Keys jingling feel like ice picks. Dishes clinking, unbearable. Even your own voice can sting. If ordinary sounds feel too loud or painful, you might be living with hyperacusis—real, treatable sound sensitivity that can shrink a life fast. The good news: with the right plan, most people get better.

Hyperacusis, in plain English

Hyperacusis is reduced sound tolerance—when everyday sounds seem excessively loud, uncomfortable, or even painful. It’s different from “just not liking” a sound. Your sound system (ear + brain) is turning up the gain, and signals that should feel safe can trigger discomfort or pain.

Helpful distinctions:

  • Hyperacusis: Loudness feels too loud (often with physical discomfort or pain).
  • Misophonia: Specific triggers (like chewing) spark anger or disgust. It’s about emotional reaction more than loudness.
  • Phonophobia: Fear of sound or of pain from sound (anxiety-driven avoidance).

These can overlap, and tinnitus is a frequent companion. An audiologist or ENT can help sort out the mix and build a tailored plan.

Why does this happen?

There isn’t a single cause. Think of hyperacusis as a “gain mismatch” between ear and brain:

  • Central gain: The brain turns up sensitivity, sometimes after hearing loss, noise trauma, concussion, or even stress. That extra amplification makes normal sounds feel intrusive.
  • Peripheral factors: The ear’s tiny hair cells and pain pathways may contribute—especially if there’s prior noise injury, ear infection history, migraine, jaw/neck tension, or TMJ issues.
  • Emotions and attention: Anxiety, hypervigilance, and negative predictions (“this will hurt”) prime the nervous system to react more strongly.

None of this means it’s “in your head.” It means your auditory system is protecting you a little too aggressively—and we can teach it to recalibrate.

When to call a clinician—fast

Seek urgent care if you notice:

  • Sudden hearing loss in one or both ears (within 72 hours).
  • Severe ear pain, fever, or drainage.
  • Neurologic symptoms (new facial weakness, severe vertigo, severe headache).
  • Major head injury with new sound sensitivity.

Otherwise, book with an audiologist and ENT for a baseline hearing evaluation and discussion of treatment options. If anxiety or distress are high, a psychologist familiar with CBT for tinnitus/hyperacusis can be a powerful teammate.

The treatment playbook (and why it works)

Effective hyperacusis care focuses on calming the system and gradually restoring tolerance. Three pillars:

  • Gentle, graded sound enrichment. Consistent exposure to comfortable, non-threatening sound nudges the brain to lower its internal gain. Think “warm-up,” not “boot camp.”
  • Smart protection—without overprotection. Use ear protection for clearly loud or hazardous noise (power tools, concerts). Avoid constant earplug use in normal environments, which can make sensitivity worse.
  • Brain-behavior tools (CBT, relaxation). Skills that lower anxiety, shift attention, and rewrite unhelpful predictions reduce distress and pain amplification.

Medication has no universal fix for hyperacusis itself. Treatment targets the system, not a single switch. If there’s an underlying condition (migraine, TMJ, ear infection), addressing it helps.

Your 8-week starter plan (evidence-informed, gentle, flexible)

This is a practical framework you can personalize with your clinician. Move slower or faster as needed. If you flare, step back and resume at the last comfortable level.

Before you start: set the stage

  • Get a baseline. An audiologist can measure hearing and discuss loudness discomfort levels (LDLs). At home, note which sounds bother you, when, and how much (0–10 scale).
  • Build a daily sound bed. Pick calm, broadband options: soft pink noise, rainfall, fan, stream, or nature ambiences. Aim for “pleasant wallpaper,” not a mask that hides the world.
  • Define safe zones. Create one or two rooms with soft furnishings, rugs, and curtains. Reduce hard echoes—your ears will thank you.

Weeks 1–2: settle the system

  • Daily sound enrichment 45–90 minutes total, split into chunks. Keep it low and comfortable—you should be able to talk over it easily.
  • Stretch tiny triggers. Brief exposures to mild triggers (cutlery, running water) at a distance, with softening tricks (tea towel under dishes, faucet half-on). Stop while still comfortable.
  • Breath + body reset. Add 5 minutes of slow breathing or progressive muscle relaxation before exposures. Calm body, calmer ears.

Weeks 3–4: nudge reality

  • Gently increase your sound bed level or duration. Small steps—think 10–20% changes.
  • Bring sound closer. Short walks on a quiet street, then a busier one. Keep earplugs in your pocket; use them only if sound is clearly too loud or sustained.
  • Thought reframe. Swap “This will hurt” with “This is safe, and I’m training my system.” It’s not wishful thinking; it guides your nervous system’s response.

Weeks 5–6: build resilience

  • Daily normal-sound time. 30–60 minutes in typical environments (kitchen, office) without protection. Add micro-breaks rather than escaping entirely.
  • Layered exposure. Combine sounds (conversation + light music) at comfortable levels.
  • Move your attention. Practice noticing a non-auditory focus (visual detail, breath, feet on the floor) while sounds occur. Attention training reduces reactivity.

