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'''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]].<ref name="WebMD" /><ref name="PMC5157031" /> 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.<ref name="bh">{{Cite web | url=https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hearing-problems-reduced-tolerance-to-sound | title = Hearing problems - hyperacusis | last = | first = | authorlink = | date = | website = Better Health Channel|archive-url=|archive-date=|url-status=|access-date=2022-01-10}}</ref><ref name="WebMD">{{Cite web | url=https://www.webmd.com/brain/sound-sensitivity-hyperacusis | title = What Is Sound Sensitivity (Hyperacusis)? | last = Konstantinovsky | first = Michelle|website=WebMD|language=en|access-date=2022-01-10}}</ref><ref name="NHS" /> [[File:UNREST Film Still Whitney.png|250px|right|thumb|[[Whitney Dafoe]] is a very [[Severe and very severe ME|severely ill ME]] patient that must wear ear protection daily, even indoors]] [[File:Chronically_Hopeful_Char_Profile_Pic.jpg|250px|thumb|right|Char, author at [[Chronically Hopeful]], writes of sound sensitivity which she suffers daily but becomes worse during a flare.<ref name="char">{{Cite news | url=http://chronicallyhopeful.com/mecfs-flares/ | title = ME/CFS flares: what do they feel like and how to cope | last = x | first = Char | date = 2017-11-02|work=Chronically Hopeful|access-date=2018-10-11|archive-url=|archive-date=|url-status=|language=en-GB}}</ref> Patients use ear protection]] Everyday sounds can be unbearable to the sufferer but will have no effect on others. [[Tinnitus]] is also common in people with hyperacusis.<ref name="WebMD" /> ===Noise sensitivity === Noise sensitivity is not the same as hyperacusis. While noise sensitivity is very common in the general population, hyperacusis is not.<ref name="WebMD" /><ref name="PMC5157031" /> ==Prevalence== Some degree of noise sensitivity is common, occurring in 20-40% of people, with high noise sensitivity affecting 12% to 15% of people.<ref name="WebMD" /><ref name="PMC5157031" /> 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.<ref name="WebMD" /><ref name="PMC5157031" /><ref name="Ren2021">{{Cite journal | title = Prevalence of Hyperacusis in the General and Special Populations: A Scoping Review | date = 2021 | url=https://www.frontiersin.org/article/10.3389/fneur.2021.706555|journal=Frontiers in Neurology|volume=12|pages=1540 | last = Ren | first = Jing | last2 = Xu | first2 = Tao | last3 = Xiang | first3 = Tao | last4 = Pu | first4 = Jun-mei | last5 = Liu | first5 = Lu | last6 = Xiao | first6 = Yan | last7 = Lai | first7 = Dan|doi=10.3389/fneur.2021.706555|issn=1664-2295}}</ref> 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.<ref name="Ren2021" /> ==Hyperacusis in ME/CFS== === 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).<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>{{Rp|7}} 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".<ref name="canadianconsensus-CCC" />{{Rp|11}} It can also be rated using the Symptom Severity and Severity Hierarchy Chart (Appendix 3), although [[photophobia|light sensitivity]], noise, [[odor sensitivities|odors]] is combined into one item.<ref name="canadianconsensus-CCC" />{{Rp|102-103}} Hyperacusis is recognized in the in the '''Visual and Auditory Disturbances''' part of the Signs and Symptoms list in Appendix 4.<ref name="canadianconsensus-CCC">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 =Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 =Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref>{{Rp|104}} 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<ref name="Potaznick1992">{{Cite journal | title = Ocular manifestations of chronic fatigue and immune dysfunction syndrome | date = 1992-10-01 | url = https://doi.org/10.1097/00006324-199210000-00011|journal=Optometry and vision science|volume=69|issue=10 | pages = 811–814 | last = Potaznick | first = W | last2 = Kozol | first2 = N|doi=10.1097/00006324-199210000-00011|pmid=1437004|issn=1538-9235}}</ref> - [https://pdfs.journals.lww.com/optvissci/1992/10000/ocular_manifestations_of_chronic_fatigue_and.11.pdf (Abstract)] == Possible causes== Hyperacusis results from the "malfunction of the central auditory pathways and their connections within the [[central nervous system]]".<ref name="PMC5157031">{{Cite journal | title = A window into the brain mechanisms associated with noise sensitivity | date = 2016-12-15 | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5157031/|journal=Scientific Reports|volume=6 | pages = 39236 | last = Kliuchko | first = Marina | last2 = Heinonen-Guzejev | first2 = Marja | last3 = Vuust | first3 = Peter | last4 = Tervaniemi | first4 = Mari | last5 = Brattico | first5 = Elvira|doi=10.1038/srep39236|pmc=5157031|pmid=27976708|issn=2045-2322}}</ref> *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.<ref name="WebMD" /><ref name="bh" /><ref name="NHS">{{Cite web | url=https://www.nhs.uk/conditions/hyperacusis/ | title = Noise sensitivity (hyperacusis) | last = | first = | authorlink = | date = 2017-10-18 | website = [[National Health Service]]|language=en|archive-url=|archive-date=|url-status=|access-date=2022-01-10}}</ref> * temporomandibular disorder<ref>{{Cite journal|title=Relationship between Otological Symptoms and TMD|date=2018-06-01|url=https://pubmed.ncbi.nlm.nih.gov/29993214/|journal=The International Tinnitus Journal|volume=22|issue=1|pages=30–34|last=Kusdra|first=Pamela Maria|last2=Stechman-Neto|first2=Jose|last3=Leão|first3=Bianca Lopes Cavalcante de|last4=Martins|first4=Paulo Francisco Arant|last5=Lacerda|first5=Adriana Bender Moreira de|last6=Zeigelboim|first6=Bianca Simone|doi=10.5935/0946-5448.20180005|pmid=29993214|issn=0946-5448}}</ref> It is not fully understand how ME/CFS causes hyperacusis. ==Potential treatments== There is no cure, but there are ways to manage hyperacusis.<ref name="bh" /> In some cases ear plugs or ear defenders should only be used when essential since they can make hyperacusis worse if used too much.<ref name="NHS" /> However in other cases setbacks from noise can be permanent <ref>{{Cite journal|title=Clinical Advancements for Managing Hyperacusis with Pain|date=2019-10|url=https://journals.lww.com/thehearingjournal/Fulltext/2019/10000/Clinical_Advancements_for_Managing_Hyperacusis.4.aspx|journal=The Hearing Journal|volume=72|issue=10|pages=10|last=Pollard|first=Bryan|language=en-US|doi=10.1097/01.HJ.0000602900.16223.0e|issn=0745-7472}}</ref> so the risks of overprotection are far smaller than the risks of noise exposure. ==Learn more== *[https://www.nhs.uk/conditions/hyperacusis/ Hyperacusis (sound sensitivity)] - NHS * [http://chronicallyhopeful.com/mecfs-flares/ ME/CFS flares: what do they feel like and how to cope] * [https://hyperacusisresearch.org/ Hyperacusis Reserach] - A research organisation raising funds for research into sound evoked pain. * [https://hyperacusiscentral.org/ Hyperacusis Central] - A patient organisation for spreading awareness about hyperacusis. ==See also== * [[Tinnitus]] * [[Hypersensitivity]] * [[Photophobia]] * [[Central sensitization]] ==References== {{Reflist}} [[Category:Diagnoses]] [[Category:Neurological signs and symptoms]] [[Category:Sensitivity signs and symptoms]] [[Category:Aural signs and symptoms]] [[Category:Potential comorbidities]]
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