Hyperacusis is a hearing condition that causes a heightened sensitivity to sound, making everyday noises, like running water, seem extremely loud.
This can make it difficult to carry out daily tasks in common environments, such as chores at home or workplace responsibilities. In turn, you might try to avoid social situations that could lead to anxiety, stress, and social isolation from exposure to noise.
Read on to learn more about the symptoms and potential causes of hyperacusis. We’ll also cover treatment options and how each one works.
Hyperacusis is a low tolerance for sound in one or both ears. It’s also known as an increased sensitivity to sound.
The condition affects the way you perceive loudness. It makes ordinary sounds, such as car engines, seem extremely loud. Even your own voice might seem too loud to you at times.
The perception of excessive loudness may cause pain and irritation, resulting in high levels of stress. It can also make it difficult to be in public settings like work or school. This can lead to:
- social withdrawal
- fear of loud noises (phonophobia)
Hyperacusis primarily affects people who:
- have tinnitus
- are assigned male at birth
- are older
Adults are more likely to develop hyperacusis since aging is associated with this condition. However, it can affect children, too.
Hyperacusis symptoms can vary. Mild symptoms can include:
- ordinary sounds seeming too loud
- your own voice sounding too loud
- discomfort in your ears
- difficulty concentrating
Severe symptoms can include:
- pain when hearing sudden noises
- a popping sensation in the ear when hearing loud noises
- poor sleep
- fear of social situations
In children, discomfort due to hyperacusis may cause symptoms like crying or screaming.
Hyperacusis is also associated with conditions like:
It’s worth noting that hyperacusis is different from phonophobia — the fear of loud sounds.
Hyperacusis affects the way you hear sounds. Phonophobia is a psychological condition that involves an emotional response to sounds. It doesn’t involve auditory issues.
However, hyperacusis can lead to phonophobia due to the perceived excessive loudness of certain sounds, so the two conditions may appear together.
Possible causes of hyperacusis include:
- High noise exposure. Loud noise is a major cause of hyperacusis. Exposure can happen over time (like playing loud music for many years) or a single occurrence (like hearing a gunshot).
- Head injury. An injury involving the head, jaw, or ear can lead to hyperacusis. One example is getting hit with an airbag in a car.
- Viral infections. Viral infections that affect the facial nerve or inner ear may lead to hyperacusis.
- Jaw or face surgery. Hyperacusis can happen if the inner ear or facial nerve is damaged during surgery.
- Some medications. Certain medications, like some cancer drugs, can cause ear damage and hyperacusis.
- Autoimmune disorders. Hyperacusis can be caused by autoimmune conditions, such as systemic lupus erythematosus.
- Temporomandibular joint disorder. The temporomandibular joint attaches your lower jaw to your skull. Problems with this joint may increase your risk of hearing issues, like hyperacusis.
- Autism. Autism or autism spectrum conditions can cause hearing sensitivities, including hyperacusis. According to 2015 research, about 40 percent of autistic children also have hyperacusis.
- Emotional stress. High levels of stress, including post-traumatic stress disorder (PTSD), can increase your risk of hyperacusis.
Sometimes, the exact cause is unknown.
See an ear, nose, and throat (ENT) specialist if ordinary noises seem louder than usual.
An ENT specialist can use the following tests to determine if you have hyperacusis:
- Physical examination. A doctor will examine your ear and head for signs of physical damage.
- Medical history. This helps a doctor pinpoint any conditions or events that might have affected your hearing.
- Questionnaire. Your doctor will ask questions about your symptoms to understand what you’re experiencing.
- Pure-tone audiometry. This is a test that measures your hearing sensitivity.
Treatment for hyperacusis depends on the cause. The goal is to manage your symptoms and reduce hearing sensitivity.
Treatments are generally the same for children and adults, with the exception of surgery.
Cognitive behavioral therapy (CBT)
In cognitive behavioral therapy (CBT), a mental health professional will teach you how to manage your emotional responses to sound. CBT can also help you manage psychological causes of hyperacusis, like stress.
Tinnitus retraining therapy
Tinnitus retraining therapy (TRT) is a tinnitus treatment that may also help hyperacusis.
TRT uses a device similar to a hearing aid. The device creates a low-intensity sound, allowing your brain to hear the noise and tinnitus. Over time, this can help your brain reduce emphasis on the tinnitus.
The treatment is also used for hyperacusis, as it can help reduce hearing sensitivity.
In sound desensitization, you listen to soft static noise for a set amount of time every day. This requires the help of a hearing specialist.
This can gradually increase your tolerance to sound. It can take about 6 months or more to see results.
A doctor may also recommend alternative treatments to control pain and stress caused by hyperacusis. These alternative treatments can include:
If the above treatments are unsuccessful, hyperacusis might require a surgery called a “round and oval window reinforcement.”
During the surgery, the tissue behind the ear is moved around the hearing bones. This supports the bones and reduces the hypersensitivity to sound.
The best way to prevent hyperacusis is to manage the condition.
Avoiding noisy settings or wearing earplugs is not recommended. These methods can actually increase your sensitivity to sound and potentially increase its severity. Being exposed to everyday sounds is important for normalizing hearing sensitivity.
The exception is limiting noise for a short period of time, such as at a concert. Otherwise, it’s best to avoid frequently using earplugs.
Misophonia occurs when certain sounds make you angry. It’s associated with hyperacusis, but the two conditions are different.
Misophonia involves an emotional response to specific sounds. It’s not an auditory condition like hyperacusis. However, hyperacusis can lead to misophonia, as the excessive loudness can make you dislike certain sounds.
Hyperacusis makes everyday noises, like running water, seem excessively loud. The sensation may be uncomfortable or even painful.
See a doctor if everyday sounds seem louder than usual. The doctor can examine your ear and use tests to evaluate your hearing. If you have hyperacusis, you’ll work with a hearing specialist to reduce your sensitivity to sound and your emotional response to noise.