Hyperacusis is a condition that makes affected individuals particularly sensitive to the intensity of sounds. Specifically, people with hyperacusis perceive noises that most people would consider to be of a perfectly normal volume as unbearably loud.
Hyperacusis is often confused with misophonia. Unlike misophonia, which causes discomfort in response to very specific sounds such as nails scratching on a blackboard, hyperacusis is a disorder where any sound can cause discomfort, or even pain.
Hyperacusis can be extremely difficult to live with. Imagine simply leaving your home and perceiving most sounds as if they were as loud as a gunshot or some other unbearable noise. Everyday tasks as mundane as going to the supermarket can become a real ordeal for people with hyperacusis.
The consequences of hyperacusis are far-reaching. This auditory disorder can have negative repercussions on physical, mental, and social well-being. The reality is that, unfortunately, there is no quick and simple cure for hyperacusis. However, there are other treatments that, over time, can help and even allow individuals to regain some normality.
Here is an overview of hyperacusis, its possible causes, and available treatment options.
Possible Causes of Hyperacusis
Hyperacusis is a unique auditory disorder, and only a small portion of the population develops it during their lifetime. Its low prevalence makes this condition quite difficult to study. As a result, hyperacusis is far from being as well-documented as other auditory problems like hearing loss or tinnitus.
The vast majority of people with hyperacusis previously had normal hearing and sound level perception, and they wonder what could have altered their auditory perception.
Here is an overview of some factors that may contribute to or be associated with hyperacusis. Much about hyperacusis remains poorly understood, but this can give you an idea of the elements for which a link has been observed.
Loud Noise
One of the strongest correlations suggested as a possible cause of hyperacusis is exposure to loud noises. Generally, the noise is loud enough to cause some degree of auditory damage or acoustic trauma.
This noise-induced hearing damage can result from repeated and prolonged exposure, for example, to very loud concerts, or from a brief, extreme sound like a firecracker exploding nearby.
A well-documented case of loud noise causing hyperacusis is that of a young girl named Cindy Redmond. Cindy had normal hearing until an air horn was sounded almost directly into her ear.
Air horns are extremely loud, and at such close range, it's easy to understand how they could damage the ears. In the days following this sound exposure, Cindy noticed that sounds seemed abnormal to her. It eventually became difficult for her to tolerate ordinary everyday noises.
Cindy's story brought immense national attention to hyperacusis, a disorder many people were completely unaware of. Unfortunately for her, her condition required her to be withdrawn from the traditional school system. This disrupted many aspects of her daily life.
Aging
Age appears to be another factor potentially linked to hyperacusis. Age is also one of the most common factors in a large number of auditory disorders. Hearing loss, tinnitus, and hyperacusis all seem to have some relationship with aging.
The main reason is that as you age, the number of different sounds your body has been exposed to increases. In other words, the older you get, the longer your ears have been working compared to those of a younger person. This can lead to gradual wear and tear on the ear.
Facial Paralysis
The ear is an extremely complex organ, and while loud noises can damage it, the body has ways to limit this damage. The middle ear contains tiny bones that transmit vibrations to the inner ear. These bones are connected to the eardrum, which generates the vibration, but also to small muscles.
The middle ear muscle, called the tensor tympani muscle, can contract and reduce the conduction of intense sounds to the middle ear by dampening the movement of the ossicles. The body has an automatic response to loud noises, called the acoustic reflex, which helps to mitigate the perception of intense sounds.
A possible cause of hyperacusis could be a dysfunction of this reflex. A condition affecting the facial nerves, such as facial paralysis, can interrupt this reflex and make noises seem louder than they would with an intact acoustic reflex.
Head Trauma
Head traumas can have major consequences for your overall health, depending on their severity and nature. After a head injury, some people develop hyperacusis, tinnitus, or even hearing loss.
Many people associate hearing only with the ears. While the ears allow your body to perceive sounds from your environment, hearing also strongly depends on the neural processing carried out by the brain. The auditory nerve and the auditory cortex play an essential role in the perception of sounds. Therefore, head trauma can damage these areas and promote the onset of auditory disorders such as hyperacusis.
What to Avoid with Hyperacusis
When you are hypersensitive to the volume of everyday sounds, you may instinctively be tempted to adopt different strategies to find relief.
Among the most common methods are wearing earplugs and social isolation. While these can provide some short-term relief, they are detrimental to well-being and may even worsen hyperacusis.
Here is an overview of what you should avoid if you suffer from hyperacusis.
Permanent Use of Earplugs
For people with hyperacusis, it can be difficult to maintain a sense of autonomy and carry on with their day normally. Many use hearing protection in public to reduce the volume of noises reaching their ears.
Earplugs and noise-canceling headphones can be an effective short-term solution for going out, but their use should be limited. In many forms of hyperacusis, the brain misinterprets the volume of sounds. If you constantly wear earplugs, you don't allow your brain the opportunity to relearn what a normal sound level is.
Prolonged use of earplugs can actually train your brain to perceive more and more sounds as intolerable. It's similar to spending months in a dimly lit room: your eyes would probably hurt when exposed to direct sunlight. The same phenomenon can occur with your hearing.
Isolation
Another coping mechanism adopted by many people with hyperacusis is isolation. When constantly confronted with intolerable noises, the simplest way to reduce pain is to limit exposure. As a result, affected individuals withdraw from social events.
Isolation can lead to loneliness and many mental health problems such as depression and anxiety. If you suffer from hyperacusis, try nonetheless to have enriching experiences to limit the impact of the disorder on your social and mental well-being.
Treatments for Hyperacusis
Hyperacusis is unfortunately a disorder for which there is no quick and simple treatment: the main approaches aim to re-train the brain to perceive sound volume normally. There are techniques that help you live with this condition.
Here is an overview of the most common treatments for hyperacusis and what they involve.
Cognitive Behavioral Therapy
A widespread treatment option for many auditory disorders without a definitive cure is cognitive behavioral therapy (CBT). CBT is used in the management of severe tinnitus, but it can also help with hyperacusis.
Cognitive behavioral therapy aims to change the way you perceive and think about your disorder to improve your quality of life. An example of a CBT exercise would involve a therapist playing a potentially unpleasant sound in a controlled environment.
They would then help the patient to simply observe this sound and move on, rather than dwelling on it and ruminating about how painful it is. This therapy can take several months to bear fruit, but it can enable people with hyperacusis to lead a more normal life.
Desensitization
Another method, called desensitization therapy, can help some people with hyperacusis. The principle is to play white noise at a volume just at the edge of discomfort.
The person can wear a hearing aid-like device that plays this noise throughout the day. Over time, the volume is gradually increased until they are able to perceive sounds normally again.
Treatments and Techniques
Much remains to be learned about hyperacusis and its underlying mechanisms. In the absence of a definitive cure, the best measures to take are to avoid risk factors such as exposure to loud noises, or to manage the disorder through targeted therapies.
Sources
Hyperacusis - StatPearls | NCBI
Characteristics of Hyperacusis in the General Population | NCBI
Help Find a Cure for Cindy's Air Horn Injury! | Hyperacusis Research
Cognitive behavioral therapy: How does CBT work? | Medical News Today
