Woman Trying to Sleep With Ear Pain.

7 Ways to Sleep Better With Ear Pain (Doctor’s Tips)

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Darshan Shingala Profile Picture.

This article has been written and medically reviewed by Dr. Darshan Shingala (M.D, MPH) – a qualified and practicing medical doctor – for maximum factual accuracy and reliability.

Ear pain can make it nearly impossible to sleep.

So what can you do to control ear pain at night and get a better night’s sleep?

The most effective way to sleep better with ear pain is to sleep on your back with your head elevated with pillows or an adjustable bed – or sleep on the side that has no pain – to reduce pressure; a warm compress and doctor-prescribed pain medications can also provide relief.

However, you must always get an accurate diagnosis of your ear pain from your doctor in order to get the best treatment – this is essential since an ear infection or damage to your ear may lead to hearing loss if treated improperly.

Otherwise, you can follow the 7 tips below that I recommend to my patients as a practicing medical doctor (at your own risk).

Related: 7 ways to sleep better with an ear infection.

7 Ways to Sleep Better With Ear Pain

How to Relieve Ear Infection Pain

Here are 7 tips for sleeping better with ear pain:

1: Elevate Your Head to Reduce Pressure

I usually tell my patients struggling with an earache at night to try to maintain slight elevation of their head while sleeping [5].

This can be achieved by either using a few extra soft pillows to support your head and neck or by elevating the head-end of your adjustable bed.

Sleeping in a slightly elevated supine position is beneficial for patients who have a bilateral ear infection or earache.

Click here to see the best adjustable beds to buy now.

2: Sleep On the Side With No Ear Pain

When you have pain in one ear, you should avoid sleeping on that side and instead sleep on the side with the ear that is pain-free – if you don’t want to sleep on your back.

However, your doctor might also suggest that you sleep on the side of the treated ear – especially if they have placed a pressure equalization tube in your ear – after a myringotomy procedure [1, 2, 3, 6].

In general, for patients who are dealing with a unilateral earache, it is safe to sleep on the side of the healthy ear [6, 7].

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3: Place a Warm Flannel Cloth Over the Affected Ear

To try and stop your earache quickly before bed, you can place a slightly warm flannel cloth over the affected ear for about three to five minutes to obtain temporary relief from earache before going to bed [6, 7].

The heat radiating to the ear can help ease the pain by releasing blockages and reducing inflammation [4, 7].

You can also use a heat pad for a warm compress, but please make sure that you place a flannel or cotton cloth between the head pad and your skin to avoid burning and damaging the delicate skin around the ear.

Make sure that you use a freshly cleaned cloth each time in order to minimize the risk of infection and complications.

If you notice any drainage on the cloth afterward, make sure to closely inspect the contents of the drainage, such as pus, blood, fluid, etc., and update your doctor with the details.

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4: Carefully Perform Exercises to Rehabilitate the Eustachian Tubes

The Eustachian tube is a narrow tube that connects the middle ear to the back of the nose [1, 2, 9].

These tubes open when we swallow, yawn, or chew, but otherwise, they remain closed [1, 9].

The Eustachian tubes help to drain the fluids and secretions of the middle ear [1, 9].

They also help in maintaining the air pressure in the ears, enabling the eardrums to work and vibrate properly [1, 9].

Sometimes fluid or negative pressure gets stuck in the middle ear, causing the pressure outside the ear to become too high, which further leads to ear pain [9].

To rehabilitate your Eustachian tubes, there are a few simple exercises you can perform at home, especially before going to bed, so that you can sleep better at night [9].

  • Try to blow up a balloon through each nostril, using an anesthetic mask.
  • Try to yawn, and you may hear or feel a pop in your ears when the tubes open (this equalizes the pressure between the inside and outside of your ears).
  • Try to chew gum or swallow some water before going to sleep, as it can help to trigger the muscles that enable the Eustachian tubes to open up and drain.
  • Close your mouth and cover your nose for a few seconds. Then try to force an exhalation against your closed mouth and nose, by blowing your nose gently. This exercise is referred to as the Valsalva maneuver [9].
  • Try to swallow while pinching your nose. This exercise is referred to as the Toynbee maneuver. Swallowing opens the Eustachian tubes, and the movement of the tongue while keeping the nose closed helps to compress the air which passes through the tubes to the middle ear [9].
  • A combination of the Valsalva and Toynbee maneuvers is referred to as the Lowry technique, which requires one to blow and swallow at the same time, while pinching their nose to close the nostrils [9].

