Hyperacusis, As I See It

Hyperacusis, As I See It.

Some members have asked for my opinion on hyperacusis as they are finding it increasingly difficult to live with. They want to know if there is a way of treating this condition so that their life can become a little easier? Or whether it can be completely cured? For a few it has become so distressing they have decided to only leave their homes when it’s absolutely necessary. This is because of the fear of making the symptoms worse, by subjecting their ears to the hustle and bustle of everyday road traffic noise and other environmental sounds that we are all familiar with.

Reading some of the posts in this forum, one can easily see that certain people daren’t leave their homes without first checking they have their earmuffs and an assortment of earplugs in various degrees of attenuation, in readiness for any potential environment that they happen to find themselves in. The cinema, nightclub, restaurant, or on public transport. If money is no object aspiring to custom made moulded earplugs for some is the way to go. It can bring the added assurance they will be getting the best hearing protection. Whether this is true or not doesn’t really matter because it’s what the person believes and this helps to give them that peace of mind which is something many of us strive for at one time or another.

The above may seem a little extreme until I tell you one member provoked a lot of discussion here, when he mentioned having the air bag in a car that he had just purchased disabled in case it was deployed in an accident. I suppose the thought of 170 decibels raining down on his auditory system and the possibility of his tinnitus and hyperacusis shooting through the roof was too much too bare and is more important than a potential life saving device. As strange as this might seem, others have discussed doing the same thing elsewhere on the Internet.

I am not an expert in this field but do have the experience of living with very severe hyperacusis that was brought on with the onset of my tinnitus twenty years ago due to loud noise exposure. It was so severe; conversation with someone at times caused immense pain. However, it was completely cured in two years with TRT and having counselling with a hearing therapist. I wore white noise generators for 10hrs a day and used a sound machine throughout the night until morning for sound enrichment. My tinnitus had reduced to a very low level.

Some people believe hyperacusis cannot be cured and if treatment such as TRT works then it merely suppresses the condition. In the event of future loud noise exposure it will return and the condition will be worse than before. I believe it's up to the individual to take care of their hearing and not subject themselves to loud noise exposure. However, accidents do happen as in my case. I have previously explained in this forum that my tinnitus increased to very severe levels in 2008 due to noise exposure so won’t go over it again. To my surprise the hyperacusis did not return and has remained the same till this day, completely silent.

This summer I went onto the Brighton Pier and into the arcade. The place was a hive of activity and many people were using the slot machines. Music was playing and mixed with loud laughter so everyone seemed to be having a good time. I had my sound level meter and also a sound App on my mobile phone. Just in case things got too uncomfortable I had my noise reducing earplugs with me that reduce sound levels by 18 decibels. This was a test and not something I normally do or recommend anyone else to try.

The sound level in that place remained constant at just over 100 decibels. My ears didn’t feel uncomfortable and I felt no pain. I stayed at the venue for 30 minutes and then left.

The next morning my tinnitus was silent and I experienced no symptoms of hyperacusis. I do not believe that it is a good idea for someone with tinnitus or hyperacusis (or both) to wear earplugs or noise-reducing earplugs with filters too often, because it’s possible for the auditory system to become hypersensitive. In some cases it could make matters worse and cause a condition called phonophobia. This is literally having a fear of sound.

I used to counsel someone that had phonophobia like symptoms although she wasn’t diagnosed. This person had hypercausis that gradually got worse and at every opportunity she kept away from sound. This got so bad going out the front door because of the noise was a problem. Her ears couldn’t tolerate the sound of the microwave, dishwasher or the washing machine. She even complained of the sound of rain falling on her conservatory roof that was made of glass. Fortunately she has improved.

There is much discussion on this in the medical field from experts saying that the overuse of hearing protection isn’t good and therefore discouraged as it will lower loudness threshold and I completely agree with this. I think if one isn’t careful they can become paranoid over sound making their hyperacusis and tinnitus worse and I don’t think it’s healthy.

I believe the answer is to seek proper treatment. If TRT is unavailable then start using a sound machine by the bedside at night for sound enrichment. This usually helps to desensitise the auditory system. Try going out for long walks and getting used to everyday sounds instead of keeping away from them by staying at home. I don’t normally recommend anyone to use white noise generators unless they are under the care of a hearing therapist. However, if your tinnitus is under control and you have habituated but experience hyperacusis, that some call: Reactive tinnitus. Then white noise generators could be the way to go. Two should be used to keep the auditory system in balance and set the volume level low, preferably below the tinnitus. This will help to desensitise the auditory system and treat the hypercusis.

