Hyperacusis

Also called: Sound Sensitivity, Noise Sensitivity, Decreased Sound Tolerance (DST)

What Is Hyperacusis?

Hyperacusis is when everyday sounds seem way too loud and uncomfortable. It’s a hearing disorder that can happen in one or both ears suddenly or over time.

Being sensitive to sound is common in kids and tends to go away as they grow up. But if some noises often seem harsh or cause any pain, it could be hyperacusis (hy-per-uh-CUE-sis). Therapy and other strategies can help kids cope with the discomfort of hyperacusis. 

What Are the Signs & Symptoms?

Certain sounds may be too loud, painful, or upsetting for someone with hyperacusis. Symptoms can include a ringing sound in the ears or ear pain or pressure (like when on a plane). In serious cases, hyperacusis can cause balance problems and, rarely, episodes that seem like seizures.

The upsetting noises of hyperacusis may cause kids to feel tense, anxious, angry, or depressed or have trouble being around others. It can also be hard to focus when hearing the sounds.

Some children cover their ears, get upset, or try to move away from the noise. They may also be afraid to go anywhere they’ve heard the sound before, like a bathroom. Tiredness and stress can make symptoms worse.

Many sounds can trigger an episode of hyperacusis, including:

• appliances running, like a dishwasher, blender, refrigerator, or vacuum
• a toilet flushing, faucet running, or hand dryer blowing in bathrooms
• a car engine humming or other vehicle sounds
• people talking, turning pages, clinking dishes, or using utensils (like forks and knives)
• dogs barking
• music playing

What Causes Hyperacusis?

Hyperacusis can be caused by different things, but doctors aren't always sure of the exact cause. For example, experts are still figuring out why certain noises are uncomfortably loud for some kids. It may be due to how the brain handles sounds. Normally, your brain helps you know how loud or soft a noise is. With hyperacusis, the brain seems to confuse sounds and make them seem louder than they really are.

Other causes are due to infections of the ear — like a certain type of middle ear infection — or of the nerves in the face, as with Bell’s palsy. Other possible causes include damage to the ear from a sudden loud noise (like a gunshot or fireworks), being around loud sounds for a long time, or taking certain medicines or poisons.

Hyperacusis usually happens along with other conditions like:

• tinnitus (ringing in the ears), misophonia (disliking certain sounds), or Ménière’s disease (inner ear problem)
• head or brain injuries, migraine headaches, some kinds of epilepsy, or Williams syndrome
• Lyme disease, Bell’s palsy, or jaw problems called temporomandibular (TMJ) disorders
• chronic fatigue syndrome or Tay-Sachs disease
• anxiety or posttraumatic stress disorder (PTSD)

Young children and kids with conditions like autism spectrum disorder may be more likely to have hyperacusis.

How Is It Diagnosed?

If you think your child has hyperacusis, see an otolaryngologist (ENT or ear, nose, and throat doctor) or an audiologist (aw-dee-OL-uh-jist) — a health care provider who helps with hearing and balance problems.

The doctor will ask about symptoms and give your child an exam and a hearing test. To check if another condition might be the cause, some kids may need other tests, like blood tests.

How Is Hyperacusis Treated?

Treatment for hyperacusis may include:

• Sound therapy or sound desensitization. This involves wearing a device on one or both ears that makes white noise (gentle background sounds, like static). Over weeks to months, this helps the brain adjust to hearing louder sounds.
• Auditory integration therapy. Kids practice listening to music each day at different volumes.
• Cognitive behavioral therapy (CBT). This is a kind of talk therapy that helps kids handle the stress that can happen with hyperacusis so that noises feel less jarring.
• Tinnitus retraining therapy. This treatment is usually for tinnitus but it can help hyperacusis, too. It combines counseling and sound therapy.
• Occupational therapy (OT). An OT therapist can teach kids ways to deal their emotions so they can better cope with sounds.
• Medicine. If an infection is the cause, treating it with medicine may ease sounds as well.
• Surgery. This may be needed to fix nerves in the face if they become paralyzed and cause hyperacusis.

How Can Parents Help?

To help kids cope with hyperacusis, try to:

• Wear headphones, earbuds, or earplugs to avoid trigger noises — but avoid overusing them. That could make your child more sensitive to certain sounds.
• Explain what the sound is. This may comfort your child. You can also have children make their own loud noise to get used to it. They can clap, play with toys that make sounds, bang a pot, or turn on an item like a vacuum while you’re there.
• Tell your child when to expect the noise, if possible. Getting kids used to the sound may be helpful but move them away from it if it’s upsetting.
• Play soft music or background noise when it’s quiet so sudden loud sounds won’t be such a surprise.
• Help your child ease stress by doing things like deep breathing. Getting enough sleep and exercise helps, too. A therapist can also help kids feel better.

What Else Should I Know?

Lots of young kids are sensitive to sound and outgrow it, so it may not always be hyperacusis. Some children are bothered by more things than just noise, like food (picky eating), and certain textures. To see if it could be a sensory processing disorder (when the brain doesn’t handle information from the senses correctly) instead of hyperacusis, ask your doctor to recommend an occupational therapist.