Hyperacusis

With hyperacusis, ordinary everyday sounds are perceived as unpleasant, too loud, or overwhelming. For some people, sounds even cause pain.

As a result, a conversation, the sound of dishes, or passing traffic can become burdensome.

The level of distress experienced varies greatly: for some, symptoms remain limited, while others must adjust their work, social interactions, or daily activities.

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how to Treat?

What is it?

What is hyperacusis?

Hyperacusis is a reduced tolerance for sounds that most people tolerate without any issues. It is not necessarily about loud sounds: even ordinary sounds can feel too intense or painful.

Hyperacusis can occur on its own or in combination with tinnitus. These are different conditions: with tinnitus, you hear a sound without an external sound source; with hyperacusis, you are hypersensitive to sounds in your environment.

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How does it develop?

The exact cause of hyperacusis is not yet fully understood. Research is focusing on factors such as changes in the auditory system and the way the brain processes sound.

Symptoms can arise after exposure to loud noise or occur alongside other conditions. A clear cause is not found in everyone. Therefore, treatment begins with a careful assessment of your specific situation.

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What forms of sound sensitivity are there?

Sound sensitivity can manifest in different ways. These forms can occur individually or together.

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Loudness sensitivity — loudness hyperacusis

Ordinary sounds are perceived as excessively loud or overwhelming. The intensity of the sound is the central issue here.

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Pain from sound — noxacusis

Sounds can cause pain, sometimes even at low volume levels. The pain can feel burning, stabbing, throbbing, or like pressure, and can occur immediately or after exposure.

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Misophonia

With misophonia, specific sounds—such as smacking, swallowing, or breathing—trigger a strong reaction. This can include irritation, aversion, anger, or tension. In this case, the type of sound plays the primary role, not just the loudness.
Misophonia is a related but distinct form of sound sensitivity.

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Why does the impact vary from person to person?

The consequences depend on which sounds trigger symptoms, whether pain occurs, and how much this impacts daily life.

During the assessment, we therefore pay attention to both the sound sensitivity and the impact on sleep, concentration, work, and social interactions.

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How to treat

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How do we treat hyperacusis?

Hyperacusis varies from person to person. That is why we tailor our approach to your specific symptoms, tolerance levels, and any underlying conditions.

We recommend first visiting an ear, nose, and throat (ENT) specialist. This is important to investigate any treatable causes or hearing issues.
If you continue to experience significant distress after this examination and any necessary treatment, you can contact BRAI3N.

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Hearing protection and managing sound

It is understandable that you try to avoid distressing sounds. Hearing protection remains important for dangerously loud noises.

However, wearing earplugs constantly in normal, safe sound environments can increase sound sensitivity. Therefore, discuss with an expert when protection is necessary and how to manage it.

Guided sound exposure can be part of the treatment for some people.
This is done gradually and tailored to your tolerance levels. This requires extra caution, especially if sound causes pain. Do not force exposure that causes pain or clear worsening; discuss this with your practitioner.

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Neuromodulation at BRAI3N

At BRAI3N, we treat hyperacusis with non-invasive neuromodulation. We use this to influence the activity of brain networks involved in sound processing, as well as the attention and emotional response that sound triggers.

The general principle is the same as with neuromodulation for other conditions: we target brain networks involved in the symptoms. We tailor which networks we stimulate and how we do it based on your clinical assessment.

With hyperacusis, the goal is to improve sound tolerance and reduce the associated distress and tension, making daily activities easier again. Results vary from person to person.

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An approach tailored to your symptoms

During the intake, we will discuss which sounds cause symptoms, whether you experience pain, and what examinations or treatments you have already undergone.

A qEEG, a measurement of electrical brain activity, may be part of our assessment. We review this information alongside your symptoms and clinical findings. A qEEG cannot predict with certainty which treatment will work for you.

Depending on your situation, the approach may consist of a combination of audiological guidance, appropriate sound exposure, support for tension and sleep, and potentially neuromodulation.

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What can you expect from treatment?

The goal is to reduce sound sensitivity, any associated pain, and the impact on daily life. What is achievable and how the process unfolds varies per person.

We will monitor the effects together and adjust the treatment plan as needed.

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Our four-phase approach

1. Assessment
We discuss your symptoms, medical history, previous examinations, and the impact on your daily life. Together, we determine achievable treatment goals.

2. Targeted treatment
We start an individual treatment plan and monitor changes in dizziness, balance, and daily functioning. If results are insufficient, we adjust or stop the treatment in question.

3. Stabilization
When the treatment helps, we try to consolidate the improvement. Where possible, we gradually reduce the frequency of treatment.

4. Maintenance
We determine whether further follow-up or maintenance treatment is necessary. The principle is: as little treatment as necessary.

After each phase, we evaluate the next step together.

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