There are various causes of chest pain in the middle of the night, the most common are the following: First, the pain may be caused by angina pectoris, usually associated with coronary artery disease, due to narrowing of the arteries supplying blood to the myocardium and insufficient blood flow, the myocardium does not receive sufficient amount of oxygen to complete its work, leading to ischemic pain, which lasts 3-5min and sometimes relieves itself. Secondly, it may also be caused by acid reflux, which irritates the esophageal mucosa when it refluxes into the esophagus, leading to pain and difficulty in swallowing. Third, the cause of such pain may be heart failure, is a manifestation of myocardial pumping function is reduced, when a person lies down the redistribution of blood in the body, the amount of return blood increases, the heart needs to pump more blood than when standing, myocardial pumping function is reduced, the blood can not be pumped, there is heart failure, manifested as shortness of breath, chest tightness and chest pain. If you experience chest pain in the middle of the night or have such symptoms for a long time, it is recommended that you go to the hospital for relevant examinations in time to clarify the diagnosis and provide timely treatment.