Most people find very loud conversations or music, as well as traffic or construction noise, unpleasant. But what if even sounds at a ‘normal’ volume suddenly become a burden?
People with hyperacusis have precisely this problem. Below you will find information on exactly what it is, its causes and treatment options, as well as answers to frequently asked questions on the subject.
Key Takeaways
- What is hyperacusis?
- Symptoms of hyperacusis
- Causes: How hyperacusis develops
- Diagnosis of hyperacusis
- Treatment for hyperacusis: these options are available
- Hyperacusis, phonophobia and misophonia
What is hyperacusis?
The word hyperacusis comes from Greek and is derived from ‘hyper’ = ‘above’ and ‘akusis’ = ‘I hear’. It refers to a pathological hypersensitivity to sound. It is also referred to as noise sensitivity.
This usually involves environmental or everyday noises, loud voices or conversations. Even at a volume of 50 to 60 dB - which corresponds to the normal volume of conversation - those affected perceive sounds as unpleasant, highly distressing or even painful. Other people do not yet perceive these sounds as unpleasant.
It is estimated that in Germany alone, around half a million people are affected by hyperacusis. Nevertheless, this condition has not yet been fully researched.
Symptoms of hyperacusis
The symptoms of hyperacusis vary considerably depending on the individual and the severity of the condition. Among other things, those affected experience
- fear of supposedly loud noises
- startle responses
- Changes in blood pressure
- sweating
- inner restlessness and panic
- Heart palpitations
- Earache
- Headaches
- Tension
If you notice one or more of these symptoms, it is advisable to consult an ear, nose and throat specialist.
Causes: How hyperacusis develops
People with hyperacusis are thought to have a disorder of auditory processing. Although the causes have not yet been fully clarified, research suggests that this disorder lies in the auditory system of the brain, the area responsible for auditory perception, i.e. hearing. Consequently, certain sounds are not processed correctly in the brain.
The causes of hyperacusis vary widely. It is often a symptom of other illnesses or mental health conditions.
For example, hyperacusis frequently occurs in cases of inner ear hearing loss. It is also typical for hyperacusis to result from psychological stress and overload, or to be associated with depression, anxiety disorders, etc. Treating the underlying causes - that is, the underlying condition - often reduces the sensitivity to noise.
Furthermore, hyperacusis is a very common accompanying symptom of tinnitus. However, tinnitus is not the cause of the sensitivity to noise. Instead, both symptoms are thought to stem from the same disturbance in the brain.
Other causes of noise sensitivity can include excessive alcohol consumption, side effects of certain medications, epilepsy, migraine, nerve damage and facial paralysis, or sudden hearing loss.
Diagnosis of hyperacusis
Hyperacusis is always diagnosed by an ENT specialist. They use various hearing tests and examinations to determine whether hypersensitivity is present. A so-called “discomfort threshold audiogram” is often produced for this purpose. This is used to check which sounds are perceived as unpleasant at which volume levels.
Based on this diagnosis, the doctor decides on the treatment or further hyperacusis tests and examinations.
Hyperacusis treatment: these options are available
Hyperacusis can have various health consequences for those affected. If left untreated, it can, for example, lead to sleep problems, reduced concentration, and further hearing problems or hearing loss.
Furthermore, people with noise sensitivity may become socially isolated, meaning they increasingly avoid gatherings, events and the like out of fear of unpleasant noises. This withdrawal can in turn contribute to psychological consequences such as loneliness and depression.
Professional treatment for hyperacusis is therefore particularly important. It is generally tailored to the patient’s individual causes and needs, for example, whether it is a condition in its own right or a symptom of another illness, whether the sensitivity to noise is physical or psychological in nature, and so on.
Possible therapies for hyperacusis include behavioural therapies, which aim to identify the triggers of hyperacusis and develop new behaviours to minimise hypersensitivity to sounds.
In sound exposure therapy, those affected are gradually accustomed to the relevant sounds through confrontation with triggering noises in controlled environments and situations, with the aim of reducing sensitivity to them.
In cases of certain types of noise sensitivity, so-called tinnitus retraining therapy may also be used. It was originally developed to treat tinnitus, with the aim of reducing the distress caused by ringing in the ears. This involves the use of a so-called ‘noiser’, a technical device designed to distract the brain from the tinnitus using pleasant white noise.
A doctor will always decide which therapy is most suitable and whether additional medication is advisable.
Hyperacusis, phonophobia and misophonia
Phonophobia is a form or symptom of hyperacusis. People with phonophobia suffer from a particular fear of certain sounds. These sounds are often perceived as very unpleasant or loud, even though they are actually ‘normal’ everyday sounds.
Another condition is misophonia, in which sufferers experience extreme aversion, anger or disgust at certain sounds.
Frequently asked questions about hyperacusis
Can hyperacusis be cured?Whether hyperacusis is curable always depends on the individual situation and the underlying condition. However, the chances of a cure are relatively high.
It is important, however, to recognise the symptoms early on and find the right treatment. If you notice symptoms of noise sensitivity, you should therefore see an ENT specialist to prevent further physical and psychological problems.
The duration of hyperacusis depends on both the cause and the treatment. Therapy, behavioural therapy or sound therapy can take several months, depending on the patient and the situation. It is also important to recognise and treat the symptoms early on so that the condition does not become chronic.
Do earplugs help with hyperacusis?No. The use of earplugs for hyperacusis is generally not recommended, as they can actually make the problem worse.
The silence created by earplugs can intensify the ringing in the ears. Consciously avoiding situations where unpleasant noises occur is also counterproductive and can further exacerbate the hypersensitivity.
If you notice symptoms of hyperacusis, are afraid of loud noises, or suddenly find sounds at a ‘normal’ volume very unpleasant, you should definitely see a doctor.
It is advisable to start by visiting an ear, nose and throat specialist. Depending on the diagnosis, neurologists or psychotherapists may also be the right people to consult.