Hyperacusis is usually treated by an audiologist, often together with a psychologist. The goal is not silence, but a wider comfort zone: more of everyday life fitting inside the range of sound you can tolerate.
1. Sound therapy
Sound therapy means listening to low-level sound, such as soft broadband noise, music or nature sounds, for longer periods so your hearing system gets used to sound again. Levels are raised slowly. Some programmes also build up gradually towards the specific sounds that bother you. Cleveland Clinic notes that sound therapy often increases sound tolerance within six months to a year. Read the full guide to sound therapy.
2. Cognitive behavioural therapy (CBT)
Hyperacusis often comes with anxiety, fear of sound and avoiding places. CBT works on those thoughts and habits. In a randomised controlled trial with 60 patients, CBT improved loudness tolerance, hyperacusis symptoms and quality of life compared with a waiting list, and the results largely held after 12 months.
3. Counselling and education
Understanding why sound feels too loud, and why it can improve, is part of most programmes. It makes the other steps easier to stick with.
4. Using ear protection carefully
It is tempting to wear earplugs all the time, but the NHS advises against it because it can make you more sensitive to noise. Protection still makes sense in genuinely loud places, such as concerts or with power tools. A specialist can help you cut back step by step.
5. Treating related conditions
Hyperacusis can be linked to tinnitus, migraine, Ménière's disease or Bell's palsy. Treating the related condition can help the sound sensitivity too.
When to be careful
Pain hyperacusis needs a different approach. If sounds cause ear pain, some specialists warn that sound exposure can make it worse. See a doctor or audiologist before you start sound therapy.
Can treatment happen online?
Much of the work, such as education, sound therapy sessions and CBT, can be done from home with regular check-ins. Online programmes are still being studied, so it helps to have a specialist who can adjust the plan for you, and to see a doctor first if you have pain, hearing loss or dizziness.
Sources
- NHS: Noise sensitivity (hyperacusis)
- ASHA Practice Portal: Tinnitus and hyperacusis
- Cleveland Clinic: Hyperacusis
- Jüris et al. (2014). Cognitive behaviour therapy for hyperacusis: a randomized controlled trial. Behaviour Research and Therapy
- Hearing Health Foundation: Hyperacusis treatment
This page is general information, not medical advice. See a doctor if you have ear pain, sudden hearing changes, hearing loss or dizziness.