Hyperacusis

Overview

Hyperacusis is a condition where everyday sounds seem much louder than they actually are. It can make normal noises — like a car engine, a vacuum cleaner, or even someone chewing — feel uncomfortable, painful, or even frightening. Your brain processes sound differently, turning up the 'volume' on certain noises.

Hyperacusis is less common than simple sound sensitivity, but it affects about 1 in 50 people at some point in their lives. Many cases are mild and improve with time or simple measures.

Hyperacusis can affect people of all ages, including children. It is more common in adults who have tinnitus (ringing in the ears), a history of loud noise exposure, certain ear conditions, or migraines. It can also occur after a head injury or ear infection.

Symptoms

Common symptoms

• Everyday sounds like clinking dishes, traffic noise, or a running tap feel too loud or painful.
• Feeling irritated, anxious, or angry when exposed to certain sounds.
• Needing to cover your ears or leave noisy situations frequently.
• Difficulty concentrating in environments with background noise, like a restaurant or classroom.

Symptoms in children

• Children may cry, cover their ears, or refuse to go to places that are noisy (like playgrounds or parties).
• They might complain that sounds 'hurt' or seem 'too big'.
• Some children become withdrawn or upset in loud situations, which can be mistaken for shyness.

Symptoms in older adults

• Older adults may notice that sounds become more bothersome, especially if they also have hearing loss or tinnitus.
• They might avoid social gatherings because of noise sensitivity, leading to isolation.
• Changes in hearing due to age can make hyperacusis more noticeable.

Causes

Main causes

• Loud noise exposure (e.g., concerts, machinery, firearms) that damages the hearing system.
• Head injuries that affect the parts of the brain that process sound.
• Certain ear conditions such as ear infections, Meniere’s disease, or acoustic neuroma (a benign growth on the hearing nerve).
• Tinnitus (ringing in the ears) — the two conditions often occur together.
• Migraines — some people experience sound sensitivity as part of a migraine attack.

Risk factors

• Repeated exposure to loud noises, especially without ear protection.
• Taking certain medications that can affect hearing, such as high-dose aspirin or some antibiotics (talk to your doctor).
• Having a history of anxiety or post-traumatic stress disorder (PTSD), which can amplify sound sensitivity.
• Being female — hyperacusis appears to be slightly more common in women.

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe sound sensitivity along with hearing loss, dizziness, or ear pain.
• If you recently had an injury or infection that affects your ear.

Book a routine appointment if:

• If everyday sounds are consistently bothersome and affecting your quality of life.
• If you have hyperacusis that lasts more than a few weeks without improvement.

Diagnosis

A doctor (usually a general practitioner or an ear, nose, and throat specialist) will ask about your symptoms, hearing, and any triggers. They will also examine your ears and perform a hearing test.

Tests that may be done

• A hearing test (audiometry) to check your hearing sensitivity and identify any hearing loss.
• A loudness discomfort level test — this measures how loud a sound has to be before it feels uncomfortable.
• A questionnaire about your sound sensitivity and how it affects your daily life.

What to expect at your appointment

Diagnosis is usually straightforward. You may be referred to an audiologist (hearing specialist) for more detailed testing. There are no blood tests or scans needed unless the doctor suspects another condition. The process is painless and can help you understand your unique sound sensitivity.

Treatment

Treatment for hyperacusis focuses on helping your brain relearn to tolerate normal sounds. It is not usually treated with medication. The main approaches are sound therapy and counselling, often guided by a specialist.

Self-care at home

• Avoid complete silence — gently expose yourself to background sounds (like soft music or nature sounds) to retrain your ears.
• Use earplugs only when necessary, such as for very loud events, but not all the time — overprotecting can make sensitivity worse.
• Reduce stress through relaxation techniques, deep breathing, or gentle exercise, as stress can amplify sound sensitivity.

Medical treatments

Medical treatment is usually not needed, but if an underlying cause is found (like an ear infection or migraine), that condition will be treated first. If hyperacusis is linked to anxiety or depression, talking therapies such as cognitive behavioural therapy (CBT) can be very helpful. Some specialists offer tinnitus retraining therapy (TRT), which uses sound generators to gradually desensitise the ear. No specific medications are approved for hyperacusis itself.

When is surgery considered?

Surgery is not a treatment for hyperacusis itself. In rare cases, if an underlying problem like an acoustic neuroma (a benign tumour) is found, surgery may be needed to address that, but this does not directly treat the sound sensitivity.

Living with this condition

Living with hyperacusis means adjusting your environment to manage sound triggers. You may need to choose quieter places to eat or work, or let friends and family know about your sensitivity. Over time, many people find ways to participate in activities without discomfort.

Lifestyle tips

• Gradually expose yourself to sounds you find hard — start with quiet, safe noises and slowly increase volume over weeks or months.
• Use ear protection in truly loud places (like concerts or construction sites), but give your ears breaks from protection in everyday life.
• Practice mindfulness or relaxation to reduce the anxiety that often comes with sound sensitivity.

Diet and exercise

There is no specific diet for hyperacusis, but eating well and staying physically active can help manage stress and overall health, which may reduce sound sensitivity. Some people find that reducing caffeine or alcohol helps, as these can affect the inner ear.

Mental health and emotional wellbeing

Hyperacusis can be isolating and frustrating, making social situations stressful. It may lead to anxiety, avoidance of activities, or low mood. It's important to acknowledge these feelings and seek support from a counsellor or psychologist if needed. If you are struggling with thoughts of self-harm, please reach out to a mental health crisis service or call your local emergency number immediately.

Prevention

Hyperacusis cannot always be prevented, but you can reduce your risk by protecting your ears from very loud noises. Use earplugs around loud machinery, at concerts, or when using power tools. Also, take care of your general health — manage stress, treat ear infections promptly, and avoid inserting objects into your ears.

Screening programmes

There is no routine screening for hyperacusis. If you have a condition that increases your risk (like tinnitus or migraine), your doctor may ask about sound sensitivity during check-ups.

Complications

If left untreated

• Social isolation — avoiding people and places because of sound sensitivity.
• Increased anxiety or depression related to the constant struggle with sound.
• Worsening of sound sensitivity over time due to avoidance and overprotection of the ears.

Long-term outlook

The outlook for hyperacusis is generally positive. With the right strategies — like sound therapy, counselling, and lifestyle adjustments — most people see significant improvement. Even if the sensitivity never fully disappears, many learn to manage it well and lead full, active lives.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.