Hyperacusis: Definition, Causes, and Treatment
What is hyperacusis?
Hyperacusis describes a disorder of loudness perception, or sound intolerance. More than typical loudness sensitivity, a person with hyperacusis typically has a perverse reaction to sounds that most people find normal or harmless. Someone with this disorder may perceive certain everyday sounds as painful, unpleasant, or distressing, whereas these same sounds may not elicit any response in the people around them. Everyday sounds that we may not notice, such as using a hair dryer or vacuum, walking down the street, going to the grocery store, or attending a show or sporting event, can be intolerable. These kinds of reactions can elicit fear, avoidance, isolation, and social and emotional distress. In extreme cases, it can also cause fatigue, nausea, dizziness, or confusion. Hyperacusis can be very disruptive, and create long term consequences in regards to a person’s mental state, relationships, or career.
Causes
Most commonly, hyperacusis appears to be caused by noise exposure. Noise exposure will cause damage to the structures of the auditory system and nerves, which can then create hyperactive reactions to noise. Often, but not always, hearing loss as well as tinnitus can also be present in a person that suffers with hyperacusis due to noise exposure. There are still many unknowns in regards to hyperacusis, however some other cause can be psychiatric conditions, traumatic brain injury, functional diseases such as fibromyalgia, or chronic joint and back issues. There have also been links found to migraine, post-traumatic stress, Lyme disease, Ménière’s disease, and developmental disorders just as Williams syndrome.
Treatment
Unfortunately, there is no easy cure or medicine for hyperacusis, but that does not mean that there is not treatment or management options.
Cognitive behavioral therapy (CBT): A form or psychological therapy that identifies and targets unhelpful thought patterns or reactions. Once these are recognized, treatment focuses on how to use this understanding as well problem-solving skills to then change these patterns.
Tinnitus retraining therapy (TRT): Although not the same condition, strategies used in TRT can also apply to hyperacusis treatment. TRT is habituation-based intervention, essentially exposure therapy, to triggering sound, alongside counseling and education.
Sound therapy: Similar to exposure therapy, sound therapy includes listening to low-level sounds for extended periods of time until the person acclimates, and is also accompanied by positive reinforcement. Use of a masking device and/or hearing aids, if appropriate, can also be considered sound therapy.
Hearing protection: Putting in earplugs or avoiding sounds may be someone’s first instinct when suffering with hyperacusis. While this may provide some relief initially, it is not recommended while in environments with “normal” or safe levels of sound, as avoidance of these may actually make the sensitivity worse. Hearing protection should only be used in the presence of loud noise, where normally appropriate, in order to provide protection for any further auditory damage.
Resources
- The Hyperacusis Network: https://hyperacusis.net/
- American Speech-Language-Hearing Association: https://www.asha.org/practice-portal/clinical-topics/tinnitus-and-hyperacusis/
- Hyperacusis Research: https://hyperacusisresearch.org/
- Hyperacusis Central: https://hyperacusiscentral.org/
References:
- Tinnitus and Hyperacusis. American Speech-Language-Hearing Association. https://www.asha.org/practice-portal/clinical-topics/tinnitus-and-hyperacusis/
- Coey JG, De Jesus O. Hyperacusis. PubMed. Published 2021. Accessed November 16, 2024. https://www.ncbi.nlm.nih.gov/books/NBK557713/
- What Is It | The Hyperacusis Network. Hyperacusis.net. Published 2020. Accessed November 16, 2024. https://hyperacusis.net/what-is-hyperacusis/
