Hyperacusis

Hyperacusis is a condition in which ordinary environmental sounds that most people find comfortable or easily tolerable are perceived as uncomfortably loud, painful, or overwhelming. It is a disorder of loudness tolerance rather than a disorder of hearing sensitivity. People with hyperacusis may find everyday sounds such as running water, clattering dishes, traffic noise, or normal conversation levels physically painful or distressing.

Hyperacusis is different from misophonia, which involves a strong emotional reaction to specific sounds, and from recruitment, which is the rapid growth of loudness associated with sensorineural hearing loss. Hyperacusis involves a reduced tolerance for a broad range of sounds and is thought to involve changes in how the central auditory system processes loudness. It can occur alongside hearing loss, tinnitus, or independently. It is associated with conditions including chronic noise exposure, head injury, Lyme disease, post-traumatic stress, and certain medications.

Treatment typically involves gradual, controlled sound exposure therapy designed to re-normalize the auditory system's response to everyday sounds. This approach, sometimes called desensitization therapy or sound therapy for hyperacusis, is delivered by an audiologist and may be combined with counseling. In Canada, hyperacusis assessment and management are within the audiologist's scope of practice.