Noise hypersensitivity (medical term: hyperacusis) is a very unpleasant acoustic disorder in which affected individuals perceive sounds of normal volume as very loud and difficult to bear. In the following, the disorder will be described in more detail, as well as possible causes and therapeutic approaches.
What is noise hypersensitivity?
Noise and stress are usually the triggers for noise hypersensitivity. Hyperacusis is a Latin word made up of the word parts “hyper” (over) and “akuo” (I hear). People who suffer from hyperacusis perceive sounds with normal or, in extreme cases, even quiet noise levels as very loud. This refers mainly to volume levels between 50-80 db. You perceive the volume as very unpleasant and in very many cases you also react physically, for example by contorting your face or wincing – and this becomes more pronounced the higher the volume is above your tolerance level. Then symptoms such as heart palpitations or sweating also occur frequently. The hypersensitivity is not limited to individual sounds, but noise such as traffic noises or music from the neighboring apartment is perceived as unpleasant across the board. The affected ears are no longer able to block out background noises such as traffic noise or the neighbor’s vacuum cleaner; the strain on those affected is enormous.
Causes
Hyperacusis is unfortunately still too little researched to be able to make really reliable statements about the causes. However, it is observed that hyperacusis often occurs in conjunction with or delayed to a tinnitus. Hyperacusis often occurs in conjunction with other physical and mental illnesses – for example, in conjunction with a traumatic brain injury, migraine, epilepsy, a Lyme disease infection or multiple sclerosis, or even in conjunction with depression, PTSD (post-traumatic stress disorder) or mania. Sometimes hyperacusis is also referred to as “recruitment,” which occurs in hard-of-hearing people whose hair cells in the inner ear are damaged, and refers to hypersensitivity to loud sounds. Once sounds reach the threshold of hearing, the increase in volume level from that point is perceived much more rapidly than in non-hearing impaired people; however, in the medically correct sense, hyperacusis is actually only spoken of when the threshold of hearing is normally expressed.
Symptoms, complaints, and signs
Individuals who suffer from hyperacusis perceive everyday sounds as particularly loud. Normal sounds such as footsteps or knocking are perceived as very unpleasant and sometimes lead to physical reactions. Hypersensitivity to sounds may be accompanied by other symptoms, such as rapid heartbeat, high blood pressure or sweating. Many patients are easily irritable, tense and suffer from inner restlessness. Especially in stressful phases of life and situations, panic attacks and a strong feeling of uneasiness occur more frequently. As a result, those affected often withdraw from social life, which can lead to depressive moods and other psychological complaints. The symptoms usually occur gradually and are not always noticed immediately by those affected or are attributed to sensitivity to noise. In childhood, noise sensitivity rarely occurs. Sometimes the symptoms disappear on their own after some time. However, they may persist for months, years, or even throughout the affected person’s life. Chronic hypersensitivity to noise usually occurs in conjunction with other psychological complaints and increases in intensity as it progresses. If the noise hypersensitivity is based on tinnitus, ringing in the ears and other symptoms are often added.
Diagnosis and course
Because sounds with a volume perceived as normal or quiet in the average population cause severe problems in affected individuals, the main danger with this condition is no longer being able to actively participate in daily life. Loud parties are perceived as unbearable torture; festive occasions, where the noise level usually rises with increasing alcohol consumption, are deliberately avoided.There is a risk of encapsulation, which of course intensifies when sufferers no longer dare to go out on the street or to work because of everyday noise, for example from traffic. This behavior can be reinforced by learning to experience the soothing silence at home as a basic state and the everyday noises of the outside world as an unpleasant state. Withdrawal into one’s own four walls leads to social isolation of the affected person. The diagnosis of hyperacusis is made by the doctor after extensive hearing tests and examination of the ear, nose and throat.
Complications
Due to the hypersensitivity to noise, there are significant limitations in everyday life and the patient’s quality of life is extremely reduced. Not only the psychological perception but also the physical function is affected by the disease. In most cases, high blood pressure and heart palpitations occur. In the worst case, this can also lead to death if the heart problems are not treated properly. The affected person often appears tense, aggressive and irritable. As a result, normal participation in active life is no longer possible. Sleep disturbances also occur, which can have a negative effect on the patient’s ability to concentrate. In stressful situations, panic attacks or sweating may occur. It is not uncommon for the patient’s social contacts to be restricted due to the hypersensitivity to noise, and the affected person withdraws. This can lead to depression and other psychological complaints. A causal treatment of noise hypersensitivity is not possible. However, hearing aids can be used to minimize the sounds and thus alleviate the symptoms. In some cases, the condition disappears on its own over time. Often, however, the patient must spend his or her entire life with the noise hypersensitivity.
When should you see a doctor?
