Sensitivity to sound disorder

What Is Misophonia?

Written by WebMD Editorial Contributors

In this Article

  • What Happens?
  • How Do You Get It?
  • How Do You Treat It?

Do certain daily sounds trigger an over-the-top emotional reaction, but yet don’t seem to bother anyone else?

This is the case with misophonia -- a strong dislike or hatred of specific sounds.

What Happens?

Misophonia is a disorder in which certain sounds trigger emotional or physiological responses that some might perceive as unreasonable given the circumstance. Those who have misophonia might describe it as when a sound “drives you crazy.” Their reactions can range from anger and annoyance to panic and the need to flee.  The disorder is sometimes called selective sound sensitivity syndrome.

Individuals with misophonia often report they are triggered by oral sounds  -- the noise someone makes when they eat, breathe, or even chew. Other adverse sounds include. keyboard or finger tapping or the sound of windshield wipers. Sometimes a small repetitive motion is the cause -- someone fidgets, jostles you, or wiggles their foot.

Similarly, people with misophonia also say they often react to the visual stimuli that accompanies sounds, and may also respond intensely to repetitive motions. Researchers believe that those with misophonia may already have issues with how their brains filter sounds and that one of the features of “misophonic sounds” may be their repetitive noise. That repetition then exacerbates the other auditory processing problems.

The disorder appears to range from mild to severe. Individuals report a range of physiologic and emotional responses, with accompanying cognitions. If you have a mild reaction, you might feel:

  • Anxious
  • Uncomfortable
  • The urge to flee
  • Disgust

If your response is more severe, the sound in question might cause:

  • Rage
  • Anger
  • Hatred
  • Panic
  • Fear
  • Emotional distress

The disorder can put a cramp in your social life. Those with the misophonia have been known to develop anticipatory anxiety when going into situations where trigger sounds may be present. You might avoid restaurants or eat separately from your spouse, family, or roommates.

Over time, you may also respond to visual triggers, too. Seeing something that you know may create the offending sound may elicit a response.

How Do You Get It?

The age of the onset of this lifelong condition is not known but some people report symptoms between the ages of 9 and 13. Misophonia is more common with girls and comes on quickly, although it doesn’t appear to be related to any one event.

Doctors aren’t sure what causes misophonia, but it’s not a problem with your ears. They think it’s part mental, part physical. It could be related to how sound affects your brain and triggers automatic responses in your body.

Because your ears are normal and your hearing is OK, the doctor may have trouble with a diagnosis. Misophonia is sometimes mistaken for anxiety or bipolar or obsessive-compulsive disorder. Some doctors think it should be classified as a new disorder.

Often doctors are unaware of the condition, and there is no consensus in regard to classification. Misophonia appears to occur on its own and also along with other health, developmental and psychiatric problems.  

A breakthrough study recently found that misophonia is a brain-based disorder. Researchers point to a disruption in the connectivity in parts of the brain that process both sound stimulation and the fight/flight response. It also involves parts of the brain that code the importance of sounds.

How Do You Treat It?

The condition does affect daily life, but you can learn to manage it.

Treatment often involves a multidisciplinary approach combining sound therapy by audiologists and supportive counseling in which coping strategies are emphasized.

You might try a device like a hearing aid that creates a sound in your ear similar to a waterfall. The noise distracts you from triggers and reduces reactions.

Other treatments include talk therapy.

Your lifestyle also plays a role. Get regular exercise, plenty of sleep, and manage your stress. You can also wear ear plugs and headsets to tune out sounds. Set up quiet areas or safe spots in your home where no one will make the noises that bother you.

And find support. The Misophonia Association is based in Oregon and California, and holds a yearly convention for suffers. The International Misophonia Research Network is a resource for doctors and researchers interested in learning more about misophonia. Misophonia  offers free resources, such as handouts for parents, and webinars in association with Duke University for those in the U.S., Canada and U.K.

Finally for those in the U.K. who are looking for support and research reports, try

You can also find online and social media groups where people share coping strategies.

