Hyperacusis: understanding and treating it

Hyperacusis is characterised by hypersensitivity to everyday sounds that become painful, uncomfortable or unbearable — vacuum cleaners, cutlery, voices in groups, road traffic. Less well-known than hearing loss, it is nevertheless common and can be severely disabling. Understanding this condition is the first step towards appropriate management.

1. Definition and symptoms

Hyperacusis is not a fear of sounds: it is an abnormal physiological response of the auditory system to sounds of normal or low intensity. It is distinct from misophonia (emotional aversion to specific sounds) and phonophobia (fear of loud sounds).

The most common symptoms:

Pain or physical discomfort when exposed to ordinary sounds (kitchen utensils, street noise, background music).

Withdrawal: people with hyperacusis gradually avoid noisy places and situations, leading to social and emotional isolation.

Auditory fatigue after even moderate sound exposure, a feeling of sensory overload.

Anticipatory anxiety in advance of sound exposure.

2. Link with tinnitus

Hyperacusis and tinnitus frequently coexist. Both conditions share common neural mechanisms linked to hypersensitisation of the central auditory pathways. It is estimated that 40 to 80 % of people with tinnitus also present some form of hyperacusis.

This coexistence is important to identify, as it guides the therapeutic choice. Management targeting both conditions simultaneously is generally more effective.

3. Diagnosis and assessment

The diagnosis of hyperacusis is based on specific audiometric tests, notably the measurement of the Loudness Discomfort Level (LDL), which assesses the threshold at which sounds become painful. In a person without hyperacusis, this threshold is above 90 dB; in cases of hyperacusis, it can drop below 60–70 dB.

This assessment can be performed at your audiologist in Aigre. It may be supplemented by an ENT or neurological consultation depending on the context.

4. Treatment and management

Progressive sound desensitisation is the reference treatment. It involves gradually exposing the patient to increasingly intense sounds, using white noise generators or hearing aids. The aim is to recalibrate the central auditory system.

Hearing aids with sound generators are particularly indicated when hyperacusis is accompanied by tinnitus or hearing loss. They deliver a discreet background sound that progressively reduces sensitivity.

Psychological therapies (CBT, EMDR, sophrology) help manage the anxiety component and avoidance behaviour.

Excessive hearing protection (wearing earplugs permanently) must be avoided: it worsens hyperacusis by depriving the auditory system of stimulation and perpetuates the cycle of sensitisation.

5. Consultation in Aigre (Charente)

If you experience hypersensitivity to everyday sounds, do not remain without answers. The Son Pour Son clinic, at the Maison de Santé Départementale in Aigre (16140), performs the necessary audiometric tests — including Loudness Discomfort Level (LDL) measurement — to objectively assess hyperacusis and propose an appropriate management plan.

Elea MANE, State-Registered Audiologist, provides follow-up in coordination with your GP and ENT specialist. The first appointment is free and with no commitment.