Waking up suddenly with pain in the middle of the chest upon exertion may be due to pleurisy, costochondritis, myocardial ischemia and other causes. 1. Pleurisy: when lung inflammation invades the pleura, the stimulation of inflammation will lead to chest pain and chest tightness, and the pain can be aggravated by coughing, deep breathing or changing position. Tuberculous pleurisy can also be accompanied by low-grade fever, night sweats and other systemic symptoms. 2. Costochondritis: mostly caused by overexertion or trauma, local tissue swelling, pain, obvious pressure pain, pain will be aggravated when exertion. 3. Myocardial ischemia: such as coronary heart disease, coronary artery lumen narrowing or occlusion, manifested as chest pain, chest tightness, tightness in the chest, etc., most of them are crushing pain. Wake up suddenly in the middle of the chest a force on the pain may also be seen in other diseases, it is recommended that patients seek medical attention in a timely manner, so as not to delay the condition.