Sound Sensitivity Causes and Treatment

Written by Michelle Konstantinovsky

  • What Is Hyperacusis?
  • Symptoms of Hyperacusis
  • Hyperacusis Causes and Risk Factors
  • Hyperacusis Diagnosis
  • Hyperacusis Treatment and Home Remedies

What Is Hyperacusis?

Hyperacusis is a hearing disorder that makes it hard to deal with everyday sounds. You might also hear it called sound or noise sensitivity. If you have it, certain sounds may seem unbearably loud even though people around you don't seem to notice them.

Hyperacusis is rare. It affects 1 in 50,000 people. Most people who have it also have another condition called tinnitus, which is a buzzing or ringing in your ear.

Hyperacusis is a hearing disorder. But a lot of people who have it also have normal hearing.

Symptoms of Hyperacusis

The symptoms of hyperacusis can affect your everyday life and include:

  • Depression
  • Anxiety
  • Ear pain
  • Relationship problems
  • Trouble connecting with others (social isolation and avoidance)

Some sounds that might seem louder than they should include:

  • A running faucet
  • A kitchen appliance, like a refrigerator or dishwasher
  • A car engine
  • A loud conversation

Some people are only mildly bothered by these sounds. Others have severe symptoms such as a loss of balance or seizures.

Hyperacusis Causes and Risk Factors

Your ears detect sounds as vibrations. If you have hyperacusis, your brain confuses or exaggerates certain vibrations. So even if you get the same signals as someone else, your brain reacts differently to them. That's what causes the discomfort.

People aren't typically born with hyperacusis. It usually results from certain diseases or health issues. The most common ones are:

  • An injury to your head (for instance, one caused by an airbag)
  • Damage to one or both ears because of medications or toxins
  • A viral infection that affects your inner ear or facial nerve (Bell's palsy)
  • Temporomandibular joint (TMJ) disorder
  • Lyme disease
  • Tay-Sachs disease
  • Migraine headaches
  • Using Valium regularly
  • Certain kinds of epilepsy
  • Chronic fatigue syndrome
  • Meniere's disease
  • Posttraumatic stress disorder (PTSD)
  • Depression
  • Autism
  • Surgery on your jaw or face
  • Williams syndrome

Being around a loud noise also can cause hyperacusis. Something like a single loud gunshot can trigger the condition. But it also can come from being near loud noises over a long period.

Hyperacusis Diagnosis

If you think you have hyperacusis, you'll see an ear, nose, and throat doctor (ENT, or otolaryngologist). They'll ask about your medical history, look closely at your ears, and give you a hearing test to confirm it.

Hyperacusis Treatment and Home Remedies

Treatment will depend on what caused it. In some cases, like with injuries to your brain or ear, the sound sensitivity might get better on its own.

If it doesn't, the doctor might suggest something called sound desensitization. You'll work with a specialist who’ll help you learn to deal with sound. You'll listen to very quiet noises for a certain period every day and build up gradually to louder sounds.

Most of the time, you’ll wear a device on your affected ear or on both ears. It puts out a sound like static, so it shouldn't bother you or cause pain. It can take 6 months to a year or more to get the full benefit of the therapy.

There hasn't been enough research done on other hyperacusis treatments to know if they're helpful. These include acupuncture and relaxation exercises. Another option, auditory integration therapy (AIT), is often used in autism treatment. It involves listening to music at different volumes for a period of time every day.

Your doctor also may give you medicine to help you manage the stress the condition can cause.

If you have hyperacusis, you might be tempted to use earplugs to muffle sound or stay away from social situations where there might be sounds that bother you. While these can give you short-term relief, they can, over the long term, make your symptoms worse. That's because when you eventually remove your earplugs or go into a social setting, the sounds can seem even louder.

Sound sensitivity, autism and hearing threshold. Part 2.

The second study by Moller and colleagues revealed how the non-classical sound sensitivity pathway, hearing threshold and persistent persistent tinnitus are related. Researchers have found that increased sensitivity to noise after electrical stimulation of the somatosensory system is often found in young children around the age of 8 and is extremely rare in adults over 20 years of age.

