Definitely the lack of sleep. Odd things were happening in her mind... because...
Something must be a bit off, here, some funerary shroud must have been sundered by a few hundred hungry talons. A brush-footed butterfly is rapping its shadow wings on the wrong steel chamber door. A charred and ruined city is finally crumbling to pieces. Momoko is laughing and she is laughing with her bone-white hand over her mouth, as if, if anyone were to see or hear it, they'd be cursed. They'd get a phone call in seven days informing them they're doomed to die.
It was the mention of the midgets...
"Surprise me with the tea." the bad moon rising said to the bearded comedy mask. "And I think it's, I think it's something else. It's just me, I'm dead." she spoke in all absolute seriousness and in bright black contrast to her earlier, light-hearted laughter.