Some Questions About Hyperacusis

I've had noise induced tinnitus for half of my life, but I've never experienced any kind of hyperacusis. I see it mentioned on this board all the time and it's made me curious if most people who get tinnitus also get some degree of hyperacusis, or is hyperacusis much less common? What's the pain like? Is it like a stabbing feeling in your ears?

And for people suffering with hyperacusis and intrusive tinnitus... Do you think you'd have habituated to your tinnitus already if you didn't have the H?

It sounds like a really rough condition to live with and my heart goes out to those who are suffering.

 

@Jacob83 Not everyone that develops tinnitus gets hyperacusis. Hyperacusis like tinnitus comes in different levels of intensity. It can be mild, moderate or severe. Some people with tinnitus are not even aware that they have hyperacusis because it's mild but can manifest itself as tinnitus spiking when certain sounds are heard. Some people say their tinnitus is "Reactive", not realising this reaction is caused by hyperacusis (sensitivity) hypersensitivity to sound. One of the best ways to treat and cure hyperacusis, is by using sound enrichment particularly at night with a sound machine by the bedside set at a low volume. Hyperacusis can also be cured natuarally without using sound enrichment but there is no guarantee.
Michael

 

Answers to Hyperacusis and Habituation

Two questions often asked about tinnitus are: How long does it take to habituate and how do I know if I have hyperacusis?

One of the main causes of tinnitus is exposure to loud noise. Quite often though hyperacusis, (sensitivity to sounds) accompanies the condition. This is because the nerves in the auditory pathway have been subjected to noise trauma and thus become highly sensitised. Hyperacusis can be extremely painful. It can cause tinnitus to spike sometimes making it last for days until it settles down again. Within this time the person affected can be in a lot of discomfort.

Music that was once pleasurable to listen to through a home music system or radio is now an ordeal so one prefers not to listen to it. The closing of doors, washing up of kitchen plates and cutlery is enough to send a person running for cover, as it can feel like a pneumatic drill is piercing through your ears and head. It can become such a problem a person is afraid to venture outside their home in fear of road traffic noise sparking an increase in their tinnitus due to their sensitivity to sound.

One of the best ways to treat hyperacusis is by using “sound enrichment”. This can be achieved in many ways but I one of the best to wear white noise generators. Two should be worn to keep your auditory system in balance. The sound level of these devices must be adjusted correctly so as not to cause further irritation to a person’s auditory system, which can make the hyperacusis and tinnitus worse. It is best to always make sure their sound levels are set just below the tinnitus. Wngs are usually worn for up to ten hours a day. Two things are achieved over time.

The hearing system is constantly subjected to low-level non-intrusive white noise, which will help to desensitise it. Secondly, they help the brain to focus less on the tinnitus and push it further into the background making it less noticeable. This form of treatment is also known as TRT.

An alternative to wngs is to use a tabletop sound machine that plays nature sounds. This can be used for sound enrichment to help the healing process of hyperacusis. Again it is best to set the sound level just below the tinnitus. As previously explained sound machines can be very useful at night by the bedside and in the day used to fill in the background ambiance in room.

Treating hyperacusis takes time as there is no quick fix and everyone will respond to treatment differently.
Please bare in mind that a person with tinnitus and hyperacuisis, if the hyperacusis is left untreated sensitivity to sound will always remain a problem. In some cases hyperacusis can get better naturally without using sound enrichment but there is no guarantee.

A word of caution. Some people use earplugs to help suppress external sounds because of their sensitivity to sound. Earplugs are available but should only be used when in noisy surroundings and not to suppress normal every day sounds, as doing so can prevent the healing process of hyperacusis.

Habituating to Tinnitus.

Habituating to tinnitus often seems shrouded in mystery for the more seriously affected people that are in distress and have had to seek help at ENT. It can be particularly difficult for people that are new to tinnitus to comprehend. How does one know when they have habituated to their T and more importantly what does this actually mean?

