Hi Dear , As per your query you have slight throb directly behind my left ear lobe , which make it difficult to sleep . Well there can be many reasons for symptoms you mention in query like tinnitus , eustachian tube dysfunction , pulsatile tinnitus or any psychological problem . But in your case it seems to me that symptoms are due to pulsatile tinnitus . Pulsatile tinnitus occur due to either overall increase in blood pressure or local increase in blood pressure do to blood vessel dysfunction Because pulsating tinnitus is usually caused by variation in blood pressure or blood flow. I would suggest you to consult ENT specialist for proper diagnosis . Doctor may order certain test like audiometer , CT scan ,MRI , low and high pitched ringing to rule out conditions like hearing loss , earwax buildup , middle ear infection . Doctor may prescribe antibiotics , eperisone , sedatives and supplement like ginkgo biloba . Doctor may also refer you to cardiologist or psychiatrist for psychological problem. Meditation and yoga will be very helpful . Hope your concern has been resolved. Get Well Soon. Best Wishes, Dr. Harry Maheshwari