Hey Team H, My personal analysis of the situation is that on some days my ears are over-sensitive, my perception of tinnitus and external sound is louder and the pain is more prevalent. On other days the tinnitus is still audible but not overwhelming, external sounds feel normal and I have little if any pain. I have been unable to point to any particular reason why some days are better than others. I figured driving my car to and from work was the problem. To so some extent it may be, yet I have had a bad weekend two weeks ago where my ears were acting up and oversensitive, yet I was just staying in a quiet bedroom at home playing video games with sound at a low level. On the better days I am able to concentrate and don't notice my T unless I stop to listen for it. On the bad days I am unable to concentrate and feel like putting my head through a wall. Can't give you an accurate pattern other than to say it's like having 2-3 bad days followed by 2-3 good days on repeat. Does anyone with hyperaccusis experience something similar?