WARNING: These Exercises Can Burst Your Eardrum if Performed Too Forcefully

These exercises come with a warning:

It is important that you are cautious while performing the above-mentioned exercises to rehabilitate your Eustachian tubes because if performed incorrectly, they can result in a burst eardrum, and affect your hearing [1, 9].

The pressure difference can also damage other body air spaces, such as the paranasal sinuses [1, 9].

Hence, I would strongly recommend you consult your doctor prior to performing any of the above-mentioned exercises yourself.

It would also be a good idea to perhaps request that your doctor or ENT specialist give you a detailed demonstration of the above-mentioned techniques and maneuvers.

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5: Meditate to Achieve Balance and Relax Yourself

Ear problems can be quite bothersome, especially if they are accompanied by disturbing symptoms, like loss of balance, hearing issues, and ringing in the ears [3].

You may consider doing mindfulness-based meditation and deep breathing exercises, to achieve a sense of balance, relax, and obtain a restful night’s sleep [4, 10].

Studies show that meditation is especially beneficial if you are experiencing tinnitus (ringing in the ears) along with your earache [10].

Try to do the following steps of a simple mindfulness-based meditation practice before going to sleep:

  • Sit in a comfortable position, and close your eyes.
  • Inhale through your nose, and hold your breath for about 5 to 8 seconds.
  • Then gently exhale through your mouth, and slowly inhale again through your nose.
  • Try to identify each of your breaths, and focus on your breathing pattern.
  • Then slowly try to count your exhalations, along with your inhalations.
  • Scan your body from head to toe in your mind, and identify all your muscles. Note which ones are sore and tense.
  • Then slowly release your tension, and try to relax your body.
  • Repeat the steps several times, until you feel relaxed.

6: Create a Noise-Free and Calm Environment in Your Bedroom

While recovering from earache and associated auditory symptoms, it is important that you care for your sense of hearing by maintaining a noise-free environment.

Ideally, your bedroom should be calm, and free from any loud or unpleasant noises, so that you can fall asleep quickly [10].

Since your ear is still recovering from the damage, it is crucial that you preserve your hearing capacity, and protect your ears from any auditory disruptors [10].

If you are dealing with tinnitus along with earache, then I would suggest you play any soothing music in the background, at a frequency of around 430 Hz [10].

This will help you to relax your mind and distract you from the constant ringing in your ears.

Click here to discover the 8 dangers of sleeping in headphones.

7: Take Doctor-Prescribed Pain and Sleep Medications 

Depending on the cause of your earache, your doctor is likely to prescribe you with a few medications, including pain-relieving drugs, and anesthetic ear drops [5, 6].

I would advise you to strictly adhere to the prescription, and follow the advice of your doctor, in order to recover as quickly as possible.

In general, your symptoms are likely to resolve within several days, with adequate care and treatment [5].

As your symptoms begin to improve, you will naturally be able to sleep better at night, due to the decrease in overall pain and inflammation.

However, if your symptoms persist or worsen with time, or if you continue experiencing difficulties sleeping, due to your earache, I would suggest you seek urgent medical attention.

In some cases, depending on your situation, your primary care doctor may refer you to an ENT specialist for further medical evaluation.

Sometimes patients may require minor surgical interventions to treat the underlying cause of their earache.

After ruling out any red flags, your doctor may suggest that you take supplements, such as amino acids, vitamin D, melatonin, magnesium, and zinc, to obtain better sleep at night [11].

These sleep-promoting supplements have been shown to improve the quality and duration of sleep, especially among patients who are struggling with an inflammatory condition, including ear infections [11].

