When a child has a strong cough when he or she sleeps, it is necessary to treat the cause to relieve it, and there are usually the following cases: First, if it is an infant or young child, focus on gastroesophageal reflux cough, which is often a strong cough when lying down in bed, you should usually eat a small amount of meals, and not lie down immediately after feeding or eating. It takes at least half an hour to lie down, and elevating the head, neck and shoulders when sleeping is good for reducing the symptoms of reflux-induced cough. Second, if the child often coughs a lot at bedtime, and also pay attention to cough variant asthma, then the child should usually take a chewable tablet of montelukast sodium before bedtime, and should also be nebulized, often with budesonide nebulizer solution plus salbutamol nebulizer solution, nebulized before bedtime to reduce symptoms and control attacks. Third, some children may have fever and other symptoms of infection in addition to a strong cough at bedtime, so they should usually see a pediatric clinic or a respiratory clinic to assess the child’s lung condition and infection status, and treat the primary cause of the infection.