In general, the common causes of back pain in sleep are mainly the following conditions. First, in patients with gallbladder stones and cholecystitis, the excitement of the vagus nerve at night can cause intermittent contraction of the gallbladder, thus causing stones to become embedded in the neck of the gallbladder and causing painful symptoms in the patient’s undershirt. Patients may be accompanied by nausea, vomiting, chills, high fever and other manifestations. They can go to the hospital as soon as possible to improve liver and gallbladder ultrasound examination to clarify the nature of the lesion, and then give antispasmodic, anti-infective and rehydration support treatment. Patients are recommended to have gallbladder removal as early as possible to avoid recurrent inflammation. Second, patients with coronary atherosclerotic heart disease, the heart muscle can intermittently contract during sleep at night, manifesting as myocardial ischemia, hypoxia and causing pain in the undershirt. Patients can take oral nitroglycerin tablets and quick-acting heart pills to dilate myocardial blood vessels and reduce pain symptoms. For patients with recurrent episodes, cardiac angiography can be improved to clarify the degree of cardiac vascular stenosis. If necessary, cardiac stent implantation can be performed to reduce the undershirt pain.