Hyperacusis refers to an increased sensitivity to and reduced tolerance of everyday sounds that people would not usually find uncomfortable.
People with hyperacusis may find these sounds merely irritating or they may have a more adverse reaction, experiencing severe discomfort and even pain on exposure to certain noises. Examples of the sounds people with this condition report finding problematic include children’s screams, the sound of machinery and high-pitched noises such as alarms or sirens.
The condition can cause people to withdraw from social and public situations in order to avoid exposure to the sounds, which can, in turn, lead to isolation and feelings of distress and anxiety. An inability to concentrate in the presence of certain sounds can also affect concentration and therefore performance at school or in the work place.
People who find that intolerance of sound is affecting their day-to-day living should seek medical attention. A healthcare practitioner would examine the ears and, if required, refer a patient to an ear, nose and throat specialist or audiologist for further testing. No tests are available that can lead to a definitive diagnosis of hyperacusis, but symptom questionnaires and a hearing test can help a physician to determine the level of sound that a patient can tolerate and the level that causes a reaction.
There are no specific drugs or corrective surgeries that can cure hyperacusis, although treating any underlying specific medical conditions could help to resolve the problem.
If no clear underlying cause can be i dentified and treated, a number of techniques are available to help patients reduce their sensitivity to sounds, as well as any fears and anxieties they have developed as a result of the condition.
Currently, the management approach to hyperacusis is therapy and counseling. This may involve the following:
Sound therapy: Since people with hyperacusis often isolate themselves in order to avoid certain sounds, therapists generally feel it is important to reintroduce sound into a patient’s life gently and gradually so that they can again start to take part in activities they had been avoiding. Alsoreferred to as desensitization, sound therapy is used to desensitize a patient’s hearing over a period of several months. This is achieved using noise generators, which may take the form of an ear-level device (similar to a hearing aid) or a bedside sound generator. White noise is the sound most commonly used.
Cognitive behavioral therapy: An alternative approach is cognitive behavioral therapy. The aim is to help patients recognize what is helpful and unhelpful when they are trying to cope with hyperacusis on a day-to-day basis. Patients are encouraged to explore the way they think about the problems associated with hyperacusis and to make changes that will help to reduce their stress levels, alter any avoidance behavior and recover from hyperacusis symptoms.
Lifestyle changes: Patients are taught relaxation techniques. They are advised to listen to soothing music or sounds and encouraged not to avoid situations where they may be exposed to noise. Patients are also advised not to rely on ear muffs or ear plugs to blot out sound since this can result in a further increase in sound sensitivity.
Counseling and education: Counseling and education can help a patient learn more about their condition and feel supported in coping with the problems it causes.
Support groups for patients include the British Tinnitus Association and Action on Hearing Loss. These organizations should provide an opportunity for patients to share and discuss their experiences with other people who suffer from hyperacusis.
Research has shown that patients tend to find counseling, cognitive behavioral therapy and education an effective combination. When a structured management approach to hyperacusis is employed, the success rate in terms of symptom relief are between 50 and 85 percent.
Reviewed by Catherine Shaffer, M.Sc. Further Reading