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Causes & Symptoms

Hyperacusis: causes of this disorder

Like tinnitus, hyperacusis has different causes. The main organic causes include hearing loss in the inner ear. Certain forms of epilepsy, signs of a migraine or drug side effects can also be considered as triggers in rare cases. Often the noise hypersensitivity is also an expression of overload or psychological impairment (anxiety disorder, depression), which is then expressed in this physical "overstimulation".

Disturbed hearing processing

A functioning hearing processing includes the separation of disturbing and useful sound. Our hearing has certain filter mechanisms for this purpose, which pass the respective acoustic information on or, if necessary, inhibit it. Hyperacusis can also focus attention on certain sounds. Certain, emotionally negative noises are perceived as unpleasant - even though the volume is not very high (example: creaking door). Stress and psychological stress can exacerbate this sensitivity. This sets in motion a cycle of fear of noise and negative reinforcement. The sensitivity to noise leads more and more to withdrawal from social activities, as normal volume levels are increasingly perceived as unbearable. The stress load on the nervous system increases. Those affected get into a vicious circle in which the sensitivity increases itself. At some point a state is reached that can often no longer be broken through on your own.

Hyperacusis symptoms: These symptoms can occur

Hyperacusis is an unusual sensitivity to normal ambient noise. The discomfort threshold drops to a value below 80 dB. It often causes reflex reactions such as sweating or racing heart.

Lack of loudness compensation for the hard of hearing

The hard of hearing may not understand soft sounds, but they are very sensitive to louder sounds.
Loud noises often trigger a startle response with heart racing, sweating, spikes in blood pressure, and dry mouth. In addition, increased neck tension can lead to headaches or earaches.

Phonophobia / misophonia

Phonophobia is the fear of certain sounds. This hypersensitivity is independent of the volume or frequency of the noise. The anxiety disorder is only triggered by the meaning of the sound to the person concerned. Abnormal sensations and acoustic misperceptions are also described. These noises are not really harmful. However, uncomfortable feelings such as fear, shame or embarrassment arise in connection with them.

Social and psychological consequences

To avoid situations with unpleasant noises, some people even wear hearing protection. Many reduce their social activities because they associate negative listening experiences with other people's company. It is not uncommon for this to result in social isolation with far-reaching consequences. In addition, it can lead to sleep problems, difficulty concentrating, fear of deterioration and failure, or depression.


Diagnosis: This is how we determine hyperacusis

The diagnosis of hyperacusis results from the connection of audiological findings and the medical history.

Audiological diagnostics

Depending on the cause of the sensitivity to noise, there are different audiological findings. Often a normal auditory finding is shown in the tone threshold and speech audiogram, in which, however, the discomfort threshold is reduced. In the case of inner ear hearing loss, a lack of loudness compensation (“recruitment”) can be the cause of the noise oversensitivity. In the case of phonophobia / misophonia, on the other hand, the discomfort threshold is inconspicuous.

Further investigations

Hyperacusis can also be a symptom of an accompanying illness in the context of depression, anxiety disorder, burnout or another crisis. That is why we also carry out psychosomatic and psychotherapeutic examinations.
The treatment concept of the Schön Klinik is comprehensive and versatile in the diagnosis and therapy of various noise hypersensitivities.