Choking and coughing at night in bed can be seen in a variety of diseases and should be considered as a combination of gastroesophageal reflux. Especially in patients with severe GERD, coughing can be aggravated when lying down. In this case, it is necessary to consider the possibility of the above-mentioned pathology, and it is recommended to improve 24-hour urine cortisol, as well as gastroscopy, etc. to clarify the diagnosis. On the other hand, if the patient has underlying cardiac disease, the cough may worsen when lying down, suggesting mainly the possibility of heart failure. In this case, an examination of the lungs and the underlying cardiac disease should be performed to clarify the nature of the lesion. If the underlying disease is a previous heart condition and signs of heart failure are evident, appropriate anti-heart failure therapy needs to be given.