Coughing at two o’clock in the middle of the night has many causes, such as cough variant asthma, gastroesophageal reflux disease, cardiac insufficiency and so on. 1. Cough variant asthma: a special type of asthma, mainly manifested as irritating dry cough, mostly at night and early morning episodes, without obvious wheezing, shortness of breath and other symptoms. It can cause cough in the middle of the night. 2. Gastroesophageal reflux disease (GERD): a chronic disease in which the contents of the stomach and duodenum reflux into the esophagus, resulting in a series of symptoms. When sleeping in a flat state, the acidic reflux material may reflux into the throat, irritating the throat and trachea, causing coughing, pharyngeal discomfort and other symptoms. Its can cause occasional coughing in the middle of the night. 3. Cardiac insufficiency: some patients with chronic cardiac insufficiency, lying down at night will appear to increase the volume of return blood, the heart load increases, aggravate the lungs bruises, causing coughing, accompanied by dyspnea, coughing up pink foamy sputum, you need to consult a doctor in a timely manner. Occasional coughing in the middle of the night has a variety of other causes, should be timely to the hospital, clear cause, under the guidance of a professional doctor, follow the doctor’s instructions for treatment.