An ear with sound waves radiating from it

Understanding Hyperacusis: Causes, Symptoms, and Treatment

Hyperacusis is a relatively rare but distressing hearing disorder that’s characterized by a heightened sensitivity to sounds that are typically considered to be normal or even tolerable. It can make everyday sounds such as traffic or the sound of someone chewing food sound excessively loud and distressing. The purpose of this article is to provide an in-depth understanding of hyperacusis by discussing its definition, causes, symptoms, diagnosis, and available treatment options.

What is Hyperacusis?

Hyperacusis is a hearing condition that’s often mistaken for tinnitus. However, while tinnitus is characterized by the perception of sound in the absence of an external source, hyperacusis is caused by an overreaction of the nerves that regulate the volume of sound entering the inner ear. It can affect people of all ages, but it’s more common in those over the age of 40, and it affects women more than men.

Definition and Overview

Hyperacusis is defined as an abnormal sensitivity to everyday sounds that are either tolerable or not even audible to people with normal hearing. It can be triggered by exposure to loud noises or a range of medical conditions.

Hyperacusis can be a debilitating condition, causing anxiety, stress, and social isolation. People with hyperacusis may struggle to cope with everyday sounds, such as the sound of traffic, the hum of a refrigerator, or the sound of a baby crying. The condition can affect a person’s ability to work, socialize, and enjoy life.

Hyperacusis is often associated with other conditions, such as tinnitus, hearing loss, and migraine headaches. It can also occur as a result of head injuries, ear infections, and exposure to loud noises, such as explosions or gunfire.

Types of Hyperacusis

There are two types of hyperacusis – subjective and objective. Subjective hyperacusis is the most common type and is experienced solely by the person affected. It is often described as a feeling of discomfort, pain, or a sensation of fullness in the ears when exposed to certain sounds. This type of hyperacusis can be caused by a range of medical conditions, including Lyme disease, Meniere’s disease, and Bell’s palsy.

Objective hyperacusis is a physical reaction that can be measured and is often associated with increased muscle tension in the middle ear. This type of hyperacusis can be caused by abnormalities in the muscles that control the movement of the eardrum, or by damage to the nerves that regulate the muscles. It can also be caused by exposure to loud noises, such as explosions or gunfire.

Objective hyperacusis is less common than subjective hyperacusis, and it is often more severe. People with objective hyperacusis may experience physical discomfort or pain when exposed to certain sounds, and they may also experience symptoms such as dizziness, vertigo, and nausea.

Regardless of the type of hyperacusis, treatment options are available. These may include counseling, sound therapy, and the use of earplugs or other protective devices. In severe cases, surgery may be necessary to correct the underlying problem.

Causes of Hyperacusis

Hyperacusis is a condition in which everyday sounds become intolerably loud and uncomfortable. It can be caused by a variety of factors, including neurological issues, acoustic trauma, medical conditions, and even certain medications and substances.

Neurological Factors

Research has shown that hyperacusis can be caused by neurological factors. Damage to the auditory pathways in the brain or increased activity in the facial nerve, which plays an important role in hearing, can lead to hyperacusis. This can occur due to a variety of reasons, such as head trauma, infection, or exposure to toxins. In some cases, existing neurological conditions such as autism, migraines, or traumatic brain injury can also cause hyperacusis.

It is important to note that hyperacusis caused by neurological factors can be difficult to treat, as it often requires a multidisciplinary approach involving both audiological and neurological specialists.

Acoustic Trauma

Loud noise exposure, especially if it’s sustained over a long period, can cause hyperacusis. Acoustic trauma, either from a single episode of exposure to an extremely loud sound or prolonged exposure to moderate to loud sounds, can cause damage to the hair cells in the inner ear and affect the way the central nervous system processes sound.

It is important to protect your ears from loud noises to prevent acoustic trauma and subsequent hyperacusis. This can be done by wearing earplugs or earmuffs in noisy environments, turning down the volume on personal listening devices, and taking regular breaks from loud noise exposure.