A visit to the doctor is necessary as soon as everyday environmental sounds are perceived as disturbing. Regardless of the intensity of the impairment or sensitivity, a visit to the doctor should be made to clarify the cause. Even in the case of minor complaints, the perceptions should be reported to a doctor, as serious illnesses can be hidden behind them. If the hypersensitivity to noise increases, a visit to the doctor is necessary as soon as possible. If there are also noises in the ears or if the person affected notices a temporary feeling of numbness in the ear, a doctor should be consulted. If there is a whistling or beeping noise in the ear, a doctor should be consulted immediately. If the affected person complains of a mood swing, inner restlessness or irritability due to the noise hypersensitivity, a doctor is needed. If behavioral changes occur, stress levels increase, or social withdrawal takes place, a physician should be consulted. If daily responsibilities at work or in private life can no longer be fulfilled, a doctor should be consulted. In case of headaches, sleep disturbances, lack of concentration and attention, consultation with a doctor is necessary. An elevated body temperature, sweating, unsteadiness of gait, and dizziness should be examined and treated by a physician. If dizziness, nausea or vomiting occur, a doctor’s visit is required. If loss of balance, pain or a feeling of pressure in the ears occurs, consultation with a physician is necessary.
Treatment and therapy
In the treatment of hyperacusis, unfortunately, it is also not possible to work on a secure medical foundation. However, there are a variety of therapies that have helped sufferers. The therapy approaches are accordingly very different and individual. In mild cases, it is sometimes sufficient to “relieve” the ear of noise, so that it can become accustomed to a normal assessment of sound levels again. In other cases, treatment is carried out by using so-called “noisers”, which are reminiscent of hearing aids and provide a gradually increasing constant background noise. In this way, the ear is supposed to learn to successfully block out environmental noises again. In cases where hyperacusis occurs in conjunction with another disease, successful treatment of that disease often brings an end to hyperacusis.
Outlook and prognosis
If the noise hypersensitivity is triggered by an emotional problem, there is a good chance of recovery.Through cognitive training, perception can be trained and the strength of the influencing factors can be regulated. In many cases, the affected person has been conditioned to certain areas due to a learning experience. This can be changed or erased in a therapy by specific exercises. In the case of a mental disorder, the hypersensitivity to sound is usually not specifically treated. In the case of depression, trauma or anxiety, the triggering cause is rather researched and worked on in cooperation with the patient. The chance of recovery increases as soon as the patient actively cooperates and is interested in changing his or her living conditions. If the patient decides not to seek therapeutic or medical help, it is usually difficult to achieve relief from the symptoms. If organic disorders can be excluded, there is a possibility of independent healing. If the patient has enough experience, he can certainly achieve a minimization of the complaints. If the hypersensitivity to sound is the result of an infection or other disease, an improvement of the complaints can be achieved by using a hearing aid or by administering attenuating medication. Permanent recovery occurs once the underlying condition at hand is diagnosed and treated.
Prevention
Not much has been found out about prevention either. Measures similar to those for prevention of tinnitus may need to be taken. In general, improved education about the phenomenon of hyperacusis will also result in faster diagnosis and treatment of the disease. Thus, affected individuals can be better understood instead of just being labeled as hypersensitive, and they themselves will then know that they can be successfully treated for hyperacusis.
Follow-up
Follow-up care is not always necessary for intermittent noise hypersensitivity. It may be due to nerves and may occur as a result of stress. If necessary, relocation may be advisable if the affected person lives in a busy and noisy area. The noise level in some neighborhoods can be considerable. However, if the noise hypersensitivity is due to a hearing problem or is a result of high sensitivity, a different approach may need to be taken. Highly sensitive people have only limited possibilities to turn off their noise hypersensitivity. They should therefore make their lives as stress-free as possible. For hearing problems triggered by the hypersensitivity, acousticians or ENT physicians are the people to contact. Hyperacusis as a result of tinnitus can also be improved as part of clinical treatment. If hyperacusis occurs as a result of tinnitus or a traumatic experience such as a bomb blast, relaxation therapies or auditory training can help restore a normal relationship to general loudness. Hyperacusis can occur as a result of exhaustion syndrome or burnout, as well as a result of [[Posttraumatic_Stress_Disorder(PTSD)|posttraumatic stress syndrome or blast trauma. For the latter two, stress relief and trauma care are at the forefront of any aftercare intervention. For the first two conditions, aftercare is more comprehensive. It can be lengthy and require life changes. Aftercare is usually provided by the primary care physician following acute clinical treatment. Psychotherapeutic support for all affected individuals may be advisable.
What you can do yourself
Because of the relatively high level of suffering and the impairment in social situations, the family doctor should be consulted as early as possible to clarify further treatment. In addition, the primary care physician can refer the affected person to specialists if necessary. For example, the otolaryngologist is able to detect the disorder in the ear through his otoscope or to rule out damage to the ear area as the cause of the disorder. The neurologist, on the other hand, can diagnose the disorder by examining the blood count or by MRI. If the disorder has psychological causes, psychotherapy and/or medication should be used to address the disorder psychologically so that the basis of the hypersensitivity to sound is removed. If, for example, anxiety is the cause of the disorder, the psychologist can help to combat the cause of the anxiety and help the person concerned to regain more courage and self-confidence.Through meditation, the affected person can also help himself, so that through relaxation he learns to become more calm again and to reduce his nervousness. Accompanying music can be useful to the person concerned during his meditation exercises to get into the right mood. Here, the music should be relaxing and follow a calm and steady rhythm so that he can become completely absorbed in the music.
