@beat16, I was curious so plugged it into AI. Here is what it says about your symptoms:

"It is not uncommon to experience these symptoms following a ruptured eardrum. The pain, sleeping difficulties, and sound sensitivity you are describing are all potential side effects as the ear heals.

Difficulty Sleeping and Pillow Pain
Sleeping after a ruptured eardrum can be a challenge. The pain you're feeling is likely due to pressure on the delicate, healing tissue.

Pressure is the problem: Placing pressure on the affected ear, even with a special pillow, can be painful. You should sleep with the affected ear facing up to minimize this pressure and allow any fluid to drain.

Alternative positions: The best positions are sleeping on your back or on the side of your unaffected ear. Elevating your head with an extra pillow can also help reduce pressure and promote drainage.

Healing time: A ruptured eardrum typically heals on its own within a few weeks to a couple of months. However, if the pain persists or worsens, you should consult a doctor as it could indicate a complication.

Sound Sensitivity (Hyperacusis)
The sensation of sounds being more shrill and high-pitched is a recognized condition called hyperacusis. It is a hearing disorder characterized by a reduced tolerance to everyday sounds, which may seem uncomfortably loud or even painful.

Why it happens: The precise cause of hyperacusis is not fully understood, but it is often associated with damage to the auditory system, including the cochlea or the central auditory system. When the eardrum ruptures, it can't vibrate normally, which can disrupt the entire sound processing pathway.

Shrill sounds: The sensitivity to high-pitched sounds, in particular, may be related to the specific part of the inner ear that is affected.

What you can do: While it might seem counterintuitive, you should not completely avoid all noise. Over-protecting your ears can actually make hyperacusis worse over time. Instead, try to gradually re-introduce yourself to sounds at a comfortable volume. It's best to consult with an audiologist or ENT doctor for a proper diagnosis and guidance on sound therapy.

When to Seek Medical Attention
It's important to monitor your symptoms. While these issues are common, you should contact a doctor if you experience any of the following:

The pain is severe or does not improve.

You develop a fever.

There is a significant increase in hearing loss or dizziness.

You have new symptoms, such as facial weakness.

If your symptoms are persistent or causing significant distress, a healthcare professional can provide a proper diagnosis and recommend a treatment plan to help manage your condition and promote healing."

Well....me here! Unless I am not understanding correctly, AI is telling you to sleep with affected ear facing UP to avoid pressure. Although that part makes sense, it then goes on to say that the fluid needs to drain. Obviously, this cannot happen if the affected ear is facing up! Maybe try a heating pad for a short while with affected ear facing down during your waking hours, and sleep with affected ear up? I try to sleep more on my left side now, since my favorite side is my right. That is why I developed the painful condition. Too much pressure on one side. Good luck!