What causes it?
Hyperacusis is typically an anxiety/fear-driven response to everyday sounds. Sounds appear unnaturally louder in perception. This is often due to the development of a subconscious perceived ‘threat’ to specific, ordinary sounds. Those who suffer from hyperacusis have developed a negative emotional label towards certain sounds, resulting in abnormal behaviours. This may come about with anxiety of aggravating pre-existing aural symptoms such as tinnitus or hearing loss.
In certain cases, hyperacusis may be a symptom of a larger pathology in play. Examples of these include Bell’s Palsy, Ramsay Hunt syndrome, a head/brain lesion, William’s syndrome, Addison’s disease and Lyme disease.
How is it diagnosed?
A full diagnostic audiological assessment with Loudness Discomfort Levels (LDL) can confirm the presence of hyperacusis and can quantify its severity. A thorough health history, physical examination and laboratory testing may also be required to exclude any major pathology.
How is it managed?
Once hyperacusis has been accurately identified with an audiological assessment, audiological counselling is required. This will typically involve reframing the client’s perspective to sounds and aural symptoms (hearing loss, tinnitus, etc). By doing so, fears and anxieties are addressed. This can be especially beneficial for those that are withdrawing from their daily activities (social events, professional activities, etc). Counselling may involve Cognitive-Behavioural Therapy (CBT) which aims to identify negative and detrimental thinking and behaviours related to their hyperacusis. Once these are identified, actionable changes can be collaboratively made with the aid of a therapist.
Some patients with hyperacusis may decide to wear ear protection to dampen everyday sounds. In the short term, this may be an effective strategy. However, constant avoidance of sounds will increase the sensitivity to sounds. An alternative may be in the form of hearing aids. Traditionally, aids are designed to amplify sounds. However, with the expert tuning of the aids, they can be tailored to dampen sounds to a tolerable level. Additionally, tinnitus masking noise can be added as nearly 50% of all tinnitus suffers have hyperacusis. With regular appointments, the audiologist can tune the hearing aids to gradually amplify sounds as the patient slowly desensitises to everyday sounds.
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