Most of the carers must be waking overnight carers, surely? The basis for the carers appeal is that J needs constant monitoring for when he vomits, as he would aspirate if there isn't immediate attention. In particular she argues that, not only does he vomit extremely regularly, but when he vomits he throws his head backward, rather than forward, retaining the vomit in his mouth. If somebody isn’t there immediately to forcefully push his head forward and remove the vomit (manually, no time for suction) he aspirates. This must surely require somebody to be awake in his room all night.
This does raise the question as to why she sleeps in a separate room on the nights she doesn’t have a carer. Either his level of needs has been exaggerated, in which case she doesn’t need the level of carers she is currently getting, or she is putting him in significant danger by sleeping in a separate room without carers.