Hyperacusis: When Everyday Sounds Feel Too Loud

Clattering dishes make you flinch. A busy restaurant feels like a wall of noise. Your family says the TV is fine, but to you it sounds harsh. If that sounds familiar, you are not imagining it and you are not being dramatic. You may be dealing with hyperacusis, a reduced tolerance to everyday sounds.

This guide explains what hyperacusis is, how it differs from similar problems, what usually helps, and when it is worth getting your ears checked. It is general information, not a diagnosis. Everyone’s situation is different, so the best next step is always a conversation with a clinician who can look at your hearing directly.

What is hyperacusis?

Hyperacusis means ordinary sounds feel too loud, uncomfortable, or even painful, even though other people around you find them normal. The sounds themselves are not unusually loud. What has changed is how your hearing system handles them.

People describe it in different ways:

• Normal sounds seem sharp, piercing or “too much”
• Certain pitches, like cutlery, a baby crying or brakes squealing, are hard to bear
• Noisy places leave you tired, tense or with a sore or full feeling in your ears
• You start avoiding restaurants, family gatherings, the gym or your kids’ hockey games

Hyperacusis can affect one ear or both. It can come on gradually or show up quite suddenly.

Hyperacusis is not the same as hearing loss

It can feel strange to be bothered by sound and still have trouble hearing, but the two can happen together. Some people with hyperacusis have a normal hearing test. Others have hearing loss as well.

There is also a related effect called loudness recruitment. With some types of sensorineural hearing loss, quiet sounds are hard to hear, but loudness climbs very quickly once a sound crosses a certain point. So you might ask someone to speak up, then wince when they do. A full hearing test helps sort out which of these is going on, because the advice for each is not the same.

Hyperacusis, misophonia and phonophobia

These three get mixed up a lot, and they are worth separating.

Hyperacusis is about loudness. Many sounds feel too loud or uncomfortable, and the reaction is mostly physical.

Misophonia is about specific sounds and a strong emotional reaction to them. Chewing, sniffing, pen clicking or someone breathing can trigger anger, disgust or panic, even at a low volume. The issue is the sound itself, not how loud it is.

Phonophobia is a fear of sound, often a worry that a noise will hurt your ears or make things worse. It can grow out of hyperacusis or tinnitus.

Many people have a mix. Being able to describe which sounds bother you, and how, makes your appointment much more useful.

What can cause it?

Often there is no single clear cause. Hyperacusis has been linked with a few things, including:

• Exposure to loud noise, either one very loud event or years of loud work or music
• Tinnitus, which very often travels together with sound sensitivity
• Some ear conditions and some types of hearing loss
• Head injuries and concussion
• Migraine, which can make you sensitive to sound during an attack
• Stress, poor sleep and anxiety, which can turn the volume up on everything

Because the possible causes are so varied, it is worth getting checked rather than guessing.

When to see a doctor first

Some symptoms need medical care before anything else. See your family doctor, visit a walk in clinic, or call Health Link at 811 if sound sensitivity comes with:

• Sudden hearing loss in one or both ears
• Ear pain, discharge or a fever
• Dizziness or vertigo
• A recent head injury
• Weakness or drooping on one side of the face

Sudden hearing loss in particular should be checked by a doctor right away. Our guide to sudden hearing loss explains why timing matters.

Why earplugs everywhere can backfire

When sound hurts, the natural reaction is to block it out. In very loud places, like a concert, a shop floor or a gun range, hearing protection is exactly right.

The catch is wearing earplugs or earmuffs all day in ordinary, quiet settings. Audiologists commonly caution against this, because cutting your ears off from normal sound can make your hearing system even more sensitive over time. The goal for most people is to protect in truly loud places and stay around comfortable everyday sound the rest of the time.

If you need protection for noisy work or hobbies, custom ear plugs can lower the volume evenly so music and voices still sound natural, which many people find easier to live with than foam plugs.

What tends to help

There is no quick fix, and anyone promising one should make you cautious. That said, many people find their tolerance improves with the right approach and some patience. Common parts of a plan include:

• Gentle background sound. Soft, steady sound at home, such as a fan, quiet music or a sound machine, keeps your ears from being in total silence and can take the edge off sudden noises.
• Gradual exposure. Slowly and comfortably spending more time around everyday sound, rather than avoiding it, is a common approach. Going at your own pace matters.
• Sound therapy devices. Some people use devices or hearing aids with sound therapy features, especially when hyperacusis comes with tinnitus or hearing loss. A properly fitted hearing aid can also be set so loud sounds do not become uncomfortable.
• Support for stress and sleep. Counselling approaches like cognitive behavioural therapy are often used for the worry and avoidance that can build up around sound. Your family doctor can help you find support.
• Understanding what is going on. Knowing that your ears are not being damaged by everyday sound takes a lot of fear out of it, and fear tends to make sensitivity worse.

The right mix depends on your hearing, your symptoms and your life. This is where an assessment helps.

What happens at an assessment

At our clinics, a Registered Hearing Aid Practitioner starts by listening. When did it start? Which sounds bother you, and in which situations? Do you also have ringing in your ears? Then we look in your ears and do a full hearing test, so we know whether hearing loss is part of the picture.

From there we explain what we found in plain words and talk through options. If your symptoms point to something that needs a doctor or a specialist, we will tell you and help you take that step. You will not be pushed toward a purchase, and if hearing aids are not the right answer for you, we will say so.

Where to get help in Edmonton and Calgary

You do not need a referral to see us. In Edmonton, you can book at Medicine Place Hearing Care 97 North on 97 Street, which is open Saturdays, or at our East clinic in Beverly on 118 Avenue. In Calgary, our Hunterhorn Plaza clinic in the northeast offers tinnitus support and hearing tests too.

Common questions

Is hyperacusis permanent?

Not necessarily. Many people find their tolerance improves over time, especially with a gradual approach and support. How it changes varies a lot from person to person, so it is best to talk it through with a clinician who has tested your hearing.

Can I have hyperacusis with normal hearing?

Yes. Some people with hyperacusis have a normal hearing test, and others also have hearing loss. A full assessment tells you which group you are in.

Should I wear earplugs all the time?

Usually not. Protect your ears in truly loud places, but wearing earplugs in quiet, everyday settings can make sensitivity worse for many people. Ask your hearing care professional what makes sense for you.

Is hyperacusis related to tinnitus?

Often. The two commonly show up together, and managing one can help with the other. Our tinnitus treatment options guide covers the tinnitus side in more detail.

If everyday sound has started to shrink your world, you do not have to just put up with it. Book a hearing test, tell us what you have been noticing, and we will help you figure out the next step.