What is Sound Sensitivity or Decreased Sound Tolerance? 

Sound sensitivity or decreased sound tolerance are terms used to describe conditions where individuals have an abnormally heightened sensitivity or aversion to certain sounds. These conditions can range from discomfort or irritation to intense fear or distress when exposed to specific noises. The most common types of decreased sound tolerance include hyperacusis and misophonia. Each condition is unique in its triggers, symptoms, and impacts on daily life, but all can significantly affect an individual's well-being and quality of life.

What are Hyperacusis and Misophonia? 

Hyperacusis: Sensitivity to Everyday Sounds

Hyperacusis is a condition characterized by an increased sensitivity to everyday sounds that would not typically be bothersome to others. People with hyperacusis may find normal environmental noises, such as the sound of traffic, a ringing phone, or even conversations, to be unbearably loud or painful. This heightened sensitivity can lead to significant discomfort and may cause individuals to avoid certain environments or social situations.

There are four distinct types of hyperacusis, each with its unique symptoms and underlying mechanisms:

1. Loudness Hyperacusis

Loudness hyperacusis occurs when ordinary sounds are perceived as being much louder than they actually are. This type of hyperacusis makes everyday noises, such as conversations, traffic sounds, or household appliances, seem overwhelmingly loud and uncomfortable.

Symptoms:

• Discomfort in response to sounds that are typically considered normal in volume.
• Avoidance of environments with moderate to loud noise levels.
• Difficulty tolerating common sounds, leading to social withdrawal or isolation.

2. Pain Hyperacusis
Pain hyperacusis, also known as noxacusis, is when specific sounds trigger physical pain in the ears or head. The pain may be sharp, burning, or aching, and can occur with sounds that others would not find bothersome.

Symptoms:

• Experiencing sharp or throbbing pain in the ears or head when exposed to certain sounds.
• Pain may persist even after the sound has stopped, leading to prolonged discomfort.
• A heightened sense of anxiety about encountering painful sounds.

3. Annoyance Hyperacusis

Annoyance hyperacusis is characterized by an exaggerated emotional response to specific sounds. These sounds, though not necessarily loud or painful, are perceived as highly irritating or distressing, leading to significant emotional discomfort.

Symptoms:

• Intense irritation, anger, or distress triggered by specific noises.
• Difficulty concentrating or relaxing in environments where these trigger sounds are present.
• Avoidance of situations where annoying sounds are likely to occur.

4. Fear Hyperacusis

Fear hyperacusis is the anticipation and fear of sounds that are uncomfortable. This type of hyperacusis is driven by a persistent sense of fear that certain noises will cause harm or trigger severe anxiety. The fear can be so overwhelming that individuals may go to great lengths to avoid exposure to these sounds.

Symptoms:

• Panic attacks or severe anxiety in response to specific noises.
• Avoidance of places or situations where feared sounds may occur.
• Physical symptoms such as sweating, rapid heartbeat, or nausea when confronted with feared sounds.

Misophonia: Emotional Reactions to Specific Sounds

Misophonia, meaning "hatred of sound," is when specific sounds trigger strong emotional reactions, such as anger, anxiety, or disgust. Unlike hyperacusis, which is related to the volume or intensity of sound, misophonia is triggered by particular noises, often those associated with human actions, such as chewing, breathing, or tapping. Over time, specific sounds may become associated with negative experiences, reinforcing the emotional reaction.

Symptoms 

• Sounds like lip-smacking, pen clicking, or repetitive tapping may provoke intense feelings of anger, irritation, or distress.
• Individuals may experience a rapid heartbeat, sweating, or a feeling of panic when exposed to trigger sounds.
• To avoid distress, individuals with misophonia may isolate themselves from situations where trigger sounds are likely to occur.

Impact on Quality-of-Life 

Hyperacusis and misophonia can significantly affect an individual’s quality of life. Individual experiences vary from mild annoyance/discomfort to withdrawing from or limiting social or work situations to avoid triggering sounds. Sensitivity to noise can also impact sleep, concentration, and emotional well-being and contribute to feelings of anxiety, stress, hopelessness, and isolation. Seeking professional help can be key to improving your quality of life.

Diagnosis and Treatment

Audiologists are the preferred healthcare providers for assessing and diagnosing hyperacusis and misophonia. They can evaluate the auditory system to determine if there are any otologic conditions or hearing loss contributing to your increased sensitivity to sounds.

Our audiologist specializes in the treatment of hyperacusis and misophonia and can help determine the nature of your sound sensitivities and the impact it has on your social and emotional well-being. Understanding the characteristics of your sensitivities is crucial for effective management.

While decreased sound tolerance conditions like hyperacusis and misophonia can be challenging to live with, several treatment options and coping strategies are available to help manage symptoms:

Behavioral Therapies: 

• Cognitive-Behavioral Therapy (CBT): Teaches techniques that can help patients cope with the emotional impact and their reactions to trigger sounds.
• Hyperacusis Activities Treatment: A CBT-based approach that involves addressing emotional aspects, understanding the impact of hyperacusis and misophonia, and developing communication strategies and coping mechanisms.
• Mindfulness and Relaxation: Techniques such as deep breathing, meditation, or progressive muscle relaxation can help manage stress and anxiety related to sound exposure.

Sound Therapy: 

• Gradual Sound Enrichment: Gradual exposure to sounds in a controlled manner can help recondition the auditory system’s response to sounds, reducing symptoms over time.
• Noise Generators: The use of external noise, such as white noise or specialized sound devices, to mask or reduce the perception of trigger sounds.

How can Hearing Brain Help Manage your Sound Sensitivities?

When you first contact Hearing Brain Audiology, you will schedule a complimentary 15-minute telehealth consultation, where we will talk about the process and get to know you and your sound sensitivities better. This is a chance to ask questions, voice your concerns, and see if our services fit with your needs. 

Before your consultation:

• Share a Recent Hearing Test: This helps us better understand your listening and communication needs for the appointment.
• Fill Out the Decreased Sound Tolerance Intake Form: This will be shared when you schedule with us.
• Complete the Sound Sensitivities-Specific Questionnaire: A link will be shared  once you schedule your consultation.

After your consultation:

We will design a fully custom, evidence-based, protocol that will outline your hyperacusis or misophonia treatment. All treatment activities and suggestions are based on the goals and impact areas the patient expressed during the consultation. Treatment may consist of sound therapy options, 1-on-1 therapy, mindfulness/relaxation-based exercises, communication skills training, and other techniques to help you better manage your symptoms. 

If individual sessions are suggested, we will work with you to schedule your appointment for days and times that work best for you. The frequency and spacing out of appointments are determined by the needs of the patient and the level of support required. Each session is scheduled for 1 hour. 

When to Seek Help

If you or a loved one are struggling with hyperacusis or misophonia, it is important to seek help from healthcare professionals who can guide you toward effective treatment options. Decreased sound tolerance conditions can significantly impact daily life, but with the right support, management strategies, and help from an audiologist, individuals can learn to cope with and even reduce their sensitivity to sounds. 

If you are concerned about your sensitivities to sound, especially if it is affecting your daily life, do not hesitate to reach out to Hearing Brain Audiology. Early intervention can make a significant difference in managing symptoms and maintaining a high quality of life.