Hypersensitivity to noise (hyperacusis)

and Eva Rudolf-Müller, doctor

Eva Rudolf-Müller is a freelance writer in the medical team. She studied human medicine and newspaper sciences and has repeatedly worked in both areas - as a doctor in the clinic, as a reviewer, and as a medical journalist for various specialist journals. She is currently working in online journalism, where a wide range of medicine is offered to everyone.

More about the experts All content is checked by medical journalists.

For some people, everyday noises like barking dogs or ringing the phone are torture. They react nervously or aggressively to them and can even get palpitations, high blood pressure and sweats. Doctors call it hyperacusis when there is an oversensitivity to all sounds.

Hyperacusis: Even quiet is too loud

People with hyperacusis find even moderately loud or even quiet noises uncomfortable. Although the volume of such noises is actually well below the pain threshold, it causes symptoms such as palpitations or restlessness in those affected. Hyperacusis is particularly common in people with tinnitus.

Hyperacusis: Many causes are possible

Hyperacusis can have different causes. Doctors suspect that the processing of hearing signals in the brain is disturbed.

The human brain normally distinguishes important from unimportant sounds and suppresses the latter. For example, a mother is awake at the slightest noise from her baby, while street noise, on the other hand, lets her sleep peacefully. This mechanism does not seem to work in people with hyperacusis.

• The increased sensitivity to noise often occurs after a sudden hearing loss or in people with tinnitus.
• Stress can affect the hearing signals and thus cause hyperacusis.
• If those affected are afraid of loud noises and withdraw into silence, this can increase hyperacusis.
• Migraines can cause temporary hyperacusis.
• Certain neurological diseases such as epilepsy, multiple sclerosis or facial paralysis (facial paralysis) can lead to hyperacusis.
• Various substances, such as active pharmaceutical ingredients such as acetylsalicylic acid, quinine and vitamin B6, can change hearing perception and thus trigger hyperacusis.
• Hyperacusis is also possible as a result of an otosclerosis operation.

Hyperacusis symptoms

The sensitivity to noise can vary in severity. Everyday noises are not only perceived as subjectively unpleasant, they also lead to physical reactions such as heart pounding, increased blood pressure, sweating, tension in the shoulder and neck area, fear or restlessness. Some of those affected live in constant fear of loud noises. They then avoid activities in public and withdraw completely socially.

Hyperacusis is often associated with other diseases. Those affected often suffer from other symptoms such as a ringing in the ear (tinnitus).

Hypersensitivity to noise rarely occurs in childhood.

Hyperacusis: Investigations

First, the doctor asks about the patient's medical history (anamnesis). He also asks about leisure activities and the job. This is followed by an ear, nose and throat examination.

In the hearing test, hyperacusis can show normal to very good hearing. In some cases, hearing impairment is the cause of hyperacusis. Anomalies can be found when checking the discomfort threshold: People who are sensitive to noise very quickly find sounds unpleasant.

Depending on the additional symptoms, the doctor will conduct further examinations to find out possible causes of the hyperacusis.

Hyperacusis: therapy

This problem cannot be solved with earplugs. The focus is on neurootological counseling: This is a detailed consultation of the patient, sometimes lasting several weeks, from a neurologist and ear, nose and throat doctor who explains the causes and relationships of noise sensitivity.

Another essential part of the therapy for hyperacusis is the use of a partial mask or noiser. The small device is similar to classic hearing aids and generates individually adjustable noises.

First of all, a very low background noise is set that the person concerned perceives as pleasant. Gradually, there are also louder environmental noises. With the help of this technique, the brain should learn to block out unimportant noises. This desensitization (habituation) process can take up to a year.

Even without a noiser, it is advisable to ensure constant, low background noise in the case of hyperacusis - caused, for example, by a room fountain, soft music, "natural noises" or a fan. It is important that the volume is just barely perceived and not disturbing.

Research is currently being carried out into whether drugs that influence the neurotransmitter serotonin in the brain can be helpful for people who are hypersensitive to noise.

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