The feeling of pressure in the chest when lying down is due to myocardial ischemia and cardiac insufficiency. For the type of angina pectoris caused by coronary artery disease, such as patients with variant angina pectoris, due to the phenomenon of coronary artery spasm caused by high vagal tone in the nighttime sleep state, which leads to myocardial ischemia, the patient may have a feeling of pressure in the chest when resting in a flat position for the state of angina pectoris attack. Medication to relieve coronary spasm, including sublingual nitrates, should be given. It is recommended to improve coronary artery imaging to clarify the presence of fixed coronary artery stenosis and give surgical treatment if necessary. Usually, medications to prevent coronary spasm, such as diltiazem and nicorandil, can be taken at bedtime for symptomatic treatment. For lying down with pressure in the chest, it is often caused by cardiac insufficiency, due to the increase in venous return blood volume when resting in the flat position, causing an increase in the burden on the heart, and the aggravation of cardiac insufficiency, which results in the corresponding symptoms, and it is recommended to optimize the anti-heart failure treatment.