Hyperacusis is a hearing disorder characterized by an intolerance or painful sensitivity to ordinary sounds, such as clinking cutlery or conversation. It is distinct from hearing loss and can affect one or both ears.
- Symptoms include physical discomfort or pain from everyday noises, social anxiety, and a feeling of ear fullness.
- Causes can range from noise exposure and head injuries to neurological conditions, ear infections, or psychological factors like stress and anxiety.
- Diagnosis involves a comprehensive hearing evaluation and a specific test called Loudness Discomfort Level (LDL) to measure an individual's sound tolerance.
- Management and Treatment focus on strategies to retrain the brain's response to sound. These include lifestyle adjustments (using soft background noise), psychological support (Cognitive Behavioural Therapy), and evidence-based sound therapy.
- Sound therapy is a key treatment that uses gradual, controlled exposure to gentle sounds to desensitize the auditory system and reduce emotional distress. It often involves the use of sound generators.
- Prognosis: Hyperacusis is not always permanent. With early and consistent intervention, many people can experience significant improvement in their sound tolerance and quality of life.
For some, everyday sounds—clinking cutlery, rustling paper, even conversation—can be painfully overwhelming. This condition is called hyperacusis, and it affects real lives in real ways.
What Is Hyperacusis?
Hyperacusis is a hearing disorder where normal environmental sounds are perceived as unbearably loud, intrusive, or even painful. Unlike typical hearing loss, hyperacusis involves sound sensitivity rather than diminished hearing volume.
Some people experience it in one ear; others in both. It can develop gradually or appear suddenly, sometimes after a traumatic noise event.
Common Descriptions by those with Hyperacusis:
- “Everyday noises feel sharp or piercing.”
- “It’s not about volume—it’s about discomfort.”
- “It makes socialising and working really hard.”
Symptoms of Hyperacusis
The symptoms of hyperacusis vary from person to person, but may include:
- Discomfort or pain in response to ordinary sounds
- Anxiety in noisy environments
- Avoidance of social settings or public places
- Ear fullness or pressure sensations
- Distorted perception of sounds (e.g. clanging or harshness)
People with hyperacusis may also develop phonophobia—a fear of certain sounds—or misophonia, a strong emotional reaction to specific triggers like chewing or breathing.
What Causes Hyperacusis?
Hyperacusis can stem from various underlying causes:
- Noise exposure: (e.g., concerts, industrial accidents)
- Head or ear injury: Including whiplash or concussion.
- Neurological conditions: (e.g., Bell’s palsy, multiple sclerosis)
- Ear infections or surgeries: Affecting inner ear structures.
- Stress, anxiety, or PTSD: Psychological factors often play a significant role.
- Chronic conditions: Such as migraines or Lyme disease.
In some cases, the cause remains unknown, which can make the condition even more frustrating for sufferers.
Diagnosing Hyperacusis
If you're experiencing sound intolerance, it's crucial to seek professional help. At Resonate Health, we follow a comprehensive assessment pathway, including:
- Full hearing evaluation: To rule out or identify any co-existing hearing loss.
- Loudness discomfort level (LDL) testing: To precisely measure your individual sound tolerance thresholds.
- Detailed case history review: Understanding your symptoms, onset, and triggers.
- Collaboration with GPs or specialists: If needed, for underlying medical conditions.
While there’s no single test to "prove" hyperacusis, a thorough diagnostic process can help identify contributing factors and guide effective treatment.
How Hyperacusis Impacts Mental Health
Living with hyperacusis can be isolating and emotionally challenging. It may lead to:
- Anxiety or panic attacks
- Depression from social withdrawal
- Hypervigilance in public settings
- Sleep disturbances due to nighttime sound anxiety
Studies show that the emotional burden of hyperacusis is significant, and psychological support is often a key component of treatment. Read more on the Ministry of Health’s mental wellbeing hub.
Coping Strategies for Hyperacusis
While there's no universal "cure" for hyperacusis, many people find significant relief through personalised strategies:
Lifestyle and Environmental Adjustments
- Use soft background sounds like a fan or white noise machine to prevent total silence.
Avoid complete silence—it can worsen sensitivity over time. - Wear musician’s earplugs, which reduce volume without distorting sound, rather than foam plugs which block too much.
- Create quiet zones at home or work for relief.
Psychological Coping
- Cognitive Behavioural Therapy (CBT): Helps manage the emotional response to sounds.
- Mindfulness and relaxation techniques: To reduce overall stress and anxiety.
- Education: Understanding the condition can reduce fear and build confidence.
Important: Avoid total sound avoidance, as this can reinforce sensitivity. The goal is to desensitise gradually, not shut the world out.
What Is Sound Therapy?
Sound therapy is a widely recommended, evidence-based treatment for hyperacusis. It involves gradual, controlled exposure to soft, neutral background sounds to help the brain “retrain” its response to sound stimuli.
Benefits of Sound Therapy:
- Desensitisation: Over time, the auditory system becomes less reactive.
- Lower anxiety response: Everyday sounds cause less emotional distress.
- Improved tolerance: Increased comfort in real-world settings.
Therapy is often supported by devices such as sound generators, which produce calming noises like rain or ocean waves. These can be worn discreetly behind the ear.
FAQs about Hyperacusis
We often get asked questions about Hyperacusis and have complied a list of frequently asked questions
Hyperacusis is sound sensitivity—everyday sounds feel too loud or painful. Hearing loss, by contrast, is a reduced ability to detect sounds. While some people have both, they are distinct conditions requiring different management strategies.
It can result from loud noise exposure, head or ear injury, chronic stress, or certain medical conditions. Sometimes, it occurs without an obvious cause. Researchers believe it involves an overactive or "wound up" auditory processing system in the brain.
Not always. With early and consistent intervention—especially sound therapy and psychological counselling—many people experience significant improvement in their sound tolerance. Treatment is often tailored to the individual.
Yes, but it requires planning. Use high-fidelity earplugs, choose seating away from loudspeakers, and pick venues with good acoustics. With gradual desensitisation, you may become more comfortable in these settings again over time.