Coughing at night is caused by a variety of reasons and needs to be analyzed and judged in the light of the actual clinical situation, as follows: 1. Coughing variant asthma: If you have allergic rhinitis or a history of allergies and have a strong cough at night, generally consider coughing variant asthma because the patient’s relative excitement of the vagus nerve at night leads to bronchial contraction and spasm, which manifests as a strong cough at night. 2. Upper airway cough syndrome: If it is accompanied by nasal congestion and runny nose, consider the possibility of upper airway cough syndrome, because when the patient lies flat at night, it leads to a more pronounced postnasal drip, which causes an irritating cough. 3. Cardiac insufficiency: If an elderly person with hypertension and coronary artery disease develops a strong cough at night, also consider the presence of cardiac insufficiency, because patients with cardiac insufficiency 4. Gastroesophageal reflux: The cardia is diastolic at night after sleep, and food tends to reflux upward after lying down, resulting in stimulation of the esophagus and throat, which can easily cause paroxysmal coughing. Therefore, if you have a bad cough at night, you need to improve allergen screening, lung function, lung CT, cardiac ultrasound and other tests to clarify.