Hyperacusis is a rare hearing disorder. People with the condition perceive sounds at normal volume as painfully loud. Sounds as soft as paper rustling, silverware clanging, or a hairdryer running are just as painful to these individuals as loud noises like sirens and horns. According to the Hyperacusis Network, about 1 in 50,000 people have this disorder in one or both ears.

Signs and Symptoms

Being unable to tolerate everyday sounds is the hallmark symptom of hyperacusis. These noises become irritating and painful, drastically affecting the person’s ability to function in public. Someone with hyperacusis may start to wear earplugs away from home or in situations where they have no control over the noise. They may also begin avoiding social situations and develop a true fear of sudden noises and sounds.

Causes: Diseases and Disorders

Hyperacusis does not have a single cause but experts link it to a variety of disorders, including Lyme disease, PTSD, Bell’s palsy, and chronic fatigue syndrome. There are also strong connections to autism. It is estimated that about 40% of children on the autism spectrum also have hyperacusis. Head trauma, severe infections of the inner ear, and even facial surgery can also lead to hyperacusis.

Causes: Loud Noises

One of the major causes and risk factors of hyperacusis is lengthy exposure to loud noises. People who work in jobs where noise exposure is common, such as machinists, construction workers, and musicians, face an increased risk. Interestingly, hyperacusis can also be triggered by a single loud noise, such as a gunshot.

Diagnosis

To diagnose hyperacusis, an audiologist performs a physical exam and collects a medical history; he or she will ask a lot of questions about when the symptoms began and their intensity. A hearing test will check the person’s reaction to sounds at varying frequencies. However, hearing tests do not necessarily present abnormal results because people with hyperacusis have otherwise normal hearing.

Will It Improve?

It is hard to predict whether or not hyperacusis will improve or how long it will take for things to become more tolerable; this often depends on the cause. Hyperacusis caused by trauma may recede over time as the body heals. In cases where the cause is unidentifiable, the condition may never improve on its own. Though wearing earplugs eases symptoms, doctors do not recommend wearing them all the time, because constantly blocking all noise further affects the way the brain processes sound.

Sound Desensitization

One possible treatment for hyperacusis is sound desensitization. This treatment is performed by a specialist and will continue for six months to a year, or longer. The person with hyperacusis listens to static noise at a barely audible level for a set length of time each day. Over time, their sound tolerance may improve, and sensitivity to normal sounds diminishes. This treatment may not cure the condition, but the improvements can help the person function more comfortably in day to day life.

Auditory Integration Therapy

Another treatment is auditory integration therapy or AIT, which is common for people on the autism spectrum and can be effective for hyperacusis. The person listens to filtered music at varying volumes every day for a predetermined amount of time. There is not a lot of scientific evidence supporting the effectiveness of this therapy, so it may not be available everywhere.

Other Treatments

Alternative treatments for hyperacusis are also available, including relaxation strategies, acupuncture, and biofeedback, all of which can increase relaxation and, as a result, improve an individual’s ability to cope with their symptoms. There is no medication to treat hyperacusis, though it is not uncommon for people with the condition to receive prescriptions for anxiety or depression.

Prevention

Hyperacusis triggers and causes such as trauma, surgery, and infection cannot be avoided, and it is difficult to predict or take precautions against single loud sounds, as well. The only cause of hyperacusis that individuals have any control over is regular exposure to loud noise over a long period. People who work in factories, machine shops, or construction sites should always wear proper ear protection.

Prognosis for Hyperacusis

The outlook for hyperacusis depends on the cause and treatment. Some people may not see improvement with sound desensitization or AIT. For others, it can take anywhere from three months to several years for hearing to begin to normalize. Therapy can be beneficial in helping people develop coping strategies and deal with anxiety.