The following doesn’t apply in every case of tinnitus for there are some people that have large fluctuations in their tinnitus and every day can be a different experience. This is one of the most severe forms of tinnitus and medications may be required to help cope with the condition. Habituating to this type of tinnitus is still possible to an extent but does present additional problems.

To others I will say this: You’ll know when you have habituated to your tinnitus regardless of whatever treatment you are using via ENT etc as your brain will over time push it further into the background so it becomes less significant, in a similar way to the people that have mild tinnitus. Although your tinnitus may be present and on occasions it will spike, over time it will cease to be so much of a problem unless you deliberately focus on it and bring it to the forefront of your mind.

Michael

 

I don't get it. How is it cured by listening to low volume sounds at night times? How does it help I mean

 

So, hyperacusis isn't a permanent condition? That's nice to know.

I'm habiuated to my tinnitus. I hear it all the time, but I have no emotional connection to it. I'll probably be hanging around these forums forever because I'm fascinated by the mysterious tinnitus.

 

When using a sound machine at night for sound enrichment. It supplies the brain and auditory system with low level sound. Over time this helps to desensitise the hypersensitivity - so the auditory sensors or gateways in the brain begin to close down, which makes them less sensitive to sound. It also treats the tinnitus and helps the brain to push it further into the background, making it less intrusive during waking hours. For this reason anyone with tinnitus particularly if it is intrusive, shouldn't sleep in a quiet room. When the brain hears silence, it has the ability to increase its own background activity and this will also increase the perception of the tinnitus.

In more severe cases, the tinnitus and hyperacusis are best treated with devices such as white noise generators and also using a sound machine at night. WNGs should be used under the care of a Hearing Therapist or Audiologist.
Michael

 

Unfortunately, hyperaucusis can become permanent if it hasn't cured naturally or a person doesn't use treatment as above. It can also get worse. So severe, that a person can develop phonophobia - this is literally having a fear of sound.
Michael

 

There is no "cure" for Hyperacusis. You can pray for natural recovery. There is no evidence behind sound enrichment, that's just the phantasm of one guru followed by sheeps...

Hyperacusis is not a disease. Hyperacusis is a symptom and it can come from different reason (noise injury, fistula, SCDC, TTTS, autism, etc...).
You have to find first the cause of the hyperacusis to try to solve the problem.

 

Are there any studies or something: P

 

@3ri0w Buy the Tinnitus Retraining Therapy book written by Professor Jasterboff and Johnathon Hazell. It is the reference book, that most healthcare professionals that work in ENT and treat tinnitus work to. It explains all about tinnitus and hyperacusis and using sound enrichment, when tinnitus is caused by Loud Noise. It is available from Amazon.

 

Like I said, when you have hyperacusis because fistulas, it's stupid to imagine TRT can help you...when you have hyperacusis from TMJD, it's stupid to imagine TRT can help you...

But you can buy books to fill your library, it's nice in a home... you can try TRT it's free, the worst is people who buy expensive sound generators for a non scientific & non logical theory

 

I typically look on pubmed. Here is one I found. Its conclusion states "The clinical relevance of recently developed <<retraining>> approaches accentuating physical stimulation should be reconsidered."

 

@Mithrandir Your comments did make me smile and thanks for that. A guru followed by sheep.
Seriously now. When I first got tinnitus and hyperacusis 20 years ago my hyperacusis was so severe conversation with someone hurt my ears. I started a TRT programme and was under the care of a Hearing Therapist and wore white noise generators for up to 10 hrs a day. I also had counselling with my therapist. The treatment lasted 2 years. At the end, my hyperacusis was completely cured and my tinnitus reduced to a level I hardly heard it.

