How to Stop the Progression of Mild Hyperacusis?

Hello all, as the title suggests, I’m seeking advice on stopping and undoing the progression of mild hyperacusis.

The two most annoying symptoms right now are the noise sensitivity and the noise distortions. I spent about a week being anxious and depressed, but I think reading enough success stories has helped me a lot in that regard.

My question now is what to do next. I’m thinking about protecting my ears for about three weeks and then trying to reintroduce bothersome sounds.

I can still tolerate a good amount of sounds, but not things like the popping of my jaw, closing doors, the opening of a soda can, or most loud and sudden sounds.

I’m trying to keep this post brief, but if anyone wants more details about how my noise sensitivity started or if there are any other symptoms, ask. Thanks in advance for any advice.

 

It is not possible to give general advice as we are all different, but I can share what has worked for me and what has not.

A three-week period of resting your ears is a good idea; I have also benefited from that. Besides that, it is crucial to protect yourself from loud sounds. I had two major setbacks from loud noise exposure, and I did not recover from them in terms of additional hearing loss and tinnitus. However, my hyperacusis improved over time. Sudden sounds with a high peak are especially dangerous.

The aim is not to overprotect during normal activities but to trust your feelings and proceed step by step. Even if you are fine again, sudden sounds can cause a setback, as your ears usually don't tolerate sounds like they did before hyperacusis.

I found white noise during the day and night to be beneficial, though I might have improved without it. This has been my experience.

All the best to you!

Stoic

 

May I ask how your hyperacusis started? I, too, have mild hyperacusis, which started with my noise-induced tinnitus.

 

Hi @sandyknight.

Using hearing protection correctly is the right thing to do when in noisy environments or using noisy power tools and gardening equipment to protect one's hearing. In some cases, it can help to ease the severity of hyperacusis to give the auditory system time to heal, but I advise this should only be done temporarily. Overusing hearing protection can actually make your symptoms worse. Please click the link below and read my thread: Hyperacusis, As I See It.

One of the best ways to treat oversensitivity to sound and hyperacusis is to use low-level sound enrichment during the day, particularly at night, using a sound machine by the bedside. Please go to my started threads and read my post: Sound Machines and Tinnitus.

Another option is seeing an audiologist specializing in tinnitus and hyperacusis management. You may be advised to wear white noise generators. These devices, used correctly, can help to desensitize the auditory system so it becomes less sensitive to sound. Please do not buy white noise generators and attempt to treat yourself without being under the care of an audiologist, as you could make your tinnitus and hyperacusis worse. They have to be introduced slowly, and counseling with the audiologist is often recommended when using them.

I wish you well,
Michael

Hyperacusis, As I See It | Tinnitus Talk Support Forum

 

If it helps ease your mind or you are interested, see if you can get a referral or appointment with a neurotologist.

They won't be able to do much for you. Still, they may be able to determine whether your symptoms are more related to tensor tympani syndrome vs. hyperacusis, which are very similar and sometimes co-occurring. If you're interested, they may be able to prescribe muscle relaxants for when it flares.

As for preventing worsening, I would suggest buying a small case of Eargasm blue earplugs and perhaps a set or two of high noise-canceling but wearable earplugs to keep in places like your keychain or car. That way, if you unexpectedly run into a loud situation (I went to a retirement ceremony, and they had a freaking band in a small auditorium,) you can be prepared, which will ease your anxiety further.

Take it easy on your ears; sometimes, it takes 1-2 years to see any improvement for minor loudness hyperacusis.

 

I believe mine started when I accidentally blasted myself with music while wearing noise-cancelling headphones. It took a few days for the symptoms to really come into effect. Prior to that accident, I had already had tinnitus for about eight years but had grown accustomed to it.

 

Do you have hearing loss? Recruitment can give you those same symptoms. Just protect your ears going forward to avoid worsening the damage.

 

Be careful of the advice. I took advice from the person here, and I'm a lot worse (so are many others!). I now have noxacusis. Protect your ears until you feel ready, then slowly reintroduce sound. Be careful. And medications are a gamble.

Good luck.

