There are many reasons for severe coughing at night, which may be related to cough variant asthma, gastroesophageal reflux disease, cardiac insufficiency and other causes. 1. Cough variant asthma: it is a special type of asthma, which is mainly characterized by paroxysmal coughing at night, which may lead to the situation of being unable to sleep at night with coughing. 2. Gastroesophageal reflux disease (GERD): when the patient is lying down, the gastric contents may reflux, which may irritate the pharynx and lead to severe coughing and sleeplessness. 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. There are many other causes of violent coughing at night, you should go to the regular hospital in time, clear cause, standardized treatment under the guidance of the doctor, so as not to delay the condition of the body to bring adverse effects.