In 2008 due to noise exposure my tinnitus increased to very severe levels but my hyperacusis did not return. I started TRT again for 2 years. My tinnitus improved but wasn't like before.
If someone buys the white noise generators and doesn't have tinnitus counselling the treatment usually doesn't work.
The counselling helps to takeaway and demystifies the negative thinking that many people have about tinnitus. It is for this reason using wngs without counselling doesn't work.
All the best
Michael
If you want to know more about tinnitus and treatments please click on the link which might be of some help: https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

 

Apparently, wng with counseling doesn't really work either... (I wish it wasn't true)
This being said, I'm really happy that you found something that worked for you, whether it was this specifically or a natural recovery, the fact that you felt better is good enough for me.

 

@Michael Leigh I believe in god and there's no proof he exists. That's the same story for TRT.

 

@Mithrandir Each person is entitled their opinion and I accept that. Since you haven't had TRT treatment perhaps try to be a little more opened minded about it and other treatments like CBT and mindfulness instead of dismissing them.
I wish you well.
Michael

 

I have made TRT, I think that's just good against phonophobia, I don't have photophobia but I appreciated brown noise. I have made CBT but I know more about my disease than my counselor...
So please when I talk I know what I say, me

Each person can believe human lived with dinosaurs or TRT functions but I need evidence, you don't have evidence for both...sorry That's just mysticism.

 

like your belief in God...lol.

 

@stophiss

Exactly, that's what I said, but there are more proof of Jesus Christ existence than TRT works >.<

 

Actually there is much greater evidence relative to the efficacy of TRT than the existence of God...the opposite of what you wrote. Now you are conflating the existence of Jesus Christ with the existence of God. You have just further disrespected the Jewish faith. Mith...or is it Myth?...you should be more reticent to cast aspersions to well intentioned members of this forum who have done so much good...whether you completely agree with them or not. Its ok to debate topics without insulting others. But while you are embarrassing yourself, please have a word with your God to eliminate my tinnitus and H or for that matter, this scourge that plagues much of mankind throughout the world.

 

I don't insulting others, I spent so many time in US to understand how you are puritans and shocked for nothing...poor little kitten ;P

 

You insulted this forum with your repeated ignorance...lol.
Hopefully you didn't stay in the US long. I am sure much was lost in your language barrier exascerbated by your boorish demeanor. Your stereotyping of Americans is further proof. Just like the 3rd world country you are from, US is hardly a monolith. Further you insulted a member from the UK who is a prominent contributor here.
I am still waiting for you to be right about something...lol.

 

Hi @stophiss Articulate and humorous as ever. The person is question can't string a sentence together without an insult...lol
All the best
Michael

 

Sorry @stophiss I read your "theory", very funny I had a good moment of fun. Just don't try to be a scientist and read the best review about hyperacusis : you'll learn more with that and stop telling bullshit

https://hal.archives-ouvertes.fr/hal-01202136v2

 

If you had a clue which you don't...nothing I wrote contradicts what was written in the abstract of the link you posted.
FWIW I am a scientist...and pretty clear you aren't.
Also, can't you find a forum in your native language..that is if they have the internet where you are from? Your butchery of the English language is tough to read...lol.

 

Ouch @stophiss that last sentence was a little bit below the belt but so true...lol

 

Maan great paper
I'm going to post it in the research section. There is everything someone needs to know about H. Im proud of my country science for once haha

 

Too bad that only the abstract is in English.
FYI they state that sound enrichment and TRT are useful.

They studied all the studies about TRT and found out that this is effective for H in 60% of tested subjects.

For people that have reactive T to the sounds enrichment or pink or white noise they suggest to start using it at the audition level, so really really low.

What's weird is that people that listened to z placebo sound also had improvements so I guess the quality of the sound doesn't matter that much as long as it isn't harsh

 

@stophiss
I prefer someone who gives good informations in bad english, than a useless english speaker

 

A third world country with a higher life expectancy than in the USA ... This quote from you doesn't sound like you're a scientist ... just saying ...
Besides, this kind of data is very easy to find on the internet, "that is if they have the internet where you are from?"