Hearing protection is important and does have its place. If I am going to venues where I believe noise level could become loud then I have my earplugs with me. Night clubs, parties etc. I would always use them at the cinema although I haven’t been to one in years. Reading some of the posts on this forum people say those places can be very loud.

When I use my petrol lawn mower or electric power tools for those DIY jobs around the home, I always use my ear defenders. I want to live life and enjoy it. Not to be living in fear of hearing a fire truck or ambulance siren coming towards me and I have to panic and quickly insert earplugs or reach for earmuffs to protect my hearing. I just think this is overkill.

Michael

PS: There is a condition called: vestibular hyperacusis. This is where the sound can cause a person to fall, lose balance or experience dizziness, and will probably require more professional help.

 

Thanks for the post, Mike. As skeptical as I am of sound therapy, your story is always inspiring to hear. I really believe that most people with hyperacusis will overcome it one way or another and regain the ability to live a normal life.

 

Thank you Sen, and I hope that you continue to make improvement....

 

Hi Michael,

I was dealing with hyperacusis for more than 3 years without wearing any hearing protection, going out in busy streets without earplugs or anything. Well, it is something I would not recommend anyone and hyperacusis did not go away, and only started to improve when I combined sound exposure at home with hearing protection when I was out.

In my opinion, the big question to get rid of H is how one gets used to sounds and frequencies that can actually harm anyone. I mean, let's suppose one starts with LDLs at 50 dbs for all frequencies and doing sound therapy and leading a normal life over a year LDLs go up to 80-85 dbs. How does one deal with sudden sounds that peak around 120 dbs? How does one deal with a passing motorbike that goes well over 100 dbs in just a second? These sounds are not only very loud but volume goes up very fast. One cannot really "train" to get used to these sounds at home, as they are genuinely harmful to anyone, plus hyperacusic ears are more prone to get set backs or get all sorts of hearing problems, like T, noise induced hearing loss and other major inner ear problems.

 

@Juan

HI Jaun,
I am pleased to hear that your hyperacuis has improved in the manner that you mention.

As you know this condition comes in different forms of severity as tinnitus does. It can be: mild, moderate or severe. Hyperacusis can get better naturally without any treatment. In more severe cases treatment is usually recommend in the form of TRT. Wearing white noise generators and using a sound machine at night. It is also recommended a person be under the care of a hearing therapist with this treatment. When a person has hyperacusis often tinntius is present (but not always) TRT will therefore treat both conditions as in my case.

I realize TRT is an expensive treatment and some people may not be able to afford it. I didn’t have to pay under the NHS and my treatment lasted two years with counselling.
My suggestions to people if they are unable to get TRT, is to try using sound enrichment at night and getting out of the home and around natural sounds, rather than keeping away from sounds, as the person that I described in my post. By keeping away from sounds and not going out her hyperacusis got increasingly worse. Some of the people in this forum that have hyperacusis are avoiding natural everyday sounds and using hearing protection too often, which can make the auditory system hypersensitive.

Hyperacusis (like tinnitus) is complex and if a person has them both even more so. When it becomes problematic, professional help is usually required as in my case. As I’ve said, my hyperacusis was so severe conversation with someone caused immense pain at times.
All the best
Michael

 

@Juan
The sound levels that you mention in your post I encountered them when I was going through my treatment. These are normal environmental sounds as far as I'm concerned and get dispersed through the air, and do not go directly into the ears. As I said: I went to an arcade where the sound level was 100 decibels and I had no problems and used no hearing protection. This was a test and something I wouldn't normally do.
Michael

 

Some noises are not normal sounds, but very loud sounds that no one would recommend listening to, let alone without hearing protection. These sort of sounds can be present pretty much at any place, at any time. I can give you an example of an unforseen situation I encountered today:

I went for a long walk. I was walking for two hours on a pedestrian track, around nature. Trees are not dense in that area and it is usually quiet, but there are stretches of the track where plants are bushes are dense on the sides, so one has to stay on the track. Unfortunately, a guy riding a crazy loud, altered trial bike, entered on the pedestrian track and headed straight at me and other people walking there. This is the sort of sound that sets me back; I am glad I had earplugs and earmuffs at hand, and lucky to have been on a spot where I could leave the track to the sides and get some distance. Other people who were walking there today and were at places surrounded by dense vegetation had to see the bike running right by their side. There are really irresponsible people out there; that guy could have run over some of the kids. Quite a shocking thing.

