Hyperacusis – Definition, Symptoms, Causes & Treatment
What is Hyperacusis?
Hyperacusis is an abnormal sound sensitivity or decreased sound tolerance, with a heightened sense of volume and physical discomfort from everyday sounds that other people can comfortably tolerate.
Sounds that are typically difficult for people with hyperacusis to tolerate are loud/impact/sustained sounds, particularly if they are unexpected and in close proximity to the ears. High frequency (pitch) sounds tend to be tolerated less well.
Hyperacusis is the consequence of an involuntary sense of threat triggered by those sounds when they are subconsciously processed. This is often due to those sounds being processed subconsciously and/or evaluated consciously as potentially damaging or potentially painful or potentially exacerbating pre-existing aural symptoms such as tinnitus or hearing loss.
Symptoms of Hyperacusis
When hyperacusis develops:
- Everyday sounds begin to appear unnaturally prominent and increasingly louder.
- Loud and sudden sounds, particularly if they are unexpected or close to the ears, may cause:
- a temporary increase in tinnitus (if present)
- a temporary increase in sound sensitivity
- escalating sensations in the ear such as pain, blockage/popping, a fluttering sensation, muffled hearing
- This reaction can generalise to include more and more sounds.
- As a result, people may come to believe that their ears are no longer able to physically tolerate these sounds or that these sounds are causing damage to their ears or hearing and should be avoided.
- The anxiety about the effects of exposure to these sounds and the resultant emotional reaction (eg panic/distress) can lead to hyperacusis escalation.
What can cause Hyperacusis?
The consensus is that about 40% of people with troublesome tinnitus have some degree of hyperacusis. Recent large-scale prevalence research, including research carried out at our clinic, has identified the development of secondary hyperacusis in about 50% of help-seeking tinnitus patients.
If acoustic shock symptoms persist after the acoustic incident, it is generally because hyperacusis has developed.
Misophonia and high levels of anxiety can predispose towards hyperacusis development.
Hyperacusis can also develop with:
- a number of conditions affecting the auditory pathway - including Meniere’s Disease, otosclerosis, perilymph fistula, Bell’s Palsy
- neurological injuries and disorders affecting auditory processing - including head injury, brain damage, migraine
- adverse reactions to some medications
- psychiatric disorders
- autistic spectrum disorders
- chronic fatigue syndrome
- Lyme Disease.
Treatment for Hyperacusis
- Understanding the peripheral and central auditory pathway, including the mechanisms of hyperacusis and obtaining a personalised explanation of TTTS
- Examination of your thoughts and beliefs about your hyperacusis – you may need to be open to accepting a new perspective
- Management of hypervigilance towards the auditory environment and your TTTS symptoms.
- Sound enrichment strategies, including the creation of a “safe space” where sound enrichment strategies can be used to create an “auditory bubble” providing a cocoon to shield from trigger sounds and detachment from the environment.
- Advice on the use of earplugs, including hearing aids set up as electronic filters
Contact our Specialist Audiologists
For more information on Hyperacusis, give us a call or submit a form below.