Child Study Center, Hassenfeld Children's Hospital at NYU Langone, New York, NY.
J Am Acad Child Adolesc Psychiatry. 2019 Mar;58(3):307-312. doi: 10.1016/j.jaac.2018.11.010.
Maggie is a 16-year-old girl who came to see me because she wanted help with her longstanding difficulties falling asleep at night and waking up in the morning. She goes to bed between midnight and 3 am and usually lies awake worrying until falling asleep at 3 to 4 am. She often video-calls or texts her boyfriend before sleep. Her wakeup time is 8 am; she typically wakes exhausted, having slept 4 to 5 hours. Although a good student, she is often late for classes. On weekends, she wakes around noon. She is tired, anxious, and demoralized. She cannot concentrate as well as she did prior to the onset of her sleep symptoms at age 10 to 11 years. Her psychiatric history includes a diagnosis of anxiety and depression, both in remission, treated with fluoxetine 30 mg daily for several years. Difficulties falling asleep and waking in the morning are common complaints among adolescents and young adults. Before my additional year of training in sleep medicine, I would have misdiagnosed Maggie as having insomnia rather than delayed sleep phase disorder (DSPD), a circadian rhythm disorder.
玛吉是一个 16 岁的女孩，她来找我是因为她想解决长期存在的入睡和早上醒来困难的问题。她通常在午夜到凌晨 3 点之间上床睡觉，并且经常躺在床上担心到凌晨 3 点到 4 点才能入睡。她经常在睡觉前和她的男朋友视频聊天或发短信。她的起床时间是早上 8 点，通常起床时感到疲惫，只睡了 4 到 5 个小时。尽管她是一个好学生，但她经常上课迟到。在周末，她大约中午才醒来。她感到疲倦、焦虑和沮丧。她的注意力不如她在 10 到 11 岁出现睡眠症状之前那么集中。她的精神病史包括焦虑和抑郁的诊断，均已缓解，曾服用氟西汀 30 毫克/天治疗数年。入睡困难和早上醒来是青少年和年轻人常见的抱怨。在我接受睡眠医学额外一年的培训之前，我可能会错误地诊断玛吉患有失眠症，而不是睡眠时相延迟障碍（DSPD），这是一种昼夜节律紊乱。
