Understanding Hyperacusis


Do everyday sounds irritate you to the point where you feel like you can’t handle them? If you have increased sensitivity to typical environmental sounds, you may have a rare condition known as hyperacusis. Hyperacusis can be incredibly disruptive if the person who has it hasn’t been diagnosed. 

Hyperacusis can disrupt someone’s career, personal life, and cause mental health struggles such as anxiety, insomnia, or depression. A person who has hyperacusis might have trouble participating in activities such as watching TV, listening to music, having dinner with friends and family, or doing chores around the house. In some cases, people can even find their spouse’s or their own voice unbearable. 

This article describes what hyperacusis is and how people can find help if they struggle with this condition. Hyperacusis has many causes, and its severity can range from mild to severe. If you or someone you know has hyperacusis, continue reading to find out how to better respond to this rare condition. 

What Is Hyperacusis? 

Hyperacusis is a condition that causes people to feel like familiar sounds are unbearably loud. High-pitched sounds such as babies crying or sirens can be ear-splitting to a person with hyperacusis. Hyperacusis may manifest itself as physical pain, fullness, or pressure in the ear. In addition to the physical pain hyperacusis can cause, tinnitus also often affects those with the condition. Some people with hyperacusis can even lose their hearing range, impairing their ability to deal with sudden changes in sound frequency appropriately. 

Hyperacusis is a rare condition that only occurs in about 1 per 50,000 people, but due to the increase of loud noise pollution, its numbers have increased in recent years. Symptoms can be mild to severe, and it’s best to schedule an appointment with an audiologist if you’re concerned about how it might affect you.  Visiting a professional audiologist will help you decide on the best treatment plan for your particular case. 

Hyperacusis Types 

There are two types of hyperacusis, cochlear and vestibular. Vestibular hyperacusis is a less common form that can cause dizziness, nausea, and imbalance. Cochlear, the more common hyperacusis type, causes pain in the ear, frustration, and general intolerance to familiar sounds. Though the two causes’ symptoms are different, they can cause anxiety, depression, social isolation, insomnia, and phonophobia. Phonophobia is an irrational fear of normally harmless sounds. 

Hyperacusis is not to be confused with recruitment. Recruitment causes an increase in the loudness of sounds at a specific frequency due to hearing loss. Recruitment makes particular noises uncomfortably loud; hyperacusis amplifies all sounds. An audiologist who specializes in diagnosing and treating hyperacusis can determine which condition you have. 

What Causes Hyperacusis?

Hyperacusis affects all age groups, and it can occur in one or both ears. People with hyperacusis can develop the condition over time or experience a sudden onset, but they are not usually born with it. Hyperacusis causes range from other diseases and syndromes such as Williams syndrome or Tay Sachs disease to other factors such as exposure to loud noise. 

The following list provides several examples, but it is not complete. Hyperacusis causes:

  • Damage to the cochlea from loud noise 
  • Head injury 
  • Williams syndrome
  • Tay-Sachs disease
  • Post-traumatic stress disorder (PTSD)
  • Lyme disease
  • Bell’s palsy 
  • Airbag deployment 
  • Meniere’s disease
  • Multiple sclerosis
  • Temporomandibular joint disorder (TMJ)
  • Viral infections that affect the inner ear or facial nerve 
  • Migraines

Children with autism, cerebral palsy, or brain injuries can also have hyperacusis. 

The list of potential hyperacusis causes is long, but experts still don’t fully understand what lies at the root of hyperacusis. Possible explanations include malfunctioning protective hearing mechanisms, auditory nerve damage, central processing system issues, or auditory nerve malfunction. 

How to Treat Hyperacusis

A definitive treatment method does not exist for hyperacusis, which is why it’s essential to have an audiologist examine your case. An expert audiologist will be able to recommend the best course of action for your particular case. Existing therapies can improve patients’ quality of life and help them cope with the condition. 

An example of a proven therapy that consistently yields results is sound therapy. Sound therapy retrains the brain’s auditory processing center. This retraining process guides the auditory complex to hearing things as it should, instead of distorting typical sounds’ loudness. SOund therapy consists of attaching an uncumbersome sound generator that produces soothing, soft sounds. The patient can control the level of these sounds. 

Over six months to a year, consistent sound therapy can rebuild patients’ sound tolerance. Coupling sound therapy with other directive counseling trains the patient to respond to different sounds and hyperacusis symptoms. 

If you have hyperacusis, you may want to muffle sounds with protective devices or earplugs. Try to avoid this practice as a substitute for therapy. Wearing protective devices and earplugs can wind up making hyperacusis worse.  The only time audiologists recommend using these devices or avoiding sounds is at loud concerts or if you’re close to power tools. 

Types of Altered Sound Tolerance 

Hyperacusis is often misused as an overarching term for altered sound tolerance. However, hyperacusis is a particular condition that should not be confused with other altered sound intolerance types. Intolerance of a specific set of sounds that causes fear is known as phonophobia. Misophonia, a relatively new word, describes the intense dislike or repulsion to particular sounds. 

Because there are different types of sound intolerance, patients need a proper diagnosis to describe what they’re experiencing adequately. 


Those who believe they have hyperacusis or any other form of sound intolerance should see a qualified audiologist right away. If left undiagnosed and untreated, hyperacusis can negatively impact mental health and cause patients to suffer needlessly. By diagnosing your hyperacusis and beginning treatment, you can start getting back to a normal life with hearing comfort. 

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