Medical Conditions and Diseases

Hyperacusis can also be caused by certain medical conditions and diseases. Lyme disease, Bell’s palsy, and Meniere’s disease are just a few examples of conditions that can cause hyperacusis. These conditions can affect the inner ear or the auditory pathways in the brain, leading to hyperacusis as a symptom.

If you have been diagnosed with one of these conditions and are experiencing hyperacusis, it is important to work with your healthcare provider to manage your symptoms and prevent further damage to your hearing.

Medications and Substances

Hyperacusis can also be triggered by some medications or substances. Some antibiotics, chemotherapy drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin can cause hyperacusis. Recreational substances like alcohol and nicotine can also cause hyperacusis.

If you are taking medications or using substances and are experiencing hyperacusis, it is important to speak with your healthcare provider about alternative options and ways to manage your symptoms.

In conclusion, hyperacusis can be caused by a variety of factors, including neurological issues, acoustic trauma, medical conditions, and certain medications and substances. It is important to protect your ears from loud noises, work with your healthcare provider to manage any underlying conditions, and seek treatment for hyperacusis if you are experiencing symptoms.

Symptoms of Hyperacusis

Common Symptoms

Hyperacusis symptoms can range from mild to severe and can vary from person to person. Some of the most common symptoms include an increased sensitivity to everyday sounds, such as traffic, conversation, or low music; discomfort or pain in response to certain sounds; and difficulty tolerating the noise of everyday life.

Associated Conditions

Hyperacusis is often associated with other medical conditions such as depression, anxiety, or post-traumatic stress disorder (PTSD).

Severity Levels

Hyperacusis can range from mild to severe, and the severity of symptoms can often depend on the underlying cause.

Diagnosis and Assessment

Medical History and Physical Examination

A medical history and physical examination are necessary to diagnose hyperacusis properly. Your doctor will ask about any medical conditions you have, the medications you’re taking, and your exposure to loud noises. They’ll also check your ears for any visible abnormalities.

Audiological Tests

An audiologist may perform audiometric testing, which involves wearing headphones and being asked to respond to sounds of different volumes and frequencies. This test enables the audiologist to determine the threshold of sound that you can tolerate.

Hyperacusis Questionnaire

A hyperacusis questionnaire may be used to assess the degree and type of discomfort you experience in response to everyday sounds. It usually covers a range of questions related to sound sensitivity, quality of life, and associated symptoms.

Treatment Options for Hyperacusis

There’s no single treatment option for hyperacusis, and treatments often vary depending on the underlying cause and severity of symptoms. However, below are some treatment options that can help reduce the intensity of symptoms.

Counseling and Cognitive Behavioral Therapy (CBT)

Therapy with a hearing specialist or a mental health professional can improve coping skills and offer strategies to manage sound sensitivity and hyperacusis-related anxiety.

Tinnitus Retraining Therapy (TRT)

TRT is a type of therapy that aims to retrain the brain and auditory system to reduce hyperacusis-related symptoms. TRT involves a combination of sound therapy, counseling, and education surrounding sound sensitivity and self-help strategies.

Management of Underlying Medical Conditions

If hyperacusis is related to an underlying condition, that condition may need to be addressed to reduce symptoms.

Hearing Aids or Sound Generators

Hearing aids or sound generators can help reduce sensitivity to everyday sounds by amplifying ambient noise, providing background noise, or masking tinnitus-like sounds induced by hyperacusis.

Environmental Modifications

Reducing loud noises in the environment or using noise-reducing headphones or earplugs, especially in noisy places or social settings, can significantly reduce hyperacusis symptoms.


Hyperacusis can be a debilitating condition, and it can significantly affect a person’s quality of life. However, with appropriate treatment, most people can effectively manage their symptoms and reduce the impact that hyperacusis has on their day-to-day lives. If you suspect you have hyperacusis, it’s essential to seek medical attention to rule out other underlying conditions and receive the appropriate treatment.