If sensitivity to everyday sounds is negatively affecting your life, please contact us for a consultation.

Hearing and Balance Specialists offers a comprehensive diagnosis and management program for decreased sound tolerance (hyperacusis, misophonia). These issues are common and manageable. You do not have to live with these symptoms.

Issues with decreased sound tolerance generally results in sensitivity to the sounds of everyday life. People with decreased sound tolerance may experience discomfort, annoyance or even pain to everyday sounds. Some sounds may make it difficult to socialize, concentrate, or sleep. Some people fear or withdraw from normal daily activities because of their sound sensitivity.

Types of Sound Sensitivity

What Is Hyperacusis?

Hyperacusis, also referred to as collapsed sound tolerance, occurs when normal, everyday sounds become uncomfortably loud or even painful. It can come on suddenly or gradually get worse. In hyperacusis, ordinary sounds can create annoyance, irritation, or discomfort. Due to a fear of being exposed to these sounds, those suffering from hyperacusis often become more withdrawn and isolated if the problem is not evaluated and managed effectively. There are many causes for hyperacusis. It can be a symptom of a medical condition. However, it is not unusual to find no clear reason for it. A thorough audiological and medical evaluation is critical for an accurate diagnosis and treatment.


What Causes Hyperacusis?

Hyperacusis affects approximately 40% of tinnitus patients, but it can occur in isolation. Research is greatly needed to understand the exact pathophysiology of the condition, but many agree that it is related to over-amplification (hyperactivity) in the hearing system. This can be caused by excessive exposure to loud noise 9whether sudden or gradual), reduced hearing, and other possibilities. Hyperacusis varies between and within individuals, and, like tinnitus, it depends on each person’s emotional state and listening environment. If no underlying medical condition exists, audiological management using sound therapy and counseling can be quite successful. The methods to promote sound desensitization for hyperacusis are very similar to managing tinnitus.

What Is Misophonia?

Misophonia, also referred to as 4S, selective sound sensitivity, and soft sound sensitivity, can be defined as an abnormally strong emotional reaction to certain or specific sounds. Patients who suffer from misophonia define a specific set of “trigger” sounds, which typically includes sounds made by other people such as oral or eating sounds (i.e. chewing, crunching, popping, lip smacking, whistling), breathing sounds (i.e. sniffling, sniffing, mouth breathing), and repetitive sounds (i.e. typing, pen clicking, fingernails tapping). These sounds trigger an instantaneous emotional — and sometimes physical — reaction. The misophonic patient may feel anger, disgust, or irritation. They may experience muscle tension, anxiety, or a sensation of being trapped. This condition often starts in childhood or early adolescence, can carry into adulthood, and disrupt the patient’s quality of life as well as relationships with others.


Research is greatly needed to describe an accurate definition, diagnosis and treatment. Currently, audiologists are part of a multidisciplinary team successfully helping misophonia sufferers.

Evaluation and Management

Hearing & Balance Specialists of Kansas City believes that understanding each individual’s experience with sound sensitivity will help direct the treatment plan accordingly. Each patient who visits our clinic benefits from a thorough case history, patient interview, and diagnostic audiological evaluation. In some cases, we can identify the presence of hyperacusis in the sound booth as well as provide a tinnitus assessment when they coexist. These results are described in detail following the evaluation.

If audiological management is indicated, sound sensitivity conditions are managed in a similar way to tinnitus. Although each individual is unique, a combination approach using sound therapy and counseling (or coaching) has been shown to be successful. Please contact our office for more information.