Tinnitus & Hyperacusis

Most people who have significant hyperacusis also have tinnitus but not the other way round. Actually, very little is known about hyperacusis as it is a subjective experience and cannot be measured directly and is, consequently, very difficult to study.

Hyperacusis is used to describe as a general altered sound tolerance. i.e normal sounds become annoying, uncomfortable or even painful. There are a number of different types of hyperacusis and these include:

• Phonophobia - Some people may be sensitive to certain sounds in that it creates anxiety leading to an aversion to those sounds.
• Misophonia - This is a relatively new word used to describe people who have an intense dislike or repulsion to a certain sound such as other people chewing food.
• Recruitment - This is extremely common as it is related to hearing loss and tends to affect people as they age naturally. As we age, we lose our ability to hear quiet sounds and our ears also can't limit the amount of sound being received by the brain. Therefore, loud sounds sound louder than they would to a normal hearing person.

People experiencing the above could be anywhere on the scale from a mild awareness to having a massive impact on their day to day lives. Although there aren't any official numbers, people working in the fields would say that the latter is extremely rare. Sound tolerances can also vary from day to day depending on stress, anxiety and tiredness levels.

For most people, there will be no clear reason for the onset of hyperacusis but there are a few medical conditions that do list it as a possible symptom:

• Migraine
• Post Head Injury Syndrome
• Lyme disease
• William's syndrome
• Bell's Palsy
• Autism (and other sensory processing disorders)

It is obviously important for you to see your GP if you feel you have hyperacusis and they should refer you to an ENT surgeon or Audiovestibular Physician.

You can also develop hyperacusis if you've experienced a sudden loud noise or a recent traumatic life event.

For most people, if the hyperacusis is not too bothersome, a good explanation of the condition and advice of how to manage certain areas of their life will enable a patient to manage their condition. For more serious cases, an audiology clinic that also specialises in tinnitus treatment will be the next stop. A patient will be introduced to sound therapy and possibly councelling in the form of cognitive behavioural therapy (CBT).

Patients who try to withdraw from everyday sounds usually end up becoming more sensitive to those sounds and so sound therapy and CBT try to bring people back to hearing more sounds with minimal discomfort. Ear protection is generally not advised unless it is to protect the ears in genuinely noisy conditions. Not all audiologists are trained in CBT and patients may see someone separately for this part of the therapy.

Tinnitus Centre Audiologists are trained to advise and treat hyperacusis as well as tinnitus.