目的：探究抑郁青少年在自然生活环境下的昼夜节律特征及自主神经功能，并分析社会时差与快眼动 （rapid eye movement，REM）期心率变异性（heart rate variability，HRV）的关系。方法：采用病例-对照研究设 计，纳入13～19岁首发、既往未经治疗抑郁的青少年34例（抑郁组）以及与患者年龄、性别、受教育水平相匹 配的健康对照18名（对照组）。采用汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评估受试者 情绪；采用慕尼黑时型问卷（MCTQ）和清晨型-夜晚型量表（MEQ-19）评估受试者昼夜节律核心特征及时型 偏好；采用失眠严重指数问卷（ISI）和爱泼沃斯思睡量表（ESS）评估主观睡眠困扰；采用可穿戴设备记录受试 者连续或间断多晚的入睡时间及出睡时间，计算客观节律核心变量，并通过分钟级的睡眠时期标记提取不同 睡眠阶段HRV时间域指标，包括心率间期差值平方的均方根（Root Mean Square of Successive Differences， RMSSD）和心率间期标准差（Standard Deviation of Normal-to-Normal Intervals，SDNN）。采用 t 检验或 Mann-Whitney U检验进行量表评分及节律变量组间比较；使用多因素线性回归分析社会时差对RMSSD的 独立影响。结果：①抑郁组HAMD、HAMA、ISI、ESS得分显著高于对照组（P＜0.05）；②客观节律变量中，抑 郁组工作日睡眠中点及加权睡眠中点显著早于对照组，社会时差显著高于对照组（P＜0.05）；③抑郁组对数 转换后的REM期RMSSD显著降低（P＜0.05）；④社会时差与REM期RMSSD呈正相关，控制组别、年龄、性 别及BMI后，社会时差仍为REM期RMSSD的显著预测因素，抑郁组别为独立负向预测因素。结论：抑郁青 少年主观睡眠满意度较低，社会时间安排和个体内在节律偏好错配程度更高，即社会时差更大；与健康青少年 相比，其REM期自主神经功能存在改变，与社会时差显著相关，可能是情绪相关生理差异更敏感的观察窗口。

To investigate the circadian rhythm characteristics and autonomic nervous function of adolescents with depression in their natural living environments, and to analyze the relationship between social jetlag and heart rate variability (HRV) during rapid eye movement (REM) sleep. Methods: A case-control study design was adopted, enrolling 34 first-episode, previously untreated adolescents with depression aged 13～19 years (depression group) and 18 healthy controls matched for age, gender, and education level (control group). The Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) were used to assess subjects’ mood. The Munich ChronoType Questionnaire (MCTQ) and Morningness-Eveningness Questionnaire (MEQ)-19 were used to assess core circadian rhythm characteristics and chronotype preference. The Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) were used to assess subjective sleep distress. Wearable devices were used to record sleep onset and offset times over consecutive or intermittent nights. Core objective rhythm variables were calculated. Minute-level sleep stage annotation was used to extract time-domain HRV indicators for different sleep stages, including the Root Mean Square of Successive Differences (RMSSD) and the Standard Deviation of Normal-to-Normal Intervals (SDNN). The t-test or Mann-Whitney U test was used to compare scale scores and rhythm variables between groups; multivariate linear regression was used to analyze the independent influence of social jetlag on RMSSD. Results：(1) The scores for HAMD, HAMA, ISI, and ESS in the depression group were significantly higher than those in the control group (P<0.05). (2) Among the objective rhythm variables, the midpoint of the sleep episode on workdays and the weighted sleep midpoint in the depression group were significantly earlier than those in the control group, and social jetlag was significantly higher in the depression group (P<0.05). (3) The log-transformed RMSSD during REM sleep in the depression group was significantly reduced (P<0.05). (4) Social jetlag was positively correlated with REM sleep RMSSD. After controlling for group, age, gender, and BMI, social jetlag remained a significant predictor of REM sleep RMSSD, while the depression group was an independent negative predictor. Conclusion: Adolescents with depression report lower subjective sleep satisfaction and a greater mismatch between social time schedules and intrinsic circadian preferences, manifesting as higher social jetlag. Compared with healthy adolescents, they exhibit altered autonomic nervous function during REM sleep, which is significantly correlated with social jetlag. This may serve as a more sensitive observational window for emotion-related physiological differences.