Lede: If dishes clinking, a baby cry, or a loud car door makes you flinch—or even feel pain—you’re not being dramatic. That’s hyperacusis, a real change in how your brain and ears process sound. The good news: you can retrain your system to feel safer with sound. Here’s a clear, practical plan grounded in what the evidence and clinicians actually use.
First, What Exactly Is Hyperacusis?
Hyperacusis is abnormal sensitivity or reduced tolerance to everyday sounds. It’s not just “not liking” noise—some sounds can feel sharp, piercing, or painful even at moderate volumes.
It often travels with tinnitus (ringing in the ears) and can follow noise exposure, stress, head injury, migraine, or ear disorders. Some people also experience misophonia (strong emotional reactions to specific sounds, like chewing) or phonophobia (fear of sound). These can overlap, but treatment approaches differ slightly.
Signs it might be hyperacusis
- Ordinary sounds feel too loud, sharp, or painful
- You start avoiding restaurants, dishes, vacuuming, or social events
- You wear earplugs frequently—even in safe environments—yet feel more sensitive over time
- Tinnitus or ear fullness joins the party
Quick note: Some treatable medical conditions can mimic “sound sensitivity,” like ear infections, superior canal dehiscence (a small bony opening in the inner ear), or a patulous Eustachian tube. If symptoms appeared suddenly, are one-sided, or include dizziness, autophony (hearing your own voice/steps too loudly), or ear drainage, please see an ENT promptly.
The Goal of Treatment: Not Silence—Resilience
Silence can feel soothing short-term, but long-term over-avoidance trains your auditory system to become even more vigilant. Evidence-informed treatment focuses on gentle, graded exposure to safe sound, reducing fear and muscle tension, and building confidence in everyday environments.
What treatment can do
- Raise your safe sound tolerance over weeks to months
- Reduce the “sting” or pain response to common sounds
- Lower stress, anxiety, and avoidance behaviors that feed the cycle
What treatment won’t do
- It won’t require you to blast loud sound
- It’s not an overnight fix—expect steady, gradual change
- It’s not DIY-only; professional guidance speeds progress and avoids pitfalls
Your Step-by-Step Plan
1) Get a proper evaluation
Start with an audiologist. They’ll review your history, measure hearing, and may assess loudness discomfort levels (LDLs). If there are red flags (sudden hearing change, vertigo, severe one-sided symptoms, autophony), you may be referred to an ENT to rule out treatable medical causes.
Gentle CTA: If you haven’t seen an audiologist yet, book an appointment. A tailored plan beats guesswork, and it keeps you safe.
2) Use sound therapy—gently and daily
Think of your brain like a smoke alarm that’s too sensitive. We’re going to nudge it back to an appropriate setting with consistent, low-level sound. This is sometimes called sound enrichment or sound desensitization.
How to start:
- Pick neutral sounds you don’t hate: soft pink noise, waves, rain, leaves, a fan, or a custom sound generator (standalone device, app, or hearing aid feature).
- Set volume where it’s clearly audible but not irritating—often barely above room level.
- Begin with 30–60 minutes, 2–4 times daily. You can split into short blocks.
- Every 3–7 days, if comfort improves, inch volume up a notch or listen a little longer.
Progression looks like this: ultra-gentle, consistent sound → mild challenge with everyday environments → busier soundscapes. You’re aiming for “comfortably present” sound—not pushing into pain.
3) Don’t overprotect: plug smart, not nonstop
Earplugs are vital for truly loud places (concerts, power tools, stadiums). But wearing them “just in case” around the house or on quiet walks can backfire by deepening sensitivity.
Use this rule:
- Protect where you’d protect anyone with healthy hearing: power tools, concerts, fireworks, stadiums, very noisy restaurants.
- Skip plugs in everyday safe spaces: home, office, calm streets, normal conversation.
- Choose musician’s earplugs (flat attenuation) for noisy social settings—they lower volume without muffling speech.
If you feel anxious without plugs in quiet places, bring them along for peace of mind but challenge yourself to leave them out unless it’s truly loud or you’re escalating stepwise exposure.
4) Add CBT tools to dial down the threat response
Cognitive Behavioral Therapy (CBT) doesn’t change your ears—it changes the brain’s prediction and meaning of sound, which often reduces distress and avoidance. In studies of tinnitus and hyperacusis, CBT improves quality of life and coping, and helps people re-enter sound environments without spiraling anxiety.
What it looks like:
- Education: why sound feels painful, how the nervous system amplifies threat
- Exposure hierarchy: a personalized ladder from “easiest” to “spiciest” sounds you practice with
- Skills: paced breathing, muscle relaxation for jaw/neck/shoulders, attention shifting, and compassionate self-talk
You can work with a psychologist familiar with tinnitus/hyperacusis or use digital CBT programs recommended by your audiologist. Many clinics combine CBT with sound therapy for best results.
5) Treat co-travelers: tinnitus, migraine, TMJ, anxiety
Addressing related issues can accelerate progress:
- Tinnitus: sound therapy via apps or hearing aids, CBT, and sleep support reduce overall reactivity.
- Migraine: if you have light/sound sensitivity, head pain, or visual aura, talk with your clinician. Migraine management (lifestyle and, when appropriate, medication) can lower sound sensitivity for some.
