Why Are Children's Earaches Worse at Night?

My son has been recently struggling to get over a nasty ear infection, one that keeps the rest of the family up at night as we try to calm him down enough to be put back to bed. He doesn't complain much about his ear during the day, so I wondered what it is about kids and ear infections that cause earaches to be worse at night. I discovered some good information in my research and thought I would pass it along to other parents suffering through sleepless nights.

What Causes an Earache?
There are anatomical reasons why little ones tend to get more earaches. When kids are small their Eustachian tube is shorter than it is in older kids. The tube is also positioned more horizontally which allows for easier admission of bacteria. Interestingly, an ear infection does not generally occur on its own as a primary symptom. Otitis Media, or inflammation of the middle ear, is typically made acute by the build up of fluids in the ear associated with upper respiratory infections or an allergy to certain pollutants such as cigarette smoke or pollen. Eventually, this build up will create pressure on the tympanic membrane, or eardrum, and in severe cases can cause a puncture in this membrane. It is this pressure that your little one is fretting about, and it is this pressure that is worsened at night because of several factors.

Earaches Worsened by Nighttime
Anyone who has suffered from the flu knows that nighttime is the worse time when it comes to symptoms. Fevers tend to run higher, and aches and pains are usually worsened with the onset of darkness. What most people don't know if that this is perfectly natural due to certain biological factors. Pressure changes in our bodies are fairly regulated as long as we remain upright. However, when kids get horizontal for sleeping the pressure tends to build in their upper bodies and head area. This pressure exacerbates the symptoms associated with nasal congestion, earaches, sore throats, and coughing.

However, the postural change is not entirely responsible for kids with ear infections feeling worse at night. Humans operate on a daily biological clock known as the Circadian Rhythm. This 24-hour cycle regulates the release of hormones such as cortisol, which is partly responsible for feeling better during the day as it masks some of the pain associated with ear infections, and helps keep fevers low. Night time also brings a slowing down of brain activity as the amount of external stimuli decreases. In other words, there are fewer things available to help "take our minds off the pain."

Remedies
For a severe ear infection there is no amount of home remedies that will totally knock out the illness. This is usually only accomplished by the prescription of an antibiotic which eliminates the bacteria causing the infection. If you find yourself taking care of a child with an earache during the middle night, try one of the following home treatment options until you can get them to a pediatrician. Give your child a pain reliever according to the package directions (or contact your pediatrician for proper dosage). Stick with Tylenol or Motrin, and avoid aspirin as it has been linked to Reye's syndrome. Apply a warm washcloth to the affected ear as heat tends to relieve some of the pain. Do not use a heating pad as there is a risk the child could fall asleep on the pad and be burned during the night. Take care at bath time to make sure the affected ear is not submerged as this could cause a painful change in the pressure in the inner ear, and could allow waterborne bacteria to enter the Eustachian tube. Be patient with your little one, especially little ones that are not old enough to verbalize what is wrong with them.