Man serving coffee at a cafe counter and coffee machine
If you find everyday sounds distressing or annoying, you may have hyperacusis.
Sounds that may cause irritation, pain or sometimes fear reactions if you have hyperacusis include:
· Running water
· Kitchen clattering sounds
· Paper or fabric noises
· Mechanical hums
· Distant music
· Alarms and other sudden or high-pitched noises
· Crowded social settings
· Traffic noise
What’s happening?
Around one in ten adults report some degree of sound sensitivity (Paulin et al., 2016), and it often occurs with tinnitus alongside it.
The brain decides how loud a sound feels. After a change in hearing, an illness, a loud event, or ongoing stress the brain turns up its sensitivity and ordinary sounds become harder to tolerate.
Your nervous system also plays a part. Any sound your brain thinks is a threat (even if it’s harmless), your muscles tense and your heart rate rises and you can become hyper aware of your surroundings.
The lifestyle impacts
People with hyperacusis manage their symptoms by avoiding noisy places or wearing earplugs in settings where noise is safe (for example, a café).
Coping strategies of avoidance may help in the short term, but over the long-term they become detrimental. For example, if you avoid social settings you used to enjoy, anxiety lessens in the moment, but this can lead to less fun in the long-term.
Treating hyperacusis
Treating the sensitivity itself is the solution, and this is what hyperacusis treatments focus on. Education, gradual sound exposure, and CBT show the most promise (Pienkowski et al., 2014).
At the clinic we use a structured and guided hypercusis activities program developed by professor Rich Tyler and collegues at the University of Iowa (used with permission), combined with CBT skills, with support throughout the week within a secure app with your clinician.
To begin, it’s helpful to know the sub-types of hyperacusis and some self-support strategies. See below.
Sound sensitivity takes different forms
There are four sub-types of hyperacusis (Tyler et al., 2014):
Loudness: moderate sounds seem far too loud.
Annoyance: certain sounds, like chewing or tapping, trigger strong irritation. This is often called misophonia.
Fear: you worry about sounds and avoid them in case they cause harm.
Pain: some sounds cause ear pain or a burning feeling.
Knowing which type you have matters, because each one responds to a slightly different approach.
Self-guided strategies to use for hyperacusis support
1. Use earplugs only for loud places: use hearing protection at concerts, with power tools or in any genuinely loud setting. Avoid using plugs in what are deemed normal listening situations such as cafes or on buses etc.
2. Add soft sounds in the background at home such as fans or gentle nature sounds at a level that seems pleasant.
3. Notice any startle or distress with curiosity and name it. For example: “that sound set off my startle response”. This brings the reaction into conscious awareness so you can challenge the distress.
4. Take a small manageable step into a situation you find distressing. For example, ten minutes in a less busy café. This is called graded exposure and is a core part of CBT therapy.
5. If sound causes you pain, talk to your doctor and audiologist first.
When to see your doctor
See your GP promptly if your sound sensitivity:
• started suddenly
• affects one ear only
• came with hearing loss, dizziness or ear pain
• began after a head injury
If none of these apply to you, a hyperacusis assessment can help with understanding your symptoms and creating a plan for treatment.
Support is available for hyperacusis. Part of your assessment includes an educational booklet with more detail on treatment supports.
You can learn more about hyperacusis treatment at the clinic here.
References
Jüris, L., Andersson, G., Larsen, H. C., & Ekselius, L. (2014). Cognitive behaviour therapy for hyperacusis: A randomized controlled trial. Behaviour Research and Therapy, 54, 30–37.
Paulin, J., Andersson, L., & Nordin, S. (2016). Characteristics of hyperacusis in the general population. Noise & Health, 18(83), 178–184.
Pienkowski, M., Tyler, R. S., Roncancio, E. R., Jun, H. J., Brozoski, T., Dauman, N., Coelho, C. B., Andersson, G., Keiner, A. J., Cacace, A. T., Martin, N., & Moore, B. C. J. (2014). A review of hyperacusis and future directions: Part II. Measurement, mechanisms, and treatment. American Journal of Audiology, 23(4), 420–436.
Tyler, R. S., Pienkowski, M., Roncancio, E. R., Jun, H. J., Brozoski, T., Dauman, N., Coelho, C. B., Andersson, G., Keiner, A. J., Cacace, A. T., Martin, N., & Moore, B. C. J. (2014). A review of hyperacusis and future directions: Part I. Definitions and manifestations. American Journal of Audiology, 23(4), 402–419.
