Sleeping chest with back pain, may be sleeping posture is not correct, but also does not exclude the intercostal neuritis, pleural effusion and other causes. 1. Incorrect sleeping position: if you sleep up with chest and back pain, you may be sleeping on your stomach or the mattress is too soft, resulting in the chest and back muscles for a long time to exert and lead to strain pain. 2. Intercostal neuritis: mostly caused by herpes zoster, but also due to nerve compression, trauma, infection and other factors caused by inflammation, which can be manifested as chest and back pain when sleeping. 3. Pleural effusion: there are more causes of pleural effusion, such as inflammation, malignant tumors and trauma, etc., which can lead to increased production of fluid in the pleural cavity and form pleural effusion. Pleural effusion can be manifested as sleeping chest with back pain, the patient will also have chest pain, shortness of breath and other symptoms. There may also be other causes of chest and back pain, so if physiological causes are excluded, the patient should consult a doctor to clarify the cause of the chest pain and receive appropriate treatment if necessary.