Thanks for asking at Healthcare Magic. I read your question and I understand your concern. Perforated ear drum is due to three main causes trauma, infection, chronic estuchian tube disorders. As you have adenoids that can cause both eustachian tube disorder if very enlarge as well as middle ear infections. The best sleeping position for you will be prop up by keeping several pillows under your head. I would also advise you take sips of liquids and decongestant at bed time. Avoid swimming, blowing nose keep some ear plug while taking bath. Hope it helps best. Take your best care. Don t forget to rate this answer and close the discussion at Healthcare Magic. Regards Dr Ejaz