There are many reasons for chest pain and tightness in sleeping at night, which may be caused by physiological factors such as anxiety and tension, as well as pathologic factors such as angina pectoris or myocardial infarction, reflux esophagitis, pneumonia, pleurisy, pericarditis, cardiac insufficiency, chronic obstructive pulmonary disease, and so on. 1. Physiological factors Sleeping at night in a state of tension, anxiety, terror, etc., will lead to sympathetic nerve excitation, heartbeat acceleration, myocardial oxygen consumption increases, causing chest pain and chest tightness symptoms. This situation does not require special treatment, adjust the mood, can be relieved. If necessary, use some anti-anxiety drugs to regulate. 2. Pathological factors Angina pectoris or myocardial infarction: this disease is due to coronary atherosclerosis leading to coronary artery stenosis, resulting in myocardial ischemia and hypoxia, which can cause chest pain and chest tightness at night. Pneumonia: this disease is due to lung inflammation stimulation of the pleura, can also appear at night sleep chest pain and chest tightness. Pericarditis:Inflammation of the pericardium can also cause chest pain and tightness at night due to inflammation stimulation. Cardiac insufficiency: cardiac insufficiency caused by various reasons may cause the diaphragm to move upward at night, aggravating the symptoms of cardiac insufficiency and causing chest pain and tightness at night. Chronic obstructive pulmonary disease: this disease is due to small airway spasm occurs irreversible airflow limitation, even chronic hypoxia, sleep at night will also appear chest pain and chest tightness. In short, if you have chest pain and tightness at night, you should consult the hospital in time to clarify the physiological factors or pathological factors, and the pathological factors need to be diagnosed and treated according to the cause.