Types of Hyperacusis

Hyperacusis exists on a continuum of severity and varies enormously by individual. Given these differences and the way hyperacusis can often change over time in an individual, there is ongoing discussion among researchers and clinicians about how to subcategorize hyperacusis. 

Annoyance hyperacusis and fear hyperacusis involve negative emotional responses to sounds and may lead to those experiencing them avoiding social situations or to feel anxiety in anticipation of hearing these sounds. 

Those with loudness hyperacusis find that certain sounds—often high-pitched impulse sounds like beeps and chimes—are uncomfortably loud. Everyday examples include clanking dishes, crying babies, and honking horns. “Noise-induced pain,” a term coined by our partner Hyperacusis Research, describes pain hyperacusis, also sometimes called noxacusis.

It is loudness and pain hyperacusis that are the most debilitating.

Those with pain hyperacusis find that almost all sounds cause stabbing pain. People describe the sensation as knives, acid, or hot pokers being jabbed into their ears. In more severe cases, people experience a baseline burning pain all the time, even in silence.

Most people living with pain hyperacusis find that it worsens readily with additional noise exposure. The ear’s reaction to a sound is sometimes delayed, so the full effects don’t manifest for a few hours, days, or even weeks.

The condition has an enormous negative impact on quality of life and impairs the ability to travel, work and communicate. There may be some underlying genetic susceptibility. At least one gene, GJB2/Connexin26, has been identified as a susceptibility gene. But people without the gene also get hyperacusis.

Recent research points to pain-producing nerve fibers that are activated with sufficient noise exposure. It’s also possible that noise affects the eardrum or middle ear muscles.

Learn More:

What Is Hyperacusis?
Types of Hyperacusis
Treatment for Hyperacusis
Our Research on Hyperacusis