In my case, even if I try to be positive about H and listen to sound many hours a day, and have no issues with most normal sounds, H does not fully go away, and very loud sounds are still quite painful, and have made me lose hearing in high frequencies over time, just due to brief accidental exposures like that described above. I went to see a TRT therapist and got psychological counselling too, but it just does not seem work for me. Maybe some day my hearing will improve a little more or, hopefully, get back to normal, but I have been suffering from H many years already, so I have accepted the situation and also the possibility that maybe it does not improve after a certain point.

 

@Juan everyone is different. I wrote my post to try and help people and if they want to try it that is their choice. I advise you to try TRT and wear white noise generators as I did for 2 years. Wearing them 10hrs a day and using a sound machine at night. I hope that you can get the help.
I wish you well.
All the best
Michael

 

@Juan I can understand a trial bike making a lot of sound off road as I use to ride one and ripped around the fields and I did not have tinnitus then.
If I saw one coming at me now my plugs would have gone in but saying that the sound would pass by quick.
Life is a rat race and louder than ever and more so in city's with dence traffic.
As long as every day sounds are ok for you then just protect your ears when you can.
We will never go through life loud noise free...eg fire alarm at work or dogs barking or alarm clock going off.
We are the best people to know protect our ears even though we have tinnitus as others risk their hearing every day with our a thought or care in the world and those people seem to get by unsaved but our ears are so delicate and tinnitus will always be a part of people's lives through lots of reasons like stress,virus,ear conditions and infections and the list goes on and then we all look for help.
CBT and TRT and sound therapy and hearing aids,maskers and medication help us all get by and each one of us finds the road to habituation with what they find the most helpful and feel better for...
This forum is 100% the best place to come for help so hope you find the best path on your tinnitus journey...lots of love glynis


Ps did you use white noise generators with your TRT treatment over the counselling that should take up 1-2 years just to see what passes off as TRT around the world ?

 

No, I did not wear the white noise generators. I visited a TRT qualified ENT and was visiting for one year, but the sound therapy I did at home, with music or white noise, turning up the volume progressively. The ENT said that it did not make much difference to go to the clinic to listen to sound there or doing the therapy by myself. The clinic is far away, so I did therapy for many hours a day at home, usually at least 8 hours of music or white sound per day, and another CD played at night.

I am ok in most normal situations, and can be in a restaurant with music at medium level and people talking relatively loud. I once measured the sound level at a restaurant I usually go to and, according to the sound meter app, it was around 90 dbs and I was ok with it. I was having dinner early and the sound was increasing progressively as people got into the restaurant. Oddly, a sound that increases very fast, such as a motorbike roaring or construction tools, do set me back even at 85 - 90 dbs. So I have reached a point from which I am not progressing much..

 

@Juan I advise you to read @Marie79 hyperacusis success story it is in the forum List. You will see it is the same thing that I have advised people not to over use earplugs, earmuffs and not to keep away from sound.
Michael

 

Michael, what Marie is describing in her story seems to be just a spontaneous recovery. As I said before, in my case I was leading a "normal" life for 3 years, without wearing any hearing protection at all, and H did not go away, and I was not retreating from sound. After trying TRT hyperacusis did not go away either. Right now there do not seem to be much more options. I listen to music pretty much all day, and do normal things, but very loud sounds affect me a lot.

After a certain point, the ambient, the daily habits, the place where one lives, all those "environmental" conditions matter a lot. To give an extreme example, just to illustrate this point, we can all imagine that is not the same to have H in some remote village at Lapland than having H let's say in New Delhi.. it's not the same to be a professional writer than to work around moderate noise or around peaks of noise. And there is the cultural thing, in some places people love just making noise for the fun of it.. recovery from H, to a certain extent and after a certain point, depends a lot not only on what caused it and the severity it reached, but on the luck about the loudness of sounds one encounters during the daily grind.

Michael, what precise steps did you take during TRT in order to improve? What I understand is you had white noise generators when you went out. How loud was the white sound to reduce the contrast with ambient sounds and peak sounds? And then, what kind of noise machine did you use at night? (I used just a normal hi-fi equipment)

 

@Juan I see your point Juan. Hyperacusis does come in different levels of severity. However, since you haven't worn white noise generators, I would suggest that if it's possible to do so in the further then give them a try. Although using a sound machine or having background music playing at home is beneficial, in more serious cases of hyperacuis like what I had and I believe you have got; I don't think this is as good as "wearable white noise generators" . They are attached to the ears and low level white noise is played for up to 10hrs per day and taken off at night, then a sound machine is used throughout the night until morning. I was on this treatment for 2 years and H was completely cured.