Weeks 7–8: consolidate

  • Test triggers tactfully. Briefly practice historically tough sounds with buffers: clink dishes over a towel, then on the counter; run the blender from the next room, then closer.
  • Routine without ritual. Keep daily sound enrichment, but vary sound types and times so your system generalizes.
  • Track wins. Compare your week-1 notes with now. Most people notice more “didn’t think about it” moments—that’s real progress.

Important: keep all sounds at comfortable levels. You’re not forcing tolerance through pain—you’re teaching safety through repetition.

Tools and tech that can help

  • Sound generators or apps. Nature, pink/brown noise, gentle instrumental. Many hearing aids can stream these or generate sound internally.
  • Hearing aids (when hearing loss is present). Properly fitted devices restore audibility and can smooth loudness growth, sometimes reducing hyperacusis distress. Ask about gradual gain ramp-up and fine-tuned compression.
  • Noise meters. Smartphone apps or a smartwatch noise feature help you make informed choices. Remember: meters aren’t perfect, but they reduce guesswork.
  • Protection, used strategically. Keep high-fidelity musicians’ earplugs for truly loud settings. If you’re wearing earplugs most of the day, talk with your audiologist about tapering.

The overprotection trap

It’s natural to “shrug away” from sound with constant earplug use. The catch: living in a quieter bubble can make regular life feel even louder, fast. Instead:

  • Use protection for hazardous noise (power tools, concerts, stadiums) or when a sound persists and you can’t leave.
  • Avoid routine use in normal environments (home, office, quiet streets).
  • Step down gradually, not suddenly, with support from a clinician.

What about medications, supplements, or surgery?

There’s no proven pill or supplement that reliably treats hyperacusis itself. Some people benefit when a related condition (migraine, anxiety, TMJ) is treated. Procedures are rarely indicated for hyperacusis alone. Be cautious with “miracle cures.” If you’re considering any medication or supplement, discuss risks and interactions with your clinician.

Work and home tweaks that make life easier

  • Soften spaces: rugs, curtains, cushions, and acoustic panels reduce harsh reflections.
  • Low-clatter kitchen: silicone mats under dishes, soft-close cabinets, quiet-cycle appliances.
  • Noise etiquette: negotiate quiet hours or “heads-up” for blender/vacuum at home or work.
  • Commute smarter: choose quieter routes or travel times when possible; use protection only as needed.

Measuring progress (so you can see it)

  • Subjective distress: Rate discomfort 0–10 for common sounds weekly.
  • Exposure minutes: Track how long you comfortably stay in typical environments.
  • Audiology metrics: Your audiologist may repeat loudness discomfort measures to document changes.

Progress is often uneven: two steps forward, one step back. That’s normal neuroplasticity, not failure.

Handling flares

  • Shorten and soften. Reduce exposure briefly; keep some gentle sound on board so you don’t slip into silence.
  • Reset the body. Sleep, hydration, gentle neck/jaw stretches, and relaxation exercises can lower the overall “threat level.”
  • Resume gradually. Return to the last comfortable point and rebuild. Most flares settle.

How long does treatment take?

People often notice small improvements in weeks, with meaningful gains over months. If your sensitivity is severe or long-standing, it can take longer—and it’s still worth it. Partnering with an audiologist and, when helpful, a CBT-trained therapist significantly improves the odds.

Find your team

You don’t have to white-knuckle this. An audiologist can guide exposure, fit hearing tech when needed, and help you taper protection safely. An ENT can check for medical contributors. A psychologist can equip you with skills that turn the volume down on distress, even when the world stays the same. Reach out—this is treatable.

Further Reading

- Hyperacusis Treatment: Rebuild Your Sound Tolerance Without Hiding (Treatment) - When Your Neck or Jaw Makes Noise: Treating Somatosensory Tinnitus (Treatment) - Tinnitus, Trained: CBT, Sound Therapy, and Habits That Actually Help (Treatment) - Your Ears Run on a Clock: How Time of Day May Change Noise Risk, Tinnitus, and Recovery (Research)

Frequently Asked Questions

Is hyperacusis permanent?

Not necessarily. Many people improve with graded sound exposure, smart protection, and CBT-based strategies. Progress is often gradual and non-linear, but it’s very possible to expand your comfort zone over time.

Should I wear earplugs every day?

Use earplugs for truly loud or hazardous sound. Wearing them routinely in normal environments can increase sensitivity. If you’re relying on them most of the day, work with an audiologist on a safe taper and replacement strategies like gentle sound enrichment.

Do hearing aids help hyperacusis?

If you also have hearing loss, well-fitted hearing aids can smooth loudness growth and reduce listening effort. Many can provide built-in sound enrichment. They’re not a cure, but they can be an important part of a broader plan.

What if I have tinnitus too?

Tinnitus and hyperacusis often travel together. The same approach—sound enrichment, attention training, and CBT—can relieve both. An audiologist can tailor sound therapy and hearing tech to address your specific mix.

References