Moller, A. R., & Rollins, P. R. (2002). The non-classical auditory pathways are involved in hearing in children but not in adults. Neuroscience Letters, 319(1), 41–4. This discovery is also interesting because the obtained age figures are associated with the development of the brain and directly correlate with the maturation of the sound sensitivity system.

The non-classical way of sound processing can no longer be left out of the attention of specialists. Selected by the author. It is hard not to add that the relationship between sensitivity to sounds and cognitive impairments identified in some children, especially those diagnosed with autism, can hardly remain outside the attention of specialists. nine0003

As children grow older, the classical path of auditory sensitivity begins to predominate, brain structures undergo higher specialization and differentiation, which allows the phylogenetically later, new, classical, sound sensitivity system to take the place of the old, less differentiated, non-classical, which is unable to so carefully and distinguish sounds accurately. As required with the acquisition and development of speech skills, transmission of intonations. No less significant is the ability to capture and realize sometimes the abstract meanings behind the sound range, which, in fact, is speech. And this, as you know, is impossible without the participation of a specific cortical projection of sound processing. Note per.) Age may be a factor that determines whether somatosensory (tactile) stimulation is able to enhance or suppress the perception of noise in a non-classical auditory tract. nine0003

Hypothetically, interfering interference from a different kind of sensitivity could be the cause of perceived tinnitus. Functional MRI (fMRI) confirms the connection of the amygdala with a non-classical auditory tract, part of the limbic system is activated in patients suffering from obsessive tinnitus. This “lower” path, which connects with the amygdala, is the path through which unprocessed unconscious (?) sound information enters the structure, the activity of which is responsible for both emotional indifference and feelings of fear, anxiety or cruelty Amygdala as an archaic center of primary emotions - a sense of fear, danger - in our ancient brain, without which survival is impossible. This connection may explain why some patients with obsessive tinnitus react so emotionally to sounds. Moller believes that this incorrect path for sound information to the limbic system may be the cause of hyperacusis (painful sensitivity to sounds or phonophobia (phone - Greek sound, phobia - Greek fear) - literally fear of loud sounds, often a loud voice, even one's own , noisy places can cause discomfort up to a panic attack). nine0003

The non-classical way of sonic sensitivity can no longer be left out of the attention of those interested in this field. New research has uncovered its links to the somatosensory system of tactile sensitivity and developmental pathology. Further study may open the gates to a greater understanding of developmental hearing disorders and possibly the treatment of malignant obsessive tinnitus. The role of the non-classical path in the sound perception system and its involvement in sound processing is too great to be ignored. nine0003


P. S.

There is probably reason to believe that the development of the classical sound sensitivity pathway is disturbed in children who are subsequently diagnosed with autism. Together with hyperacusis, they also have a special sensitivity to touch, which is explained from the point of view of the author of the article by the interference of signals of tactile and auditory sensitivity. The environment for such children may be perceived as inadequately dangerous, in such conditions normal development is difficult. The potential ability to more deeply distinguish between speech meanings, learning by ear is impaired. And this despite the fact that children with autism have a larger brain volume compared to others due to an increase in the volume of gray matter (directly brain cells) of the frontal and temporal lobes, an increase in the growth of the path trajectory, a larger volume of the amygdala compared to the control group (Rong Chen , Yun Jiao, Edward H. Herskovits (2012) Structural MRI in Autism Spectrum Disorder, 69, 1–13. Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104 Abstract doi:10.1203/PDR.0b013e318212c2b3). Most likely, the most comfortable conditions for the adequate development of such children should be a special atmosphere of silence, in which loud sounds will not cause a feeling of threat from the external environment, and the quiet speech of the mother will push for efforts to recognize the meaning of other sounds, including differentiation and maturation of the correct, classical sound sensitivity pathways in the brain from an early age. nine0003

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Characteristics of human hearing - hearing thresholds and ranges

Hearing threshold

The human hearing threshold is the minimum level of sound that a person can perceive. This characteristic is one of the main ones.

