The short answer
Hyperacusis is a heightened sensitivity to ordinary sounds in general: they feel too loud, uncomfortable or painful. Misophonia is a strong dislike of specific sounds, such as chewing or tapping, that triggers intense emotions like anger, anxiety or disgust. With hyperacusis, volume is the problem. With misophonia, it is the sound itself, even when it is quiet.
Side by side
| Hyperacusis | Misophonia | |
|---|---|---|
| What triggers it | Many everyday sounds, especially louder or sharper ones | Specific trigger sounds, often made by other people |
| Does volume matter? | Yes, louder is worse | Not much, quiet triggers can be just as bad |
| Typical sounds | Cutlery, doors, traffic, voices, sirens | Chewing, lip smacking, breathing, sniffing, pen clicking, typing |
| Main reaction | Discomfort, pain, feeling overwhelmed | Anger, anxiety, disgust, an urge to get away |
| Main approaches | Sound therapy, CBT, careful use of ear protection | Therapy to manage triggers and reactions, sound masking |
Where they overlap
Clinicians sometimes describe an “annoyance” type of hyperacusis that looks a lot like misophonia, and a fear type (phonophobia) where people come to fear sound. Many people have more than one of these, and tinnitus often comes along too. That is why a proper assessment matters.
What helps
For hyperacusis, sound therapy and cognitive behavioural therapy are the main approaches. For misophonia, therapy focuses on identifying triggers and changing how you respond to them, sometimes with background sound to keep attention away from trigger sounds. Some techniques are shared.
Which one do I have?
Ask yourself: is it that many sounds are too loud, or that certain sounds make you feel intensely angry or disgusted? If it is mostly volume, it points towards hyperacusis. If it is mostly specific sounds and strong emotions, it points towards misophonia. A GP can refer you to an audiologist or psychologist to find out more.
Sources
- ASHA Practice Portal: Tinnitus and hyperacusis
- Cleveland Clinic: Misophonia
- Cleveland Clinic: Hyperacusis
- NHS: Noise sensitivity (hyperacusis)
This page is general information, not medical advice. See a doctor if you have ear pain, sudden hearing changes, hearing loss or dizziness.