wider range of patients can find a therapist who truly understands their lived experience and the unique cultural contexts of their daily stress. And they treat the exact triggers we've been talking about. You know, anxiety, depression, trauma, PTSD, grief, relationships, and just general life stress. Plus, they see teens 13 and up and offer life coaching, covering all the bases. But here is the part that I think is the real gamecher. They operate as a 100% teleaalth IPA compliant practice, which is so important nowadays. When you think about it, the traditional model of healthcare is stressful in itself. Taking a half day off

work, fighting cross town traffic, sitting in a sterile waiting room surrounded by old magazines while your anxiety spikes. Just trying to get to the appointment raises your cortisol. Right. So, being completely virtual directly removes so many of those logistical barriers. This raises an important question for you, the listener, to consider. Yeah. How often do the logistical barriers and the friction of the health care system actually compound the exact stress you are trying to treat? Oh, all the time. Right. We know that unressed daytime stress manifests at night in these profound physical ways. By utilizing an accessible 100% teleaalth model, the friction of accessing care is completely removed. You're just at home. You are logging on

from the safety of your own couch. Acknowledging that and reducing that friction is almost a therapeutic intervention in itself. And one of the biggest hurdles to getting help is always the financial cost. Always. But practices like CHC are built to bypass that too, right? Rather than operating strictly on an expensive out-ofpocket cash model, they take major commercial insurance and even Medicaid. That accessibility is incredible. Yeah, it really is. Conceptually, what this means is that some patients are getting highly specialized root cause care for the cost of a couple of cups of coffee or in many cases entirely for free because Medicaid has a $0 co-pay with them. Rick, exactly. Medicaid is a $0 co-pay and

for commercial insuranceances like Etna, Sigma, Blue Cross Blue Shield, United Healthcare, and Humanana, it's typically just a $10 to $40 co-pay per session. That's amazing. They are actively tearing down the financial barriers to treating the root causes of these sleep disorders. For anyone in Georgia listening who recognizes themselves or a loved one in this deep dive, you can reach them at sick theapy.com, email them at supportsix theapy.com, or simply call them at area code 404-832102. It is a comprehensive model of care that successfully moves the conversation from the abstract science of sleep architecture directly into practical actionable steps for the patient. Yeah. It takes it out of the textbook and into real life. Exactly. Well,

we have covered a massive amount of ground today. We really have. We started by completely busting the pop culture myth that a sleepwalker is simply a zombie acting out a vivid dream. Goodbye to the zombie walk. Seriously, we learned that the clinical reality is actually a nonrem disorder happening in a deep dreamless void driven by a profound disconnect between an active motor cortex and a completely sleeping consciousness. And we also explored the wide spectrum of how these neurological glitches manifest physically from a confusing blank stare in bed to the terrifying adrenalinefueled racing heart of a sleep terror. The hardware misfires, right? And we identified how adult lifestyle factors, specifically our modern societal struggles with chronic

stress and sleep deprivation, acts as the primary chemical triggers for these episodes. And finally, we explored how evidence-based clinical solutions from resetting the sleep cycle with scheduled awakenings to utilizing accessible teleaalth therapy to chemically downregulate our daytime nervous system are essential for treating the root causes of these nighttime glitches. Understanding the biological mechanics of sleep and recognizing the profound, undeniable connection between our daytime mental health and our nighttime physical reality is really the very first step toward taking control of it. So, as we wrap up this deep dive, I want to leave you with one final thought to ponder based on everything we've unpacked today. Okay, let's hear it. Think about this for a second.

If the human body is perfectly capable of standing up, navigating the spatial dimensions of a dark house, unlocking complex deadbolts, and walking outside, all while the conscious mind is entirely switched off in a dreamless void. What does that say about the sheer amount of hidden autopilot processing power our physical brain possesses when we aren't even awake to control it? It is a truly staggering realization. It turns out the person walking down the hall at 3.3 a.m. isn't the zombie trapped in a dream movie at all. Not at all. They are a masterpiece of biological hardware, quietly running complex programs in the dark, just waiting for the conscious mind to finally wake up and take the

wheel.