Otitis media pain at night is caused by a combination of environmental factors, anatomical and structural factors, and neurological factors. 1. Environmental factors: during the day, the body’s attention may not be all in the ear. Generally at night, the surrounding environment is quieter, the body is in a resting state, so the attention is more focused, the discomfort symptoms are more obvious, such as otitis media at night, ear pain is more obvious. 2. Anatomical and structural factors: during the daytime with the head activity inflammation is not confined to the middle ear cavity, but when sleeping on the back or side at night, inflammation or pus may accumulate in the middle ear, stimulate the middle ear mucosa, aggravate the local infection, causing ear pain is more pronounced than during the day. 3. Neurological factors: vagus nerve activity is stronger at night, inducing pain sensitivity, so otitis media pain is more significant at night. Therefore, otitis media suggests timely medical treatment, standardized treatment, to reduce the pain and discomfort symptoms at night.