Hyperacusis is a rare disorder that affects 1 in 50,000 people. The person suffering from hyperacusis finds daily sounds like a telephone, doorbell ring, or traffic noise too loud and unbearable. At times the discomfort is so high that the sound hurt’s their ear.
What Is Hyperacusis?
Hyperacusis is a hearing disorder that makes soft sounds seem very loud and intolerable. The brain of the affected person amplifies the sound signals more than normally needed; this results in unbearable loud sounds. Hyperacusis means sound sensitivity or noise sensitivity. It is a sensory or auditory processing disorder that increases sound sensitivity.
Depending on the intensity, sensitivity to sound can be mildly irritating to totally unbearable. It can affect one ear or both and can affect suddenly or come on gradually.
What Are The Symptoms Of Hyperacusis?
The most obvious symptom is that the ear is oversensitive to sound. Everyday sounds at normal volume for others are too loud and intolerable for a person having hyperacusis. This condition is also known as noise sensitivity or reduced tolerance to sound.
Below are some of the common hyperacusis symptoms:
- Soft sounds are tolerable but sound at ordinary level seem too loud
- At times even conversing at normal speech is loud
- Sound of coins jingling, refrigerator or a vacuum cleaner is very loud and intolerable
- Sometimes, one’s own speech sounds distorted
- Sudden noise like a dog barking or a car honking causes discomfort and even pain
- Loud sound can temporarily increase the sound sensitivity and make even soft sounds intolerable
- Can also increase Tinnitus for some time
What Causes Hyperacusis?
Hyper sensitivity is not hereditary and is mostly acquired. Some of the common hyperacusis causes are:
- Head injury, also triggered by something as minor as a slap.
- Exposure to sudden loud sounds like an explosion or a gunshot at close range
- Continuous exposure to loud sound like working in a workshop without ear protection
- Due to ototoxicity caused by certain medicines
- Severe infection affecting the inner ear
- Lyme Disease
- Ménière’s disease
- Multiple Sclerosis
Persons having noise sensitivity in one ear should consult a doctor, as it could be a case of acoustic neuroma (Tumour) which can be surgically removed.
Noise sensitivity can also be caused by some neurological reasons:
- Post-traumatic Stress Disorder (PTSD)
- Depression and Anxiety
- Chronic Migraine
What Are The Types Of Hyperacusis?
There are two types of hyperacusis:
- Cochlear Hyperacusis
- Vestibular Hyperacusis
Cochlear hyperacusis is the most common type and causes intolerance and often pain. While the vestibular type causes nausea and dizziness.
The types may be further sub classified as:
- Loudness hyperacusis
- Annoyance hyperacusis
- Pain hyperacusis
The other types of hearing sensitivity conditions are:
- Misophonia
- Phonophobia
What is Misophonia?
You have misophonia if the sound annoys you or makes you angry. In this case, the annoyance is usually towards everyday accepted sounds like loud breathing, finger tapping, or the sound of car wipers swishing.
What is Phonophobia?
Phonophobia is an anxiety disorder, it is the fear of loud sounds. People suffering from Phonophobia fear traffic noise or people talking loudly.
How Do You Test For Hyperacusis?
While there is no specific hyperacusis test, a general description of the symptoms will help the doctor arrive at a conclusion. However, the doctor will refer you to the audiologist to evaluate your hearing and reconfirm the hyperacusis diagnosis.
Hyperacusis Test
The audiologist will conduct a pure tone audiometry test, tones at different frequencies are presented to the ear through headphones in a soundproof cabin. The audiologist starts the test by presenting tones of low intensity and gradually increases the intensity or loudness of the tone till the sound reaches an uncomfortable level, known as UCL.
By plotting the uncomfortable level at various frequencies, the audiologist can confirm if you are hypersensitive.
How Do You Treat Hyperacusis?
Hyperacusis treatment involves diagnosing other medical conditions like head injury, inner ear infection, acoustic neuroma, or anxiety and depression that are the possible causes. These can be identified and treated to effectively reduce or treat sensitivity to sound.
Though there is no hyperacusis cure or treatment for immediate relief, sound desensitization therapies are very helpful. Therapies can improve the quality of life.
Sound Therapy
It involves therapy as well as the use of an external device that emits sound. The external device is like a hearing aid that continually emits white noise (A mix of noise containing many frequencies)
The person is mentally conditioned to ignore this continuous noise in the ear and consider it as not wanted and unimportant. This helps the person ignore and become tolerant to unwanted sounds in real life.
Cognitive Behavioural Therapy (CBT)
The therapist helps people to change their thought processes and perception. The negative and detrimental thoughts which can increase anxiety and depression are identified. And replaced by positive and more realistic thoughts which helps them to face and handle the situation better.
Use Hearing Protection
Though it is an easy solution to use earplugs or headphones to cut off the external irritating sounds, continuous use of earplugs should be avoided. This reduces the chances of getting accustomed to the external sound and increases intolerance. One should keep earplugs handy and use them in intolerable situations. Selective exposure to sound will desensitize and increase tolerance.
If in a group conversation, the situation permits, request people to converse softly.
Auditory Integration Therapy
This involves listening to music at low and high volumes over a period of time. This activity will slowly increase tolerance to high volumes.
What Is The Difference Between Tinnitus And Hyperacusis?
Tinnitus is hearing sounds in the ear in absence of any external source of the sound. The intensity and the type of sound the affected person hears varies from one person to another and also on the situation. The sound level increases if the person is under stress.
Whereas, in the case of sound sensitivity the external sound is present but it is highly amplified by the brain and is intolerable. The probability of having a hearing loss or tinnitus along with hyperacusis is high but not necessary.
People suffering from hyperacusis do not venture out and isolate themselves. This affects their professional and social life. They should consult the doctor and start a suitable therapy so they can resume a near-normal life as soon as possible.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC539655/
https://www.nhs.uk/conditions/hyperacusis/
