What Is Twilight Sleep?

Historically associated with childbirth, the term twilight sleep is often used to describe a modality of anesthesia in which a patient who is undergoing any sort of painful procedure is given a cocktail of drugs that both minimizes pain and reduces consciousness of the event. In many cases, twilight sleep induces an amnesic condition so that the patient does not remember the procedure or any discomfort experienced after the anesthetic drugs wear off. This type of anesthesia was originally introduced in the area of obstetrics as a way of minimizing women's discomfort during childbirth. Although the original combination of drugs, morphine, and scopolamine is generally no longer used, other drugs that can have a similar painkilling and sedating effect are commonly offered to patients in a variety of medical and dental procedures.

Around the turn of the 20th century, German doctors published information about their work in obstetrics anesthesia. The goal of twilight sleep was to reduce the stress and discomfort of the laboring woman and to enable her to completely forget the experience. After labor and delivery was completed, she could be presented with her new baby and not have any memory of the labor experience. Twilight sleep continued to be used for several decades in maternity wards despite undesirable side effects, such as causing women to behave so erratically that they required restraints. Some women also complained that, because they had no memory of giving birth, they felt disconnected from their children; babies born to mothers under the influence of twilight sleep drugs often developed breathing problems.

Eventually the trend toward so-called natural childbirth as well as new anesthetic techniques that allowed women to remain conscious while giving birth meant that twilight sleep was generally no longer used in obstetrics. Other medical practitioners, however, continue to use anesthetic techniques that work on a principle similar to twilight sleep. Sometimes known as modern intravenous sedation, IV sedation, or light sedation, it is typically indicated for individuals undergoing a painful medical procedure that does not mandate the use of more risky general anesthesia. In some cases, IV sedation is offered to patients who are fearful of undergoing a procedure that could be performed under local anesthesia, such as a tooth extraction.

The degree of unconsciousness experienced by individuals who undergo modern twilight sleep anesthesia varies considerably. In many cases, however, the individual will be able understand and respond to verbal instruction offered by health care professionals. For example, a person who is under the influence of IV sedation may be able to dress himself after a procedure and get into a wheelchair in order to be transported to a recovery room with minimal assistance. Yet this individual may have little or no memory of the procedure or any pain experienced.