Understanding Tinnitus & Sound Sensitivities

What is Hyperacusis?

Hyperacusis is a symptom of a malfunction in the auditory system. Normal sounds seem amplified, as if someone has turned up the volume of the ear. Often we describe hyperacusis as "the collapse of the normal range of tolerance for sounds.." This is a good description as most often, when people suffer hyperacusis, they still find soft sounds to be acceptable in an ordinary way, but medium loud or slightly louder sounds seems to suddenly, very loud and uncomfortable!


Hyperacusis can affect people of all ages. It is often related to its auditory cousin, Tinnitus, which is a ringing, hissing or other sound that one hears inside their own head. About half of all people with tinnitus, also have a degree of hyperacusis. However, there are also many people who only suffer from hyperacusis by itself.

Hyperacusis can come on suddenly or gradually. It can be mild, moderate, severe, or even profound. It can fluctuate in degree of affect, and can come and go very similarly to other auto-immune inflammatory conditions, such as arthritis or colitis. Hyperacusis can even disappear and never return again.

An audiologist can evaluate a person for hyperacusis in a complex and complete evaluation process that would include pure tone air and bone conduction testing, speech tests including Most Comfortable Level (MCL), and Uncomfortable Level (UCL), and Loudness Discomfort Level testing with Pure Tones and Noise (LDL). Many people with hyperacusis have perfectly normal hearing and normal appearing ear canals and eardrums.

The most common causes of hyperacusis are acoustic trauma such as air bag explosions or gun shots, or head injury such as whiplash or falls, or as the result of taking certain medications or combinations of medications. The true mechanism of hyperacusis is yet unknown, but many research projects are underway to try to discover these important details.

Two things we do know about hyperacusis in general are:

  • 1. It can start in one ear sometimes, but fairly quickly, hyperacusis will affect both ears equally, in the vast majority of people, pointing to a central nervous system involvement
  • 2. Using earplugs to avoid the discomfort of sounds or bothersome noises, will, over time, make the hyperacusis worse.

Another very similar condition of sound sensitivity occurs in people who have significant hearing loss, and we call that kind of problem, recruitment. It is not uncommon for people with hearing loss to find that certain louder sounds become too loud, too fast. Using advanced technology of current digital hearing aids, much of the discomfort of recruitment can be improved or prevented.

Hyperacusis is a treatable problem

In some cases, the symptoms of discomfort spontaneously disappear over time, and people go about their former activities. In other cases, people with hyperacusis need professional evaluation and treatment to help improve the hyperacusis. The most common method for treating hyperacusis is the use of a sound therapy program based on the work of Dr. Pawell Jastreboff, neurophysiologist, who studied hyperacusis beginning in the 1980s. He developed the program known as Tinnitus Retraining Therapy, a treatment for tinnitus, and along the way, discovered that the use of broad band noise also improved tolerance levels for those with hyperacusis.

There is no official name for the use of sound therapy to treat hyperacusis at this point in time, however, there are highly trained medical professionals, mostly audiologist, who are able to evaluate, prescribe, and treat those who suffer from this troubling symptom. It is estimated that about 95% of those who have hyperacusis can improve with treatment at this time. Improvement may be partial, or it may be complete. Using bilateral broadband signal generators or hearing aids with broadband noise as an option, or even listening to a wide variety of noises and sounds, including music, pink noise, or nature sounds, can positively affect hyperacusis in most people.

We recommend that you consult a well trained and certified practitioner such as a Fellow Member of the TPA to investigate your symptoms and prepare a treatment program for your specific needs.

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