Health & Medical Sleep Disorders

Twilight sleep in obstetrics

Your problems can be evaluated by an Ears, Nose, Throad (ENTor otolaryngologist) doctor--if you are having sleep problems associated with significantly enlarged adenoids and a very relaxed palate then various surgical operations may be necessary to review. The problem is not one of too little oxygen, but rather may be related to anatomical issues (how his air passages are designed). Speak with your doctor about this. Many times it is helpful to make a video tape for either his doctor or the ENT doctor to see--a picture and sound is worth a thousand words.

The term "twilight sleep" applied to the combination of analgesia (pain  relief) and amnesia (loss of memory) that was produced by a mixture of morphine  and scopolamine ("scope") given by a hypodermic injection (an injection under  the skin). The mixture of the two drugs created a state in which the woman,  while responding somewhat to pain, did not remember it after delivering her  baby. Twilight sleep was once in vogue in obstetrics.

Morphine and scopolamine are both venerable drugs that have been around a  long time. Both are also naturally occurring members of the very large chemical  class of compounds called alkaloids:

Morphine: The name "morphine" was coined in 1805 by the German  pharmacist Adolf Serturner -- "morphine" refers to Morpheus, the mythologic god  of dreams -- to designate the main alkaloid contained in opium. Opium, of  course, comes from a plant: the poppy. Morphine is a powerful narcotic agent  with strong analgesic action and other significant effects on the central  nervous system. It is dangerously addicting.  Scopolamine: Scopolamine was introduced in 1902 and used up until the  1960s. The name comes from that of the 18th-century Italian naturalist Giovanni  Scopoli. Together with atropine, scopolamine is a component of belladonna which  comes from a plant called "deadly nightshade," once used as a means of poisoning  ones enemy. When scopolamine is given in lower (non-poisonous) doses, it causes  drowsiness, amnesia, and euphoria (a "high") and was thus used as a  preanesthetic agent. Combined with morphine, scopolamine provided childbirth without pain (or  without the memory of pain), once a much sought-after objective. However, there  were serious problems with twilight sleep. It completely removed the mother from  the birth experience and it gravely depressed the baby's central nervous system.  This sometimes made for a drowsy depressed baby who was difficult to resusitate,  to get breathing normally.

Twilight sleep has, therefore, fallen entirely out of favor and is now merely  a chapter in the past history of obstetrics.

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