Five o’clock in the morning cough chest tightness, may be asthma, heart failure, gastroesophageal reflux disease, etc., according to the specific disease, to be targeted treatment. 1. Asthma: asthma often in the early morning or early morning attack, can appear paroxysmal cough, chest tightness, wheezing and other symptoms. Commonly used inhaled glucocorticosteroid treatment, such as budesonide powder inhaler. If the chest tightness and wheezing are serious, short-acting β2 agonists, such as terbutaline, can be given. 2. Heart failure: blood redistribution during sleep and lying down increases pulmonary blood volume, and at the same time, vagal tone increases at night, small bronchial constriction, elevation of the diaphragm, resulting in coughing, nocturnal paroxysmal dyspnea and other symptoms. Diuretics such as furosemide and spironolactone, and drugs to enhance cardiac contractility such as digoxin are commonly used. 3. Gastroesophageal Reflux Disease (GERD): When lying down at night, gastric contents may reflux into the esophagus, pharynx and airway, resulting in coughing, heartburn, chest tightness and other symptoms. It is commonly treated with proton pump inhibitors such as omeprazole and gastric motility drugs such as mosapride. There are other diseases that can cause coughing and chest tightness at five o’clock in the morning, if the symptoms are not relieved or aggravated, it is recommended to consult a doctor in a timely manner, improve the examination, and comply with the doctor’s instructions for treatment, in order to prevent delays in the condition.