RNID: For deaf and hard of hearing people.

About this factsheet

This factsheet is part of RNID’s medical range. It is written for adults who have hyperacusis and would like to understand more about their condition. If your child has hyperacusis you should discuss this with your GP.

Read this factsheet to find out:

What is hyperacusis?

If you have hyperacusis you will have an increased sensitivity to sounds. This means that you may feel pain or discomfort when you hear sounds that most people are able to tolerate. People with hyperacusis are not all affected by the same type of sounds.

  • You can get hyperacusis on its own or with a range of other conditions such as depression, migraine, Menière's disease, chronic fatigue syndrome and visual over-sensitivity.
  • If you have hyperacusis you may also have tinnitus. This is the word for noises that some people hear in the ears or in the head - buzzing, ringing, whistling, hissing and other sounds.
  • You may also find that the area around your ear is painful or aches.

What does it feel like to have hyperacusis?

If you have hyperacusis it might feel painful or startling. It may make you feel angry, distressed or anxious. You may find yourself panicking when you try to get away from the sound.

You may find that after being exposed to an uncomfortable sound the discomfort continues for a period of time afterwards and becomes worse if you hear the sound again.

Your reaction to an uncomfortable sound may be made worse if you are in an environment where you expect to hear the sound. When you are afraid of hearing a sound, you may become anxious, which increases your discomfort, and when you are afraid or stressed the brain produces substances, which increase the sensitivity to sound.

However, everyone reacts differently to hyperacusis.

What causes hyperacusis?

There are probably a number of different causes of hyperacusis but researchers don’t really have a clear understanding of why some people have it. It is possible that some functions of the hearing system, which normally ‘balance’ sounds and protect the system, may be affected.

When you are in a noisy environment your brain sends 'information' about loud noise back to the inner ear, so that the 'volume' can be turned down and the inner ear can be protected. It is thought that damage to this feedback mechanism may be an underlying cause of hyperacusis.

Our brain also plays a vital role in processing the sound signals it receives from the inner ear. Problems in the way these signals are processed could be another cause of hyperacusis.

We do know that some people first develop hyperacusis after sudden exposure to very high levels of sound or after a head injury. This may damage delicate structures within the inner ear, which could lead to hyperacusis.

What kind of treatment is available?

  • If you think you have hyperacusis you should visit your GP.
  • They may refer you to a specialist in audiology/audiological medicine or the ear, nose and throat (ENT) department in your local hospital. They will be able to investigate your hearing system to try to find a cause for your hyperacusis and to advise you on the most appropriate treatment.
  • You may need specialised hearing therapy, usually from a hearing therapist.
  • You may also be referred to a clinical psychologist or behavioural therapist to help you manage the anxiety, phobia, stress and avoidance, which are associated with hyperacusis and may make it worse.
     

Auditory desensitisation

As part of your treatment you may be offered auditory desensitisation as part of an auditory retraining programme. This should be available through an audiology department and is usually carried out by an audiologist or hearing therapist.

It aims to help improve the level of noise you can tolerate and involves listening to different types of sound known as ‘white’, ‘broadband ‘or ‘pink’ noise on a daily basis. This is played through small noise generators which you wear in your ear canal. You start by listening to a very low level of noise for a very short time. The level and length of time is gradually increased. Some people may find this gives them initial relief, but auditory desensitisation is usually a long process and you may need to follow this treatment for at least 12 months to get a long-term positive effect.

Behaviour modification programme

An auditory desensitisation programme will be more effective if you follow a behaviour modification programme at the same time. A clinical psychologist can help design an individual programme for you. This aims to break down any routines that you may have developed to avoid noisy situations. It should also help you control the anxiety patterns that you may have developed because of the pain and distress caused by certain sounds.

Are there ways I can help myself?

If you have hyperacusis there are several things you can do:

  • Try not to wear earmuffs or earplugs unless you really need to, and then only for short periods of time (see below for more information).
  • Try not to avoid situations where you might hear sounds that will cause you discomfort.
  • Try to avoid being in a completely quiet environment. It is important to try and listen to everyday sounds, as a quiet environment tends to make hyperacusis worse.

Is it a good idea to use earplugs or earmuffs?

Some people with hyperacusis tend to use devices such as earplugs or earmuffs to block out sound. Your audiology specialist may refer to these as ‘attenuators’. Although these may provide temporary relief, in the long-term they can undo any progress you are making to adapt to sound and they may even make hyperacusis worse.

However, if you are exposed to loud sounds for a long time, for example in your job, this can make hyperacusis worse. Therefore, you may find it helps to wear special ‘active’ electronic sound attenuators and musicians’ earplugs if you work in a noisy place. Your audiology department may be able to provide these or read our factsheet "Noise exposure (opens new browser window)" for more information about where to buy these.

Where can I get further information?

Our Information Line offers a wide range of information on many aspects of deafness and hearing loss. Contact us for further copies of this factsheet and our full range of information factsheets and leaflets. You can also contact us if you would like information in Braille, on audiotape or large print.

RNID Information Line
19-23 Featherstone Street, London EC1Y 8SL
Telephone: 0808 808 0123
Textphone: 0808 808 9000
Fax: 020 7296 8199
informationline@rnid.org.uk

RNID Tinnitus Helpline
19-23 Featherstone Street, London EC1Y 8SL.
Telephone: 0808 808 6666
Textphone: 0808 808 0007
Fax: 020 7296 8199
tinnitushelpline@rnid.org.uk

RNID Information, August 2006

Acknowledgement

This factsheet was produced with the help and advice of:

  • Professor Linda Luxon, Professor of Audiological Medicine at the Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust in London and
  • Dr Borka Ceranic, Lecturer in Audiological Medicine at the National Hospital for Neurology and Neurosurgery, London.