Why earache may feel worse at night

During the day, activity can distract from discomfort. At night, lying flat may make congestion from a cold or sinusitis feel more pressurised. A middle-ear infection, irritated ear canal, or wax build-up can also hurt at any time and become more noticeable when you are trying to sleep. The nighttime pattern does not by itself show which condition is responsible.

Use suitable pain relief according to the label and your pharmacist’s advice. Try a comfortably warm cloth over the outer ear and sleep with your head gently raised if congestion is present. Keep water and objects out of the canal. Avoid using leftover antibiotics or ear drops unless prescribed for this episode; treatment depends on the cause. If repeated night pain is disturbing sleep, arrange a daytime assessment.

Contact a clinician if pain is severe, lasts beyond a short period, returns on several nights, or comes with fever, discharge, reduced hearing, or swelling. Seek urgent help for sudden hearing loss, severe dizziness, facial weakness, swelling behind the ear, or a severe headache with illness. Do not wait for morning if symptoms are rapidly worsening.

Ask whether congestion, wax, infection, or another source is involved, which bedtime pain relief is safe, and whether the ear needs a hearing or eardrum check.