Hyperacusis

Hyperacusis or severe noise sensitivity or severe sound sensitivity is a hearing disorder that makes ordinary sounds or noise feel unbearably loud, causing discomfort, excessive annoyance, fear, or pain. Hyperacusis is considered to be a reduced tolerance to noises that don't seem to be noticeable to others and may be limited to certain types of noise; for example: a car engine, a fridge, or a vacuum cleaner.

Everyday sounds can be unbearable to the sufferer but will have no effect on others.

Tinnitus is also common in people with hyperacusis.

Noise sensitivity
Noise sensitivity is not the same as hyperacusis.

While noise sensitivity is very common in the general population, hyperacusis is not.

Prevalence
Some degree of noise sensitivity is common, occurring in 20-40% of people, with high noise sensitivity affecting 12% to 15% of people.

Estimates of hyperacusis prevalence vary considerably, from less than 1 in 1,000 people to 4-17% in certain groups, hyperacusis is generally regarded as rare while noise sensitivity is common.

Hyperacusis is more common in certain groups, including professional musicians or music students, people with autism, William's syndrome or certain other conditions, adolescents and older people, and is more common in females.

Symptom recognition
Hyperacusis is a symptom of ME recognized in the International Consensus Criteria's neurosensory symptoms, and counts towards the neurological symptoms required to diagnose ME or atypical ME (which is when symptoms are partially rather than fully met).

Hypersensitivity to noise is mentioned as part of the "overload phenomenon" diagnostic symptom in the Canadian Consensus Criteria's Neurological/Cognitive Manifestations.

The same section also refers to "sensory disturbances". It can also be rated using the Symptom Severity and Severity Hierarchy Chart (Appendix 3), although light sensitivity, noise, odors is combined into one item.

Hyperacusis is recognized in the in the Visual and Auditory Disturbances part of the Signs and Symptoms list in Appendix 4.

There is no reference to noise sensitivity in the more commonly used Fukuda criteria.

Notable studies

 * 1992, Ocular manifestations of chronic fatigue and immune dysfunction syndrome - (Abstract)

Possible causes
Hyperacusis results from the "malfunction of the central auditory pathways and their connections within the central nervous system".


 * Hearing loss is a significant risk factor for both hyperacusis and tinnitus, although many people with hyperacusis have normal hearing.
 * Damage to the inner ear caused by ageing
 * One-off or ongoing exposure to very loud noise
 * Damage to the facial nerve
 * Ear surgery
 * Head injury
 * William's syndrome
 * Autism spectrum
 * Neurologic diseases including Ménière's disease, migraine and Lyme disease
 * certain medications.

It is not fully understand how ME/CFS causes hyperacusis.

Potential treatments
There is no cure, but there are ways to manage hyperacusis.

Ear plugs or ear defenders should only be used when essential since they can make hyperacusis worse if used too much.

Learn more

 * Hyperacusis (sound sensitivity) - NHS
 * ME/CFS flares: what do they feel like and how to cope