What Is Hyperacusis?

Hyperacusis is a debilitating disorder of sound tolerance, where even ordinary, everyday sounds are perceived as abnormally loud and sometimes excruciatingly painful. In some ways, it’s the opposite of hearing loss. The volume of the world is turned up, not down. 

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The prevalence of hyperacusis is unknown; there are many nonspecific definitions of the condition that put people with occasional mild ear discomfort together with people in agonizing pain. Prevalence figures range from 0.2 percent of the population to more than 17 percent. It can occur either unilaterally (in one ear) or bilaterally (in both ears).

The most common cause of hyperacusis is a noise injury, sometimes called acoustic trauma, from noise overexposure. Hyperacusis can occur suddenly (eg, from an airbag deployment, smoke alarm or fireworks explosion) or gradually (eg, from cumulative exposure from headphones that don’t seem especially loud, or from episodic exposure such as from concerts).

According to the American Academy of Otolaryngology–Head and Neck Surgery, hyperacusis can also be associated with a number of other conditions, including head injury, ototoxic drugs, viral infections like Bell’s palsy, temporomandibular joint (TMJ) syndrome, post-traumatic stress disorder (PTSD), chronic fatigue syndrome, and other health disorders and neurologic conditions.

Hyperacusis is often accompanied not only by tinnitus (ringing in the ears) but also by aural fullness and pain that is generally burning or stabbing. There may also be sound distortion, echoing, thumping, fluttering, and pain or pressure extending to the neck, jaw, throat, scalp, and face.

Ordinary sounds such as running water, revving vehicles, whirring appliances, scraping chairs, crunching leaves, swishing fabrics—and even regular conversations—are difficult to tolerate. Generally, high pitches and low throbs are the most uncomfortable, as are artificial or processed sounds, such as those from phones or computer audio. 

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