Sound therapy for hyperacusis: how it works

Why sound, when sound is the problem?

When sound feels too loud, the natural reaction is to avoid it. But avoiding sound, or wearing earplugs all day, can keep your hearing system on high alert. Sound therapy does the opposite: it gives your ears and brain steady, low-level sound, so they can slowly get used to it again. This process is called habituation.

What it involves

• Low-level background sound for longer periods each day, through a speaker, headphones or small ear-level sound generators.
• Levels raised gradually, usually week by week, and always kept comfortable.
• Step-by-step exposure to the specific sounds that bother you, in some programmes.
• Regular check-ins with a specialist to adjust the plan.

Pink noise, white noise and other sounds

Broadband noise is the classic choice. White noise has equal energy across all frequencies and can sound hissy. Pink noise has less energy in the higher frequencies, so many people find it softer, a bit like steady rain. Music and nature sounds are also used. There is limited evidence that one type works better than another, so the best sound is often one you can comfortably listen to for a long time.

How long does it take?

It is gradual. Cleveland Clinic notes that sound therapy often increases sound tolerance within six months to a year. Progress is rarely a straight line, and everyone's starting point is different.

Everyday sound levels

To give a sense of scale, these are typical levels for common sounds:

Not for everyone as is. If sounds cause ear pain, speak to a doctor or audiologist first. Some specialists warn that sound exposure can worsen pain hyperacusis, so the plan needs to be adjusted.

Sound therapy with other treatments

Sound therapy works best alongside education and, for many people, cognitive behavioural therapy. See our guide to hyperacusis treatment for the full picture.