Hyperacusis & Misophonia

Decreased Sound Tolerance:

Hyperacusis & Misophonia

Bothered by loud noises or specific sounds? You may be suffering from Decreased Sound Tolerance: hyperacusis and misophonia. If you suffer from some sort of negative reaction when exposed to sound that would not trigger the same response in the average listener, then you’re experiencing Decreased Sound Tolerance (DST).
DST can cause you to feel a range of negative reactions from dislike or discomfort to pain, distress, anxiety, annoyance or even fear. DST often comes hand and hand with tinnitus and hearing loss, and can be reported in many medical conditions including head injuries, migraines, Lyme disease, Williams Syndrome, autism, Bell’s palsy, benzodiazepine withdrawal, and post stapedectomy. However, it’s not unusual for DST to be reported as the sole complaint.

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What is Hyperacusis and Misophonia?
Hyperacusis occurs in about 25-30% of tinnitus patients and is the experience of moderately-intense sounds (e.g., dishes clanging) being perceived as overly loud and annoying. In other words, there is a negative reaction to sound that depends on only the physical characteristics of the sound itself (e.g., loudness).
Misophonia, experienced by about 60% of tinnitus patients, is a dislike, fear, or negative reaction to a specific sound with a certain pattern and meaning (e.g., chewing of a specific person). Reactions are usually context-specific (e.g., eating at a restaurant would not bother you, but eating at home does). Unlike hyperacusis, someone with misophonia can tolerate a high level of other sounds, such as music or traffic noise. Patients with misophonia tend to have an increased awareness of external sounds as well as somatosounds (internal body sounds, like chewing).
Other terms you’ll see associated with misophonia include:
Although hyperacusis and misophonia differ in terms of how we approach treatment, there is no fundamental difference with how you treat misophonia vs phonophobia vs 4S, so for simplicity’s sake, we use the term “misophonia”.
Treatments for DST
The first step is a thorough consultation with us. We’ll listen to your concerns rather than tell you to “just live with it.” To effectively treat DST, we consider all the dimensions of the condition:

Treatment packages start at $3,900

Sound Therapy

Depending on whether you have hyperacusis or misophonia (or both), we will recommend sound therapy in different ways. For example, someone with hyperacusis will undergo a desensitization procedure that introduces soft, low-level sound which we gradually increase over time to induce “auditory toughening”; the idea is to gradually desensitize your auditory system. Although white noise is typically used, our rule is to only use sounds that are not annoying or bothersome to my patients. If the idea of listening to noise is not appealing, there are tons of other sound options out there; flexibility is crucial to getting you to restore a sense of control so that we can “reset” your relationship with sound. Sound therapy is delivered through discreet and comfortable ear-worn solutions that can be incorporated seamlessly into your daily routine.

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