The short answer
When you sleep on your side, your ear gets pressed between your head and the pillow for hours. That pressure can leave it sore. A softer pillow, a pillow with a space for your ear, and taking turns on each side take some of the pressure off. A sore lump on your ear, or pain that stays, is a reason to see a doctor.
Sleep Foundation estimates that more than 60% of adults sleep on their side. That means one ear spends a lot of the night on the pillow. Here is why it can hurt, what to try tonight, and when to get it checked.
Why does my ear hurt when I sleep on my side?
Your head is heavy, and your outer ear sits right between it and the pillow. If the pillow is firm or thin, the ear can get folded or squeezed for hours. Phones, headphones and hearing aids can press on it in the same way.
Skin doctors have a name for one kind of sore spot this can cause. The British Association of Dermatologists says the commonest cause of chondrodermatitis nodularis is "pressure on the skin of the ear, usually from sleeping on one side."
What is the sore lump on the rim of my ear?
If one small spot on the top rim of your ear hurts when you touch it or lie on it, it may be chondrodermatitis nodularis. The same British Association of Dermatologists leaflet describes "a single lump, often quite small (5-10 mm)," usually on the upper part of the rim. It can look red, scaly or crusty. The leaflet says it affects middle-aged and older people.
Only a doctor can tell you what a lump is. If you find a new one, get it checked.
Could the pain be something other than the pillow?
Yes. MedlinePlus lists many causes of ear pain, including ear infections, ear wax, a sore throat, a sinus infection, a tooth infection and jaw problems like TMJ. So not every earache comes from the pillow. If your ear hurts when nothing is pressing on it, ask a doctor to take a look.
How do I stop my ear hurting when I sleep on my side?
- Take turnsGive the sore ear a break and sleep on the other side. The dermatologists' leaflet suggests this for a tender spot.
- Use a soft pillowThe same leaflet says to make sure your pillow is soft, so your ear sinks in instead of getting squashed.
- Make a space for your earIt also suggests making a hole in the pillow where the sore spot presses, or using a donut-shaped pillow that leaves a gap for the ear.
- Keep your neck straightSleep Foundation says to use a pillow that fills the space between your head and the mattress, so your neck is not bent up or down.
- Lay your ear flatWhen you settle down, check that your ear is lying flat and not folded over.
- Take off headphonesSleeping in headphones or earbuds adds one more hard thing between your ear and the pillow. Here is what happens when you sleep with earbuds in.
Is the sore ear a new piercing? See how to sleep with a new ear piercing for the travel pillow trick piercers suggest.
Should I just learn to sleep on my back?
You can try, but it is not easy. Sleep Foundation notes that even if you fall asleep in a new position, you may go back to your old one during the night. A sleep doctor quoted in the same Sleep Foundation guide put it this way:
"Your sleeping position can change throughout the night. Allow yourself freedom of movement and your body will naturally find the best position without disturbing your sleep." Brandon R. Peters, MD
So for most side sleepers, it makes more sense to fix the pillow than to fight the position.
Can earplugs make ear pain worse on your side?
They can. An earplug that sticks out of your ear gets pushed in by the pillow. One that is too big or too hard presses on the inside of your ear all night. We go into this in why earplugs hurt when you sleep on your side.
If you wear earplugs to sleep, pick a shape that sits low in the ear and a tip size that feels snug, not tight. Our guide to earplugs for side sleepers covers what to look for, and how to put in earplugs shows how to seat them without pushing too deep.
If you need to hear a baby, an alarm or someone who may need you at night, check you can still hear them with your earplugs in.
When should I see a doctor about ear pain?
See a doctor if a lump on your ear does not go away, if your ear hurts when nothing is pressing on it, or if the pain keeps waking you up. The dermatologists' leaflet says the sore lump can come back if pressure is put on that spot again, so tell your doctor how you sleep.
Questions people ask
Why does the top of my ear hurt when I sleep on it?
The top rim of your ear can get pressed hard when you lie on your side. A small sore lump there may be chondrodermatitis nodularis, which skin doctors link to sleeping on one side. Get any new lump checked by a doctor.
What pillow is best if my ear hurts?
A soft pillow, and one that leaves a space for your ear, like a pillow with a hole or a donut-shaped pillow. It should also be thick enough to keep your neck straight.
Why does my ear only hurt on the side I sleep on?
That is the ear pressed into the pillow. If both ears hurt, or the pain is there when you are sitting up, it may be something else, so ask a doctor.
Can earplugs cause ear pain when I sleep on my side?
Yes, if they stick out past your ear, are too big or are too hard. The pillow pushes on them all night. A shape that sits low and a tip that feels snug, not tight, help.
Which Vespré earplug is made for side sleepers?
Wing. It sits low in the ear with a soft fin and is designed to stay put. It is $29.95, and you get 30 nights to try it from delivery. Worn pairs are fine to return.
Every Vespré shape comes with more than one tip size and 30 nights to decide. Worn pairs are fine to return.
