Gender male/female

Age 26 years old

Professional graduate students /IT/ doctors/white-collar workers/self-media authors, etc.

Birthplace Hubei Sichuan Guangxi Ningxia Henan Shandong Guizhou Yunnan townlet village

The medical record number is 2019112.

Chief complaint is irregular staying up late 10 years or more, 1 year aggravation, headache for half a day.

Patients with current medical history began to "stay up late" because of the "College Entrance Examination" more than 10 years ago, which showed that they read their writing assignments until late at night, thought about sleeping during the day, were not focused in class, and had no fever or chills. After ignoring the "college entrance examination", the patient's "staying up late" situation improved slightly and his sleep gradually became regular. After entering the university and contacting many roommates who are addicted to games, the patient's condition deteriorated sharply, and there was "computer and game dependence", which showed that he didn't eat or go to the toilet for more than ten hours in front of the computer, even chatted and played games all night, accompanied by complications such as decreased vision and hair loss, and the patient didn't care. Four years ago, patients were facing "postgraduate entrance examination" and the symptoms of "staying up late" were further aggravated. He slept less than 5 hours a day for about 1 year. During this period, the patient was accompanied by wisdom tooth inflammation, gastritis, cystitis, hemorrhoids and other complications, which improved after symptomatic treatment. After the "postgraduate entrance examination", the patients felt physically exhausted, listless, in a trance and emotionally unstable, and their symptoms improved slightly after adjusting their work and rest. 1 year ago, patients began to write graduation thesis and look for a job, and once again appeared "staying up late" symptoms, sometimes even staying up all night; After graduation, patients go to work in the company, often busy during the day, go home at night to continue their studies until late at night, and then go to see Weibo brush Tik Tok until the early morning, accompanied by mental irritability and restless sleep. Today, they have a persistent headache and paroxysmal aggravation, which is unbearable. The outpatient department was admitted to our department because of staying up late. Since the onset, mental and physical strength have gradually deteriorated, sleep is seriously insufficient, diet is irregular, defecation is acceptable, and weight has increased by about 7kg.

In the past, Shi was usually healthy, liked to eat snacks, watch TV and didn't exercise.

Personal history, long-term living history in the north, Guangzhou and Shenzhen. Deny the hobby of smoking and drinking; Deny the contact history of patients with AIDS, syphilis and other infectious diseases.

Family history Parents are healthy and have no "staying up late". Brother 1, 30 years old, 10 years ago was diagnosed as "staying up late" and improved after treatment 3 years ago; Sister 1, 22 years old, occasionally "stayed up late" and didn't handle it.

Physical examination, conscious, poor mental reaction, fair reaction, pale face, conjunctival congestion, blue eyelids on both sides, pale lips, clear breathing sounds in both lungs, no dry and wet rales, arrhythmia, heart rate of 65 beats/min, slightly dull heart sounds, no murmur, no special abdominal examination, incomplete muscle strength examination of limbs and normal muscle tension.

Diagnosis of staying up late, severe; arrhythmia

Diagnosis and treatment plan

1, shut down the internet and confiscate the mobile phone computer;

2. Strictly guarantee the sleep time (8 hours/day), advance the sleep time by 10 minute/day, and gradually adjust it to 22: 00;

3, require more exercise, at least 3 times/week, 30 minutes/time;

4. Improve routine hematuria and stool, liver and kidney function, myocardial enzyme examination and electrocardiogram examination;

5, depending on the patient's condition and treatment cooperation, decide when to open the network and return the mobile phone and computer.