Information Informative Articles

Information on Hyperacusis

Article contributed by Aimee Cooke, Tinnitus and Hyperacusis specialist – The Tinnitus and Hyperacusis Network

For some people, sudden sensorineural hearing loss (SSNHL) is accompanied by sound sensitivity, also known as hyperacusis.

What is Hyperacusis?

Hyperacusis is a condition whereby everyday sounds that are tolerated by most people are instead found to be uncomfortable, too loud, and on occasions painful.

What are Loudness Discomfort Levels?

Our auditory systems are truly amazing and have an extraordinary range. We can hear quiet sounds (gentle bird song), yet we are able to tolerate extremely loud sounds (loud music at a concert). 120dB is around the level of sound that can cause physical pain. However, we reach a point where we feel that sound is too loud long before we reach the threshold of pain.

Fingernails scraping a chalkboard, painful noise
Fingernails scraping a chalkboard

Maximum loudness discomfort levels tend to vary from person to person regardless of sensitivity and can be affected by many factors such as mood or tiredness.

Most people can find they have some intolerance to certain sounds that are deemed unpleasant regardless of the level of their sensitivity (running water, nails on a chalkboard, polystyrene). These are normal variations of sound intolerance. However, some people are unable to tolerate sound to the point that it can impact on their ability to live a ‘normal’ life.

For some people, hyperacusis can lead to a fear of sounds and so they withdraw from normal activities and try to avoid sound altogether. This can lead to the auditory system becoming even more sensitive. People may also achieve temporary relief from earplugs. But, a quieter environment can, in turn, lead to long-term sensitivity.

More recently, research has shown there are other possible forms of altered sound tolerance such as Misophonia, Recruitment, and Phonophobia.

How Common is Hyperacusis?

It is promising to note here that there is research into tinnitus and hyperacusis happening as you read this. However, there is still limited information about the number of people with troublesome hyperacusis.

Recent studies suggest that around 9% of adults have some sound tolerance problems. However, an estimate suggests that around 2% of adults have a significant degree of hyperacusis.

What Can Cause Hyperacusis?

It is not always known why people develop hyperacusis. For me the most important aspect here is the treatment/management. It is known that many different medical conditions have hyperacusis as a symptom. These include the following:

  • Migraine                          
  • Post Head Injury Syndromes                     
  • Sudden Loud Noise Exposure

Some research has suggested a significant distressing life event may also have some involvement in altering sensitivity to sounds.

How is Hyperacusis Treated?

With the right assessment and intervention, many patients with hyperacusis can start to tolerate sounds better. There are proven techniques that successfully help and treat heightened sound sensitivity so that most patients can return to activities that they had to avoid as a result of their hyperacusis.

The key to helping resolve the problems associated with hyperacusis symptoms is getting the correct information and help as soon as possible from experts within the field. Self-research on the internet can be helpful. But, beware of information that is biased with a negative focus, incorrect or misleading, as this could lead to further anxiety and distress.

The first step to receiving the correct help, advice, and support is to attend an initial assessment appointment with an expert within the field.

Information is obtained by taking a comprehensive history and completing a series of diagnostic audiological tests. Your tinnitus and hyperacusis specialist will identify how the hyperacusis affects you, and what you can do to reduce the impact of hyperacusis on your day-to-day life.

Older woman or female pensioner with a hearing problem make a hearing test and may need a hearing aid, in the foreground is a model of a human ear
Woman with hyperacusis wearing headphones, taking a hearing test. In the foreground is the back of a female audiologist and a model of a human ear.

Hyperacusis Management

In practise, following assessment, I introduce my patients to a targeted hyperacusis management programme designed for them, which uses elements of the following approaches:

  • Sound Therapy
  • Desensitisation Techniques
  • Treatment of other Medical Conditions

The most important message for anyone reading this is that there are people who can help find a constructive way forward.

More Information

If you need any further information, please do contact The Tinnitus and Hyperacusis Network.


T: 01270 660011/ Freephone: 0800 028 8411



Thank you to Aimee Cooke at The Tinnitus and Hyperacusis Network for this contribution.

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