Understanding Sounds Tolerances & Sound Sensitivity

There are a number of different types of sound sensitivity or decreased sound tolerance.

Hyperacusis is decreased tolerance for volumes that are typically well-tolerated by most people. An individual with hyperacusis may experience physical discomfort or pain when exposed to common everyday sounds. The volume at which sound becomes uncomfortable or painful may be different across individuals with hyperacusis.

Misophonia is decreased tolerance for specific sounds, regardless of volume. Misophonia is also known as selective sound sensitivity. An individual with misophonia may experience a negative emotional reaction such as annoyance, disgust, and/or rage when exposed to specific “trigger” sounds. Trigger sounds are commonly mouth-oriented (such as breathing, chewing, swallowing) or repetitive (such as dripping, clicking, tapping).

Phonophobia is fear that non-harmful volumes will cause discomfort/pain, hearing loss, or tinnitus. An individual with phonophobia may experience a fearful emotional reaction when exposed to common everyday sounds.

Individuals with sound sensitivity may avoid exposure to common every day or trigger sounds through lifestyle modifications or overuse of hearing protection. Over time, this can make the sensitivity worse.

Management Options

Hyperacusis may result from a change in auditory function or might occur secondary to brain injury or other health conditions. It is common for hyperacusis to coexist with tinnitus. Hyperacusis is managed through the process of desensitization. Sound therapy for hyperacusis involves consistent exposure to a stimulus that is gradually increased in volume. Improvements in loudness tolerance may happen in as quickly as a few weeks.

The causes of misophonia and phonophobia are less well-understood. A team approach to management may be recommended. Sound therapy has shown to be an effective management option for these types of sensitivities, often in combination with cognitive behavioral counseling.

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