Jasterboff recommends white noise generators for curing Hypercusis and I agree with him. If you have habituated to your tinnitus then I don't think you need the counselling and therefore, just need to buy the white noise generators.
That is my opinion but it's up to you.
All the best
Michael

 

I note that my tinnitus gets lower when I have been staying at home for a couple of days, and it gets worse after I have been out for one day, to my office. Isn't there a possibility then that tinnitus could disappear if I stayed at home in silence for a longer period of time?

Isn't it true that hyperacusis is never a big problem, but tinnitus is, in the following sense: while hyperacusis can be cured (by going out in noisy places), tinnnitus can not be so easily cured.

Isn't it then better to focus the attention on trying to cure tinnitus, than worrying so much about mental disorder problems that may arise by too much silence.

If one is very worried about those mental disorders related to silence (which I personally believe do not exist), then one can always move to a remote place where it is very quiet, yet completely natural for any human to live, on say a farm keeping animals and grow vegetables and potatoes using a hourse and no machines.

It is not natural for humans to hear the sound from our civilization, traffic, air planes, helicopters. The natural state for a human is that of Jesus. Suppose Jesus did a time travel from Jerusalem year 17 to New York city year 2017. How do you think he would react? Perhaps he would behave very similar to a person we today would classify as having serer hyperacusis. Jesus would run around in circles and cover his ears with his hands and scream out in panic, wondering where all that noise in New York came from, what all those cars are, whether they are some war machines that would try to kill him rather than a taxi asking Jesus if he wanted a ride.

By definition, a disease can not be defined in a different way for each millenium of our civilization. Hyperacusis seems to be defined differently for each millenium. These days we are saying a person has hyperacusis if he can not stand the sound from an ambulance. That definition made no sense year 17.

 

Avoiding ear damage from construction noise, sirens, motor bikes, car horns, or whatever else is out there through the use of ear protection or covering your ears with your hands is smart, even if you have healthy ears. If everyone did this, there would be a lot more healthy auditory systems out there.

Anyone that tells you that you will make your ears hyper sensitive and give yourself H by protecting your ears from these "normal" sounds is insane, there is no proof of this.

I know a lot of people that live very quiet lives, I can assure you that they haven't developed hyperacusis by living this type of lifestyle. On the other hand, loud sound pressure levels and prolonged noise can cause or worsen H, this is pretty obvious but seems to be somehow overlooked.

My H developed through a ear injury, it seemed to progress with drugs that weee used to treat my ears, and then finally were made a lot worse while taking the advise of the TRT twits telling me to get out into "normal" sounds too quickly.

 

For some, the "normal" sound-exposure approach works great. For others, it can be disastrous.

Many hearing professionals recommend exposure to normal daily sounds like a "one-size-fits all" hat. But this warning should be added: "Because everyone is different, there's really no way of knowing how it will turn out. It's up to you to take the risk."

 

I once read a magazine editorial written by a doctor. He said he had five patients who were profoundly deaf from air bag detonations. The irony was that all happened during minor fender-benders in parking lots.

It's easy to see how a person with tinnitus or hyperacusis (whose big day out might consist of a trip to the grocery) might not want a car rigged with multiple 170-decibel explosive charges.

 

Indeed...

 

Just by-the-by, Cars sold in America had a lower threshold for airbag detonation than cars sold in countries where seat belt use by all passengers is compulsory. I don't know if this is still the case but that's why you in the US used to have airbag detonations in comparatively minor benders.

 

@Michael Leigh
There are various types of Hyperacusis like there are various types and causes for T.

In your case you cleary mentionned your "above level hearing ability " which does not indicate hearing damage so the H will have a different cause.

Most likely misophonia, or any of the mental anxiety we find in these forums, especially for people like yourself who are using antidepressant or other psycho drugs .

Like someone saying they have a broken leg but their running ability is "above average "...they convinced themselves they have a broken leg and they go around saying it's fine to walk with broken legs just because they are able to do it.

Bad advice for someone with a truly broken leg.

 

@Bobby B I normally don't respond to impertinence but on this occasion I will.
You have had tinnitus for a grand total of 5 mins and think you know everything. Well, I assure you that you don't.
Goodbye
Michael

 

@Michael Leigh
Unlike your T which goes completely silent at times - mine never stops that's the nature of noise induced damage.

