For some people, exposure to everyday sounds presents a significant problem.

Hyperacusis is a rare disorder of loudness perception, where sounds that are ordinarily considered harmless become intolerable. People may perceive this sensation as painful, frightening, unpleasant, or excessively loud. Hyperacusis often co-exists with tinnitus and can cause significant distress, with patients regularly reporting impairment in their social, occupational, and recreational activities. The terms phonophobia (fear of sound) and misophonia (dislike of sound) can be associated with intolerance to specific sounds and may have an emotional component with the former mostly associated with migraine.

Some people with hyperacusis also have hearing loss, but not all. However, having hearing loss does not mean you have hyperacusis.

There are several theories about the mechanisms that underlie hyperacusis. What they share is that hyperacusis is usually associated with increased sensitivity (or auditory gain) in the central auditory system (the hearing pathways in the brain). This sensitivity can be influenced by mood.

 

Hyperacusis has similar causes to hearing loss such as excessive noise exposure, Meniere’s disease, and head injury. Other causes of hyperacusis include Bell’s palsy, migraines, and genetic disorders. For children with hyperacusis, the causes may be more complicated, and include, but not limited to autism and Williams syndrome.

 

There are several treatment options that show positive results for patients with hyperacusis. However, research is still emerging about the effectiveness of these therapy approaches:

 

• Counseling and Cognitive behavioral therapy (CBT).

• Ear plugs to reduce sound exposure.

• Sound therapy using background sound to reduce annoyance and/or increase sound tolerance.

• Relaxation exercises to provide coping strategies, reduce fear and anxiety in response to environmental sounds.

• Visual imagery.

• Medications to manage anxiety, depression, sleep problems.