Living with hyperacusis: practical tips for work, home and going out

Keep living, but plan ahead

When sound hurts or overwhelms, staying at home can feel like the safest choice. The trouble is that avoiding noise completely can mean missing out on everyday life, and the NHS notes it can also make you more sensitive to noise over time. ASHA describes how, for some people, avoidance grows until it changes their routines and relationships. So the aim is to keep going out, in a way you can manage.

• Choose quieter times. Shops, cafés and public transport are often calmer outside peak hours.
• Pick your seat. In restaurants, ask for a table away from speakers, the kitchen and the door. A corner or a booth can help.
• Pace yourself. Shorter visits, with a quiet break in between, are often easier than one long outing.
• Have a plan B. Knowing where you can step outside for a few minutes can make a busy place feel less daunting.

At home: some sound, not silence

It is tempting to make home as quiet as possible. But treatment for hyperacusis usually works the other way, with low-level sound over long periods to help the hearing system settle. ASHA mentions steady background noise, music and environmental sounds. At home that might mean a fan, soft music or a nature sound playing quietly, at a level that feels comfortable. Our guide to sound therapy explains the idea in more detail.

Ear protection: for loud places, not everyday life

Earplugs and ear defenders have a place. Tinnitus UK suggests using them for genuinely noisy activities, such as using DIY tools, but not for normal daily life. The NHS advises against wearing them all the time, and Cleveland Clinic notes that people who rely on them may find sounds even more intense once they take them out. For more on striking this balance, see earplugs and hyperacusis.

If sound causes pain. Advice differs for pain hyperacusis. The Hearing Health Foundation recommends protection whenever noise is above your tolerance and cautions that sound therapy can make pain worse for some people. If sounds hurt, talk to a specialist before changing how you use protection.

Sleep and stress

Cleveland Clinic notes that symptoms can get worse when you are stressed or tired, and that even worrying about noise can make things worse. Looking after sleep and stress will not cure hyperacusis, but it may make the hard days a little easier.

• Try relaxation techniques such as slow breathing exercises, which the NHS suggests for hyperacusis.
• Keep regular sleep and wake times, and give yourself an hour to wind down before bed.
• If a silent bedroom makes you more alert to small noises, a quiet, steady sound may feel more restful.

If worry about sound is taking over, cognitive behavioural therapy is one of the main treatments and focuses on exactly that.

Hyperacusis at work

Many people find it helps to explain what they need rather than go into every detail. Small changes can make a real difference: a desk away from printers and kitchens, a fixed desk instead of hot-desking, a quiet room for calls, or flexibility around noisy events.

In the UK, employers must make reasonable adjustments so that workers with disabilities or physical or mental health conditions are not substantially disadvantaged. GOV.UK gives the example of letting someone have their own desk instead of hot-desking. Whether hyperacusis counts as a disability under the Equality Act 2010 depends on your situation: the test is whether a condition has a substantial and long-term (12 months or more) effect on normal daily activities. The government's Access to Work scheme can also help people with a physical or mental health condition get or stay in work, for example with specialist equipment or mental health support. Outside the UK, rules differ, so check local guidance.

Explaining it to family and friends

Hyperacusis is invisible, so people close to you may not realise how much everyday sounds affect you. ASHA notes that involving family members in counselling can help. A few ideas:

• Describe it simply: “Some ordinary sounds feel much louder to me than they do to you.”
• Be specific about what helps, such as a quieter restaurant or lowering the television a little.
• Share a guide like what is hyperacusis? so they can read about it in their own time.
• Let them know you are working on it, so they understand the goal is not to avoid every sound.

Support organisations

• Tinnitus UK (formerly the British Tinnitus Association) is a UK charity with information on hyperacusis, a free helpline, web chat, email and support groups.
• American Tinnitus Association offers information on tinnitus and related conditions, including hyperacusis, plus support groups.
• Hyperacusis Research is a US non-profit that funds hyperacusis research through the Hearing Health Foundation's grant programme.

When to seek help

See a GP if everyday noises feel too loud or painful. They may refer you to a hearing specialist. Cleveland Clinic advises against trying to manage it entirely on your own, and notes that the sooner you are diagnosed, the sooner you can find treatment that helps. Our guides to diagnosis and treatment explain what to expect.