Always coughing in the middle of the night, commonly found in left heart failure, cough variant asthma, gastroesophageal reflux, bronchitis, etc., should be further diagnosed and treated in the hospital. 1. Left heart failure: the main symptoms of pulmonary stasis and decreased cardiac output, with varying degrees of dyspnea; cough, fatigue, dizziness, coughing up sputum, hemoptysis, fatigue, panic, reduced exercise tolerance; oliguria and renal impairment, long-term blood urea nitrogen creatinine elevation, accompanied by corresponding symptoms of renal insufficiency. 2. Cough variant asthma: with episodic cough as the main clinical manifestation, there is no obvious wheezing and shortness of breath, but there are airway symptoms. Cough variant asthma: a special type of asthma with episodic cough as the main clinical manifestation, without obvious symptoms such as wheezing and shortness of breath, but with airway hyperresponsiveness. The main manifestation is irritating dry cough, usually more violent cough, night cough. 3. Gastroesophageal reflux (GERD), which is the reflux of gastroduodenal contents into the mouth, esophagus and lungs causing discomfort and/or complications, may manifest symptoms such as cough, heartburn, acid reflux, dysphagia, pharyngeal foreign body sensation, and retrosternal pain. 4. Bronchitis: – is an inflammation of the mucous membranes of the trachea and bronchial tubes as well as their surrounding tissues caused by a variety of factors, with the main symptom being coughing up sputum. Recurrent bacterial and viral infections, air pollution, cold air, allergies, smoking, etc. may lead to the onset of the disease. The presence of a significant nocturnal cough requires active medical attention to clarify the cause of the disease and then provide targeted treatment.