 

From what I've read so far, this seems to be the most common method of recovery, and I’d like to eventually employ this strategy.

Though not exactly comparable, I sleep with a fan at the lowest level for some background noise. It does not cause me any discomfort, but I’ve read reports from others that prolonged exposure to even low-level sounds can be damaging. There’s also the dysacusis that ramps up at night and then settles in the morning. It goes from a mild buzzing/whistling to very intrusive ringing.

 

One of the best ways to treat noise-induced tinnitus, with or without hyperacusis, is to use sound enrichment. Although you probably find the fan helpful, it is not as good as using a dedicated sound machine by your bedside, as mentioned in my post, Sound Machines and Tinnitus.

When applied correctly, low-level sound enrichment from a sound machine will not make tinnitus or hyperacusis worse. Sound enrichment should be introduced slowly at night. It can take up to 8 weeks to get used to using it. Keep the sound low so it doesn't draw attention to itself. The post above and other posts on my started threads explain more about this.

Read: The Habituation Process, How to Habituate to Tinnitus, Tinnitus and The Negative Mindset, Acquiring a Positive Mindset.

Try to keep things simple with tinnitus. I advise you not to use terminology such as dysacusis, noxacusis, and reactive tinnitus. The more complex you make tinnitus and hyperacusis, the more difficult it can become to treat these conditions. Please read my thread: Keeping Things Simple with Tinnitus.

Michael

Keeping Things Simple with Tinnitus | Tinnitus Talk Support Forum

 

Holy sh*t, man. That's terrible. What caused your noxacusis, and what was the "bad advice"?

 

I wanted to add one more thing that might be trouble later on. About 70% of the time, when I swallow without drinking or eating, I hear this clicking noise in both ears. Sometimes it’s pretty loud, and sometimes it’s not. I’m currently using a decongestant, but I don’t think I’m seeing much improvement.

 

Have your Eustachian tubes checked out by an ENT. They will again likely give you an antihistamine nasal spray for a month, then an antihistamine + steroid nasal spray for another month. They will then tell you to wait six months to a year or possibly talk to your insurance about Eustachian tube balloon dilation if it persists.

If your only symptom is clicking, they won't do much about dilation. If you have issues like going 50 ft up or down while driving and your ears need to pop, they may consider more intervention.

 

Is there anything I could do in the meantime to help alleviate the clicking? I'm trying to keep my noise exposure under control, but this clicking and the popping of my jaw are annoying as hell.

 

The click in your ear is your Eustachian tube. It won't kill you, and while it may be annoying, it will more than likely subside over weeks to months. If you're having clicks in your jaw, you might have something with TMJ going on, but that's beyond my experience and something to talk to an orthodontist about after a consult with a dentist. Over-the-counter, antihistamine nasal spray is probably your best bet for Eustachian tube issues. Azelastine, its equivalent, or Nasacort (steroid, I wouldn't do it first, but I certainly wouldn't do both without a doctor).

Be careful of creating more problems through intervention/medication than you already have. It's really easy to get pissed off/annoyed and try to treat the non-tinnitus/hyperacusis symptoms just out of desperation, but by obsessing over trying to speed recovery faster than possible, you might invite disappointment/worsening.

 

I wanted to provide an update on my situation. Unfortunately, I've encountered my first real setback, which has undone all the progress I had made—and then some. I'm currently worse than ever.

My tinnitus has spiked and become either reactive or unstable, though I'm not entirely sure which. It gets masked in the shower, which supposedly can't happen with reactive tinnitus, but it seems to increase in volume when my AC comes on. While the intensity has decreased slightly after two weeks, it's still louder than before, with new tones appearing from time to time.

My noise sensitivity has also returned in full force. If I had recovered about 30-40%, this setback feels like it has undone 60% of that progress, if that makes sense. The initial accident only set me back a little, but two additional loud noise exposures have made things much worse. Chewing anything even remotely crunchy or crispy (like soggy lettuce) is uncomfortable. Breathing too hard without my earmuffs is uncomfortable. Even something as small as a sesame seed falling onto a styrofoam tray is uncomfortable. At its worst, it seemed like my earmuffs weren't enough to protect me from even tiny sounds, but that has improved slightly.

