I think the most like thing is still teething (the top middle 2 teeth are next). Sometimes this might be accompanied by low grade fever, so you can check if he has that? I gave paracetamol once to my baby because of that, and she did sleep better.
Other things to look out for are signs of ear infection (irritability, baby keeps rubbing the ears) - less likely
If not it could be a growth spurt or sleep regression
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