Hyperacusis — Sound Sensitivity Explained

Hyperacusis is a condition where everyday sounds that others find perfectly comfortable are perceived as uncomfortably loud, distressing, or even painful. It can significantly affect quality of life, making routine activities like shopping, commuting, or socialising extremely difficult.

Symptoms

People with hyperacusis may experience:

• Everyday sounds (plates clinking, running water, traffic) feeling painfully or distressingly loud
• Physical discomfort or ear pain in response to normal sound levels
• Anxiety or avoidance of situations where sound may be uncomfortable
• Difficulty concentrating due to sound sensitivity
• Fatigue after spending time in moderately noisy environments

Causes

Hyperacusis can develop due to:

• Noise exposure — a single loud event or prolonged noise can trigger hyperacusis
• Head injury
• Ear surgery or ear infections
• Stress and anxiety — can worsen or trigger sound sensitivity
• Neurological conditions — including migraine, Bell's palsy, or Lyme disease
• Tinnitus — hyperacusis and tinnitus frequently co-occur

In many cases, the central auditory system becomes over-sensitised, amplifying its response to normal sound levels.

Management

Hyperacusis can be effectively managed with professional help:

• Sound therapy — gradual, structured exposure to gentle sounds helps desensitise the auditory system over time
• CBT (cognitive behavioural therapy) — addresses the emotional and anxiety response to sound
• Hearing aids or sound generators — devices that provide low-level background sound to help the brain recalibrate
• Counselling and education — understanding the condition reduces fear and helps develop coping strategies

Where to get help

Hyperacusis assessment and management is available through NHS audiology (via GP referral) and private audiologists with specialist training. The RNID and British Tinnitus Association also provide information and support.

Important note

While it may be tempting to wear earplugs constantly to block out sound, over-protection can make hyperacusis worse by further sensitising the auditory system. Professional guidance on appropriate sound exposure is essential.