The thumping and aural fullness in my ear have also returned. The thumping happens a handful of times throughout the day at seemingly random intervals, not in response to any particular sound. The aural fullness is very common and can affect both ears.

The most troubling symptom is the pain I sometimes experience. I don't believe it's noxacusis because the pain is brief (less than a minute), very mild (sometimes so mild it doesn't even qualify as pain), and almost always a dull, aching sensation. From what I know, noxacusis typically involves severe stabbing or burning pain that lingers. The only reason I even suspect noxacusis is because the pain sometimes seems to be in response to sound, but at other times, it occurs at night when the only sounds are my AC, my PC, and my fan. I don't find any of those sounds uncomfortable, and if they were causing the pain, wouldn't they cause it every time they activated?

I really wish I could find comfort in believing this is just a temporary setback, but I can't. I can't stop worrying that this might be a plateau or a permanent worsening. I've been doing my absolute best to protect my ears, but living in such a noisy household means I only have a few hours of true silence each day. After that, I risk further damage from someone slamming a door near my room.

 

I'm sorry to hear that your hyperacusis has worsened. I've been dealing with it for five years now, and it can still be challenging. I often have to wear earplugs in the kitchen to protect myself from the noise of crockery, pots, and pans clattering together, and even the sound of opening a drink can be painful.

To be honest, it's something I've just learned to accept. My flare-ups mostly happened in the early months, but in the past two or three years, it has gradually eased off a bit. I’ve mostly given up live music, which I used to love, and I don’t socialize as much as I used to. Despite these changes, I try to live as close to a normal life as possible.

Some people report a greater improvement in less than five years, but everyone’s experience is different. I suppose 40 years of rock concerts probably haven't helped my chances!

 

Thanks for your input. I think I can handle giving up things like concerts or going to the cinema. What hurts the most is having to give up headphones, but I believe I'll eventually learn to cope. I just want to regain some sense of normalcy again. Right now, I basically need to wear earmuffs for everything. I'm wearing them as I type this because even typing at a moderate pace feels overwhelming.

I keep blaming myself because I believe this setback was entirely avoidable—I just didn’t have the discipline to stop myself.

 

We all tend to blame ourselves when our condition first begins. Learning not to be so hard on ourselves is a crucial part of the habituation process. After all, concerts and headphones don’t come with health warnings on the packaging.

There is evidence that wearing ear muffs constantly may not be beneficial, as it can prolong the recovery from hyperacusis. Initially, you do need to protect yourself while the damage is still fresh, but after a few months, you'll likely notice that things haven't worsened. At that point, you can begin to ease up on the protection.

There are many types of earplugs available, from foam plugs that claim to reduce sound by 32 dB to fluted silicone earplugs, which are easier to insert quickly. I still carry a pair with me whenever I leave the house, but I no longer need to use them in every shop or on every street when I go out.

I hope you’re able to navigate the challenging early stages and that things start to settle down for you soon.

 

Yeah, I’m trying to avoid this right now. I know the topic of overprotection is somewhat controversial in this community, but I do think there's some truth to it. For the first month, I didn’t really think about it too much. I wore my muffs whenever I left my room but took them off as soon as I came back inside. I didn’t try sound therapy like others; I just used my fan as background noise so I wasn’t sitting in total silence.

As much as I hate to say it, I think I’ve had yet another small setback. I was getting to the point where things like my hair ruffling against the pillow and my blanket weren’t so uncomfortable, but now that sensitivity has returned. My tinnitus also spiked really badly, with multiple new tones in both ears. Thankfully, that has calmed down, but it was really scary.

It feels like a snowball effect. The worse it gets, the harder it is to climb out. I’m trying my absolute best to protect my ears, but unless I wear muffs most of the day, there’s no way to predict or avoid sudden loud noises, like a door slamming. Unfortunately, I might have to resort to that.

I'm happy to hear that you've recovered enough to go out again. I hope to reach that level someday too. Disorders like these really make you appreciate the things you once took for granted.