Hearing sensitivity depends on the hearing threshold: the lower the hearing threshold, the higher the hearing sensitivity, and vice versa. The range of the highest sound sensitivity is from 1000 to 4000 Hz. It is in this interval that information about speech signals is located. Hearing thresholds at 200 Hz are 35 dB higher and at 100 Hz are 60 dB higher than hearing thresholds at 1000 Hz. nine0003

The normal hearing threshold is between -10dB and +10dB. In cases of hearing impairment, the thresholds can be different - from 20 to 120 dB.

Source: introduction to audiology and hearing aid I.V. Queen

Discomfort threshold

The threshold of discomfort is the level of sound that causes discomfort in a person. The norm is 100-110 dB, and it depends not only on the state of the hearing organ, but also on the excitability of the nervous system as a whole. In patients with hearing impairments, the discomfort threshold is usually greater than 110 dB. However, many people with sensorineural hearing loss have thresholds of discomfort that are the same as those of people with normal hearing or lower - a phenomenon called recruitment, or the "amplifying loudness phenomenon. " nine0003

Pain threshold

Pain in the organ of hearing, as a rule, causes a sound of 130-140 dB. In addition, one should distinguish between the threshold of touch and the pain threshold - in the first case, a person feels only pressure on the eardrum (130 dB), in the second - already pain sensations (140 dB). The threshold of discomfort for people with hearing impairment may differ from the norm, but the pain threshold is always the same for everyone.

Hearing frequency range

The ability to perceive sounds in the frequency range from 20 to 20,000 Hz is considered the norm for a person. Sounds with a frequency above 20,000 Hz are called ultrasonics, and those below 20 Hz are called infrasounds. A person can perceive ultrasound only if its source is applied to the bones of the skull - this property is sometimes used in the diagnosis of hearing impairment.

Source: introduction to audiology and hearing aid I.V. Queen

Approaching the study of hearing, the sound frequency range is conventionally divided:

to low frequencies - up to 500 Hz;

at medium frequencies - 500-3000 Hz;

to high frequencies - 3000–8000 Hz;

for ultra-high frequencies - above 8000 Hz

Hearing dynamic range

The dynamic range of hearing is the total amount of sound levels that a person is able to perceive, normally it is 130 dB. The difference between the quietest and loudest sound perceived by the human ear (up to palpable or pain thresholds) is large - the latter is higher by about 10 13 times.

In audiology, the dynamic range of hearing is the range from a person's hearing threshold to their discomfort threshold.

Both dynamic and frequency range can be different for people with hearing loss.

Differential hearing threshold

The minimum differences in frequency, intensity, or duration of a sound perceived by human hearing are called the differential hearing threshold. nine0003

It is the ability to detect minimal differences between sounds that allows us to perceive speech. The intensity and frequency of the differential hearing threshold depends on the duration, level and frequency of the sound. The norm for a person is 1–1.5 dB in intensity at frequencies of 500–4000 Hz at a sound level of 40 dB.

The reason for the poor perception of speech by people with hearing impairment lies in the increase in their differential hearing threshold - they simply cease to perceive small differences between speech sounds. nine0003

Binaural hearing

The ability of a person to perceive sound with two ears and process the received signals in the corresponding symmetrical auditory centers of the brain is called binaural hearing. This property provides the so-called process of binaural fusion - this is when sounds of different characteristics entering the right and left ears of a person are perceived by the human auditory system as a single and integral auditory image. In addition, by comparing the sounds entering the right and left ears, the auditory system determines where the sound source is. nine0003

It is binaural hearing that allows us to perceive speech in noisy environments - the so-called “binaural release from disguise” effect occurs.

Article about binaural prosthetics.

Source: introduction to audiology and hearing aid I.V. Queen

Hearing adaptation

Like other sensory systems of the human body, the auditory system is able to adapt to external conditions.

Learn more