However, it is crucial to strictly follow your doctor’s advice and refrain from taking any supplements without the knowledge of your doctor.

Conclusion: Consult With Your Doctor

Understanding the underlying cause behind your ear pain will help you to improve your ear care.

Thus, it is important to approach your doctor for an accurate diagnosis, to identify if your ear pain is primary (otogenic) or secondary (referred), based on the etiology.

It is generally advisable to sleep on your back in a supine position while keeping your head slightly elevated – especially when both your ears are affected.

If you have a unilateral earache and you are a side sleeper, you can also try to sleep on the side of the healthy ear – unless otherwise instructed by your doctor.

If your doctor has treated your ear and placed a pressure equalization tube in after a myringotomy, they might ask you to sleep on the side of the treated ear to encourage drainage.

To obtain comfort and temporary pain relief, you can place a slightly warm flannel cloth over the affected ear for about three to five minutes before going to bed.

Try to do a few simple exercises before going to bed, to rehabilitate your Eustachian tubes, so that you can obtain a restful night’s sleep.

The most common and effective Eustachian tube exercises are the Valsalva and Toynbee maneuvers, and the Lowry technique.

If your earache is accompanied by symptoms like loss of balance, hearing issues, and ringing in the ears, you may consider doing mindfulness-based meditation, and deep breathing exercises, to achieve a sense of balance, relax, and sleep better.

It is also important that you maintain a noise-free and calm environment in your bedroom, to protect your hearing from further damage, and so that you can sleep well at night.

Lastly, always follow the advice of your doctor, adhere to your prescription, and if you continue to struggle with sleep while recovering from your ear pain, discuss with your doctor whether the inclusion of a sleep-promoting supplement would be an option for you.

Sleep-promoting supplements, such as amino acids, vitamin D, melatonin, magnesium, and zinc, can help you to recover sooner, and improve the quality and duration of your sleep.

Up next: the truth about sleeping in AirPods and getting cancer.

Sources and References

1: Harrison E, Cronin M; Otalgia. Aust Fam Physician. 2016 Jul45(7):493-7.

2: Conover K. Earache. Emerg Med Clin North Am. 2013 May;31(2):413-42.

3: Coulter J, Kwon E. Otalgia. [Updated 2021 Aug 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549830/

4: Murtagh J. The painful ear. Aust Fam Physician. 1991;20:1779–1783. [PubMed] [Google Scholar]

5: Kim SH, Kim TH, Byun JY, Park MS, Yeo SG. Clinical Differences in Types of Otalgia. J Audiol Otol. 2015;19(1):34-38. doi:10.7874/jao.2015.19.1.34

6: Earwood JS, Rogers TS, Rathjen NA. Ear Pain: Diagnosing Common and Uncommon Causes. Am Fam Physician. 2018 Jan 01;97(1):20-27.

7: Ely JW, Hansen MR, Clark EC. Diagnosis of ear pain. Am Fam Physician. 2008;77:621–628. [PubMed] [Google Scholar]

8: Charlett SD, Coatesworth AP; Referred otalgia: a structured approach to diagnosis and treatment. Int J Clin Pract. 2007 Jun61(6):1015-21.

9: Llewellyn A, Norman G, Harden M, et al. Interventions for adult Eustachian tube dysfunction: a systematic review. Southampton (UK): NIHR Journals Library; 2014 Jul. (Health Technology Assessment, No. 18.46.) Chapter 1, Background. Available from: https://www.ncbi.nlm.nih.gov/books/NBK262265/

10: Rademaker MM, Stegeman I, Ho-Kang-You KE, Stokroos RJ, Smit AL. The Effect of Mindfulness-Based Interventions on Tinnitus Distress. A Systematic Review. Front Neurol. 2019;10:1135. Published 2019 Nov 1. doi:10.3389/fneur.2019.01135

11: Chan V, Lo K. Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis [published online ahead of print, 2021 Jan 13]. Postgrad Med J. 2021;postgradmedj-2020-139319. doi:10.1136/postgradmedj-2020-139319

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