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Hyperacusis - what is it and is it treatable?

Hyperacusis is over-sensitivity to "normal" levels of sound. Our auditory system has an incredible ability to hear very soft sounds such as the rustling of leaves, yet also be able to tolerate (even enjoy) extremely loud sounds at a music concert. We all generally have a point where sound can be painful and normally it is around 120 decibels. However, some people (those with hyperacusis) experience significant discomfort with normal everyday sounds and therefore have a much lower threshold before sound becomes painful.

 Child with painful sound

How common is it and what causes hyperacusis?

Figures quoted in studies for the number of people with Hyperacusis vary widely from 2% of all adults, to 1 in 50,000 people world-wide. Experience from The University of Auckland’s Hearing and Tinnitus clinic suggests severe hyperacusis in 1 in 200 tinnitus patients, but more work is required to determine how common it is in the general population.

Potential causes of hyperacusis

There are range of potential other causes including some diseases, or disorders:

  • Meniere's disease 
  • Bell's palsy
  • Autism spectrum disorders
  • Chronic fatigue syndrome
  • Lyme disease
  • Head trauma including whiplash
  • Viral infection in the ear
  • Exposure to loud noise (for example an explosion, or long term exposure to loud music or machinery) 

Impact of hyperacusis

Many people with hyperacusis resort to wearing earplugs even for normal conversation. However, wearing of earplugs when not exposed to loud sounds is actually detrimental for these people as the reduced stimulation of the hearing system can result in increased sensitivity and tinnitus. Overall, hyperacusis makes normal life, particularly in our noisy cities very difficult for people. As a result they will tend to find it difficult to work or socialise.

The strain on normal family life is also huge with pressure on children to continually be quiet and restrained. Things we normally take for granted such as watching television, listening to music, going out to a restaurant, or even driving a car can become intolerable for someone with hyperacusis.

Recommended treatment for hyperacusis

Assessment is vital as always, partly to identify any underlying medical causes so they can be treated, but also evaluation by an audiologist to quantify the degree of noise intolerance. It is also important to identify any other potential causes of the discomfort, for example migraine before establishing the most appropriate form of treatment.

Management of hyperacusis then typically consists of two main parts: "weaning" the sufferer off hearing protection and then stimulation.

1. Sudden abstinence from hearing protection can be uncomfortable for a person with hyperacusis so a gradual reduction is suggested. Often using special non-linear earplugs is helpful. Non-linear earplugs reduce loud impulse sounds while allowing quieter sounds through at more normal levels.

2. The second component of hyperacusis management is stimulation through sound therapy. Sound can be used in combination with counselling in a manner similar to how tinnitus is managed. Comfortable sounds used at a low volume can be gradually increased over time. Because what is a comfortable sound varies so much, trying a range of different sounds is important. If you are a member you can access the full library of sounds.

The sounds included under the Relaxation, Adaptation  and Brain Training sections will be the most appropriate for helping you manage hyperacusis . The material available under the Counselling and Progressive Relaxation of this content site will also help .