I wish I had the type of T which offers some relief periods.

And I dont have above average hearing abilities...so I guess I know better than you the consequences of hearing loss and damage in terms of impact in ones life

 

Michael isn't interested in your experience or knowledge regarding T+H, he is interested in his own very bizarre assumptions based on his personal experience with T+H and TRT. He claims he had a noise exposure incident which lead to him having severe T+H for years, so bad he could not have a conversation, but also says he has no hearing loss. When trying to discuss with him the inefficacy of audiograms, and the concept of synaptopathy (hidden hearing loss) he evades the topic, and says stuff to the effect of "I don't respond to negativity, I got better and I believe you can, if you don't it's because you're negative and can not be helped".
When really hearing damage and t+h are not the same for everyone. When I try to ask him how he got better, or how he got T without hearing damage, he says doctors told him he didn't have hearing loss, and that "they are the doctors" so he is convinced he does not have hearing loss. As a result, he believes that he had severe noise induced T+H, but has no hearing loss, and got better, and expects everybody else to have the same results. He is also uninterested in examples which clearly exemplify that his method of recovery is not a one size fits all, and is in fact impossible/dangerous for others.



He is relying on the same dangerous assumptions that some ENTs/audiologists/TRT practitioners do, that an 8k audiogram can diagnose all forms of hearing damage (It can NOT). That all people following acoustic trauma induced h, are not more vulnerable to further damage than regular people. (they are not see @Foncky for proof). And that everybody will experience/recover from noise induce t+h as he has.

 

My tinnitus/hyperacusis came on following a very noisy microsuction procedure...my audiogram up to 8khz is what doctors call "in the normal range" but at 12khz my hearing does a huge nose dive...my tinnitus pitch was measured at 12khz. I have TTTS too.

Doctors/audiologists rely too much on audiograms up to 8khz when they really need to consider the ultra high frequencies in more detail where T + H are concerned. I have been suffering for almost 11 months with constant ringing and sound sensitivity but none of the doctors take me seriously as I have "normal" speech frequency hearing!!! Hence the lack of efficacy in my audiogram!

 

Get a referral to see a Hearing Therapist to discuss your treatment options. Although hyperacusis can improve with time. Depending on how intrusive it is, it may need treatment with white noise generators as part of TRT. It is one of the best treatments for tinnitus and hyperacusis. It is not a cure but many people do benefit with a reduction in the tinnitus and hypercusis. However, this treatment can be expensive depending on where one lives.
Best of luck
Michael

 

Thanks for the advice Michael but I tried WNG with an audiologist for several months last year. It seemed to help at first but then after a while i could no longer tolerate the WNG so stopped the treatment. My H fluctuates but is very reactive to loud/high pitched sounds. I have to keep plugs with me at all times and use muffs in certain situations.

 

@Blue28
Sorry to hear that Blue. Perhaps the WNG didn't suit you. Did you keep their level below your tinnitus? I'm just curious because usually, if the volume is kept low over time the auditory system is gradually desensitized. Did you also use a sound machine by your bedside at night for sound enrichment? I am also wondering if you had tinnitus counselling with your Audiologist? I would like to know, thanks.
Michael

 

I was referred to the audiologist by a tinnitus/hyperacusis ENT. The WNG were kept at a low level and the sound was slightly increased every 2 weeks or so to supposedly retrain my ears to hearing normal sounds. I had no counseling as such. I used a sound app at night (and still do), it helps me to fall asleep as my tinnitus is very bothersome.

 

I have had TRT twice @blue in 20 years with good results. I do not agree with the Audiologist advisng you to turn up the volume 0f white noise generators. This can cause irritation to the ears, and make the hyperacusis and tinnitus more intrusive. They should have been kept below your tinnitus and your auditory system would have automatically desensitized. Counselling is always advised but if you didn't have there's not much you can do.

If it's possible, try using the white noise generators again but keep the sound low, below the tinnitus. The idea is for the brain to habituate to the white noise and slowly, over time, it pushes the tinnitus into the background and your auditory system will desensitize. Wearing earmuffs isn't the answer long term. I realize you are in discomfort at the moment, but if you can resume using the WNGs, I think it would help.
Michael

 

Thank you for your advice Michael. Maybe in the future I will try white noise generators again but for now I'm trying to rest my ears a little. I don't know if this will help or not but I feel like I have to do something. The doctors I have seen have been little help.