Twilight sleep

Scopolamine doses An anticholinergic that induces mental clouding or twilight sleep at high doses. 

The use of opiates in obstetrical analgesia is a highly specialized field requiring considerable experience and sound judgment to ensure safety. Morphine has been combined with scopolamine in twilight sleep, but this mixture is not used nearly as much as formerly. Various combinations of meperidine, barbiturate, scopolamine, paraldehyde, and the inhalation anesthetics have made morphine less popular in obstetrical work. The opiates are powerful respiratory depressants. The fetus is especially susceptible to morphine, which greatly increases the incidence of asphyxia in the newborn. Morphine and its derivatives are particularly contraindicated in premature labor because of the untoward effect of such medication on the premature infant. 

In a laboratory-based study of sleepiness using the Multiple Sleep Latency Test (MSLT), hospital residents were found to be near the twilight zone following postcall (mean time to sleep of 5.5 min) (46). Perhaps most provocative was that their baseline (not on-call) level of sleepiness was not significantly different at 6.5 min. This demonstrated both the level of chronic sleep deprivation experienced (as reflected in the baseline condition) and the physiological level of sleepiness that can be expressed postcall. When the residents had the opportunity... 

Effects Possible nausea during first 45 minutes, followed in several hours by silly feelings and giggling, and then dryness of mouth and throat, flushing of skin and bloodshot eyes, heavy intoxicated feeling, incoherent speech and impaired motor function. This is followed by tranquil feelings, stupor with inability to sleep, euphoria and twilight state dreams. Total experience lasts about 12 hours, followed by 24 hours of drowsiness and sleep. 

Sea otters feed on clams, mussels, and other crustaceans. To break open these hard shells, they use rocks, which they bring up from the sea bed, as tools. As a sea otter lies on its back, it places the stone on its chest and beats the prey against it, thereby cracking the shell and exposing the meat inside. At twilight, sea otters move into kelp beds to sleep, tangling themselves in the vegetation so that they do not drift out to sea. 

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