- Jaw/neck tension: physical therapy, splints (for bruxism), posture, and relaxation help calm the startle/muscle reflex loop.
- Stress, PTSD, or anxiety: counseling, mindfulness, or medications when appropriate can reduce the nervous system’s gain.
Gentle reminder: No single pill “cures” hyperacusis. Some medications can be helpful for coexisting anxiety or migraine, but long-term dependence on sedatives isn’t a solution. Discuss options with your healthcare provider.
6) Consider helpful devices
- Hearing aids (when hearing loss coexists): properly fitted devices can reduce listening strain and include sound therapy features.
- Wearable sound generators: deliver consistent low-level noise for desensitization.
- Musician’s earplugs: custom or high-quality universal options provide predictable, flatter attenuation for social life without isolation.
7) Build a “sound diet” you can stick to
Design daily routines that keep sound present but gentle:
- Morning: soft pink noise while making coffee
- Work: low ambient sound (fan or nature sounds) in the background
- Breaks: breathing or stretch breaks to relax jaw/neck
- Evening: a walk without plugs on a quiet street, then a calm hobby with background sound
Sleep: Keep bedrooms quiet, not silent—think distant fan or low nature sounds if tinnitus or sound sensitivity spikes at night.
8) Track wins (they’re easy to miss)
Progress is often “small but steady.” Track:
- Daily comfort ratings (0–10) for a few target sounds
- Minutes in sound before discomfort
- How often you needed earplugs
Share your log with your audiologist to fine-tune steps. Some clinics use structured tools like the Hyperacusis Questionnaire or LDLs to measure change.
Special Cases to Rule Out
Not all “sound sensitivity” is the same. If you recognize these patterns, ask your clinician about targeted evaluation:
- Autophony (your own voice, breathing, or footsteps sound booming), sound-triggered dizziness, or the ability to hear eye movements: ask about superior canal dehiscence (SCD). This has specific tests and, in some cases, surgical options.
- Ear fullness that improves when reclining or hearing your own breathing: consider patulous Eustachian tube.
- Predominantly rage/disgust to specific human sounds (chewing, sniffing) with less focus on loudness: this may be more like misophonia, treated with CBT and exposure strategies tailored to triggers.
These aren’t DIY diagnoses. If you suspect one, consult an ENT and audiologist.
What About Timeframes?
Most people notice early wins within 4–8 weeks when they combine daily sound therapy and CBT-style skills. Bigger shifts often arrive over 3–6 months. Setbacks happen—illness, stress, or a loud event can flare sensitivity. That doesn’t erase progress; it’s a nudge to return to gentler steps and rebuild.
Safety Notes
- Never force exposure into pain. Discomfort can be a mild stretch; sharp or lingering pain is your stop sign.
- Use hearing protection anytime sound levels are truly hazardous (power tools, concerts). When in doubt, an audiologist can help judge risk.
- If you experience sudden hearing loss, severe ear pain, new drainage, spinning vertigo, or new facial weakness, seek urgent medical care.
Realistic Expectations, Real Relief
Hyperacusis recovery isn’t about “toughing it out.” It’s about teaching your nervous system that everyday sound is safe again—patiently, consistently, and with the right support. Thousands of people reclaim restaurants, hobbies, and social life with this approach.
Gentle CTA: To get a plan tailored to your life and sound triggers, partner with an audiologist—ideally one with experience in hyperacusis and tinnitus. If needed, ask for a referral to a psychologist familiar with CBT for sound sensitivity.
Further Reading
- When Everyday Sounds Hurt: Treating Hyperacusis with Gentle Sound and Calm Brain (Treatment) - When Your Neck or Jaw Makes Noise: Treating Somatosensory Tinnitus (Treatment) - Earwax, Safely Solved: At‑Home Softeners, When to Flush, and When to See a Pro (Treatment) - Sudden Hearing Loss: The 72-Hour Treatment Playbook (What to Do Now) (Treatment)Frequently Asked Questions
Isn’t wearing earplugs all the time the safest choice?
It feels safer at first, but overprotection can sensitize your system further—silence makes everyday sounds seem even louder later. The smart approach is selective protection: use plugs for truly loud environments (power tools, concerts, stadiums) and skip them in safe everyday settings. If you feel anxious without them, carry them along but challenge yourself to keep them pocketed unless sound is objectively hazardous.
Will sound therapy make my hyperacusis worse?
Well-run sound therapy should feel gentle, not punishing. You start at low, comfortable levels and progress gradually based on your own comfort—never forcing into sharp pain. Most people improve with consistent, daily exposure. If you feel worse, pause, drop the level, and check in with your audiologist to adjust the plan.
How is hyperacusis different from misophonia?
Hyperacusis is mainly about loudness or pain—many everyday sounds feel too intense. Misophonia is more about specific triggers (often human sounds like chewing) that spark strong emotions like anger or disgust, even if they’re not loud. Treatments overlap (education, exposure, CBT), but the focus and exercises differ. An audiologist and a clinician trained in CBT can help tailor your plan.
Are there medications or surgery that cure hyperacusis?
There’s no universal pill or surgery for typical hyperacusis. Medications may help with related issues (anxiety, migraine, sleep), and rare structural problems like superior canal dehiscence have specific surgical options after proper diagnosis. Most people improve with behavioral approaches—sound therapy, CBT-style strategies, and smarter hearing protection—often guided by an audiologist.
