Hyperakusis/ Geräuschempfindlichkeit - Ursachen, Symptome, Behandlung

Hyperacusis/sensitivity to noise

Hyperacusis describes a non-specific, pathological noise hypersensitivity. This extreme sensitivity manifests itself in the fact that those affected perceive normally loud or objectively even quiet everyday noises as unpleasantly loud. If normal noises are not only perceived as loud, but also as painful, this is referred to as hyperacusis dolorosa.

The sound of a dog barking or a doorbell can become an unpleasant experience with this condition, to which those affected sometimes react nervously, aggressively or with physical symptoms. Stress and psychological strain often intensify the effect, creating a vicious circle of social avoidance and intensified symptoms.

Causes of hyperacusis

Although the causes of hyperacusis are diverse, it is generally assumed to be a disorder in the central auditory system of the brain. The hypersensitivity often occurs as an accompanying symptom of other clinical pictures:

In rare cases, hyperacusis is triggered by medication


Sensitivity to noise and stress

Stress and psychological strain are key factors that can manifest themselves in noise sensitivity or make it worse. In particular, the fast pace of modern society, noise, hectic pace and professional or personal stress are seen as causes of stimulus overload. In addition, hyperacusis itself can contribute to the feeling of stress, which in turn often leads to social withdrawal.

Hyperacusis anxiety disorder

Anxiety disorder also falls under psychological stress, which can manifest itself physically in the form of hyperacusis. For many, this awakens a new fear - the fear of loud, unpleasant noises. This often results in an avoidance reaction, in which patients withdraw massively from everyday life.

Hyperacusis tinnitus

More than 40% of people with tinnitus are also affected by hyperacusis. Study results show that tinnitus and hyperacusis are also associated with hearing loss in around 83% of cases.

Sensitivity to noise/hyperacusis symptoms

In general, hyperacusis symptoms manifest themselves in a hypersensitivity to ambient noises that are objectively perceived as normally loud. The discomfort threshold drops to below 80dB. Sometimes physical reactions such as a racing heart, sweating and a rise in blood pressure accompany the symptoms. Neck tension, headaches and earaches also occur. Sleep problems, difficulty concentrating and other anxieties are known to have further consequences. Which symptoms occur and how severe they are varies.

Hyperacusis diagnosis/hyperacusis test

In order to make a diagnosis of hyperacusis, both audiological findings and the patient's individual disease history are taken into account. As the subjective perception of the symptoms is particularly important, a detailed patient consultation is essential.

In the field of audiology, a hearing test is usually carried out first. In addition, a test of the stapedius reflex in the ear and determination of the discomfort threshold is carried out. The latter is particularly relevant, as the discomfort threshold is lowered in hyperacusis, even though the findings in the tone and speech audiogram are often unremarkable.

Psychosomatic and psychotherapeutic examinations round off the diagnosis to determine whether hypersensitivity is a concomitant symptom of depression, anxiety disorders or burnout. A questionnaire is also used to rule out misphonia (a feeling of discomfort with specific sounds).

Hyperacusis treatment/therapy

In contrast to many other degenerative hearing disorders, there are good prospects of a cure for hyperacusis. The treatment or therapy for hypersensitivity depends on the individual cause.

If it is a concomitant symptom of another illness, the underlying illness is treated. Psychosomatic and psychotherapeutic approaches help to reduce the fear of loud noises and can therefore ultimately also help to reduce the symptoms. In addition, hearing exercises are a suitable option for therapy.

Hyperacusis self-help

Simple listening exercises can help to reduce hyperacusis as part of self-help. To do this, it is advisable to create a quiet soundscape at home using background noises - such as a small fountain or the sounds of nature. The brain gradually learns to block out irrelevant information. However, this is usually a month-long process that should be approached with patience.

Noiser hyperacusis

Noisers are small devices that resemble hearing aids and generate sounds to mask disturbing sounds and help to relax. They are often used for tinnitus therapy and are therefore suitable when hyperacusis occurs together with tinnitus. You can find out more about Tinnitus Noiser here.

Hyperacusis hearing protection

Some sufferers wear hearing protection to avoid the unpleasant noises. However, earplugs are not a suitable solution, nor can they directly prevent the occurrence of hyperacusis. In order to find a successful solution, the cause of the hypersensitivity must be identified and this is precisely where the therapy should be applied. However, wearing hearing protection is generally recommended when spending time in noisy environments in order to prevent hearing damage and relieve the strain on the hearing


Differentiation of terms: dysacusis and hyperacusis

Hyperacusis should be distinguished from hypacusis, the technical term for hearing loss. There is also a risk of confusion with dysacusis, a hearing loss. If there is only hypersensitivity to certain sounds, this is referred to as misophonia. Finally, a distinction must be made between recruitment, the lack of loudness equalization in frequency ranges affected by hearing loss, which also leads to noise hypersensitivity. The latter is a concomitant symptom of sensorineural hearing loss.