Hyperacusis Test: What To Expect
February 03, 2022

When people think of hearing-related disorders, hearing loss tends to be the only condition that people think of. While hearing loss is certainly one of the most prevalent hearing-related issues, there are many other disorders that can impact the way you hear and perceive sounds. 

One hearing disorder that doesn’t seem to see the light of day is hyperacusis. Hyperacusis is a decreased tolerability to sounds that most would consider a reasonable volume. Hyperacusis can be confused with other sound disorders such as misophonia and phonophobia.

Understanding what hyperacusis is and how it is tested can provide some clarity as to what hearing disorder may be present and the best next steps that should be taken to achieve some relief. 

What Is Hyperacusis?

Hyperacusis is a hearing disorder that causes individuals to have strong unpleasant reactions to sounds that would normally be considered a normal volume to most people. Hyperacusis can range in its severity; some people may find that normal everyday sounds become unbearably loud.

Read on and discover everything you need to know about hyperacusis.

What Causes Hyperacusis?

Hyperacusis is thought to be a sound perception disorder in which the brain adapts to become more sensitive to sound inputs. There are a number of different potential causes of hyperacusis, and many of them have to do with exposure to loud sounds.

Abrupt exposure to loud sounds or pressure such as that experienced by an airbag impact or noise-induced trauma can cause hyperacusis. In addition to abrupt exposure, sustained and prolonged exposure to loud sounds can also contribute to the development of hyperacusis. 

Potential Consequences of Hyperacusis

When normal everyday sounds become unbearable to listen to, it can have drastic implications on your overall health. Many people who have hyperacusis can face challenges in navigating social situations and maintaining positive mental health. 

Mentally the constant struggle of dealing with hyperacusis can lead to feelings of anxiousness when going out in public. Imagine going to the grocery store and every day sounds like squeaking shopping carts or sounds of the cash register are just so loud that it becomes unbearable. When this becomes normal when going out into public, it is easy to understand how anxiety can develop. 

Social wellbeing can also take a large hit when it comes to hyperacusis. Many individuals with this hearing problem tend to isolate themselves from others as a means of avoiding noises that are unpleasant to them. 

What To Expect When Getting a Hyperacusis Evaluation

If you have begun to notice that you are bothered by noises that were not before, you may want to take a trip to your local audiologist for a hearing evaluation. Some people think of audiologists as just doctors that prescribe hearing aids, but this is only part of their duties. Audiologists are extremely well versed in disorders of the ear and hearing and could help to identify whether or not you have hyperacusis. 

Below is a look at everything you could expect from a hearing visit, including what to expect from a hyperacusis test. Many people can be nervous when going into the doctor’s office. That can be especially true for those with hyperacusis who are hyper-aware of the sounds that may be present.

Being informed before the visit can help to ease your nerves and be prepared for what is to come. 


The first thing you can anticipate coming across is paperwork. When you are going to the audiologist, they only have a limited amount of time to have a holistic view of you and your life. Paperwork and questionnaires are the quickest and most efficient ways to obtain this pertinent information.

With the paperwork, you can anticipate answering some questions on your family medical history, your medical history, as well as a section to describe your chief complaint.

It can be nerve-racking for an individual with hyperacusis to sit in public and fill this out. So, you may want to call in advance to see if this information can be filled out at home, where you are more likely to not encounter agitating sounds. 


With your paperwork filled out, you will most likely be brought back into a sound, isolated room. There, your audiologist will talk with you and gain a better understanding of what you filled out in the paperwork as well as any other information they may need. 

The main test that audiologists utilize is known as an audiogram. It is a machine that utilizes headphones, and different tones of sound are emitted at different frequencies to determine an individual's hearing ability.

While an audiogram may seem unrelated to hyperacusis, it could have the potential to help. By analyzing your ability to hear, an audiologist can also determine what tones of sound and volume are bothering you due to hyperacusis. 


Once all of the assessments are done, your audiologist will have a better idea of your specific condition and will be able to recommend further treatment. While an audiologist can help to identify hyperacusis, they can be limited in what they can offer in the form of treatment.

Because of this, the audiologist may refer you to another specialist, such as a psychologist. They will be able to educate you about the different options available to you. 

Hyperacusis Treatments

While hyperacusis can be challenging to live with, there are a number of different options when it comes to getting some relief. 

Here are some of the options available when it comes to hyperacusis relief and treatment: 

Hearing Aids

Hearing aids are the best treatment for hearing loss, but they may also be used as a means of helping those with hyperacusis. Hearing aids are small devices that have the ability to take incoming sounds to the ear, modify them, and then deliver the modified sound to the ear. For those with hearing loss, this would consist of increasing the output volume so they can hear sounds outside of their hearing threshold. 

Hearing aids for hyperacusis could work if the hearing aid is programmed specifically to an individual’s sensitivities to ensure that the sounds that are unbearable are filtered out.

Over time, the hearing aids can be adjusted to incrementally increase the sound levels. As time passes, those individuals may be able to have a normal level of hearing. This would utilize a programmable hearing aid and could cost quite a bit of money. 


Another option when it comes to hyperacusis relief is therapy. Therapy (such as desensitization therapy or cognitive behavioral therapy) can help reduce the negative reaction that comes with hypersensitivity. 

Desensitization therapy works by slowly introducing louder and louder sounds over a long period of time. A machine such as a sound generator can be used to control the volume of sound and allow you the control to achieve this slow desensitization process. 

The other form of therapy that may be helpful is known as cognitive behavioral therapy, also known as CBT. CBT focuses more on your reaction to sounds than the hyperacusis itself. 

CBT therapy has shown to be extremely helpful in other hearing conditions that have no definite cure, like tinnitus. Over time, you can effectively retrain the way that you react to sounds and achieve a greater sense of normalcy. 

Other Things To Be Aware Of

There is a lot of information about hyperacusis. It can be difficult to live with before you get the answers you need from an audiologist or healthcare professional.

Take a closer look at the things you should be aware of and try to avoid when you suspect hyperacusis: 

Avoid Earplugs

When the hypersensitivity to sounds begins, many people try to limit the amount of noise that is able to enter the ears by using earplugs. While this can certainly allow for some temporary relief, in the long run, it could increase the severity of hyperacusis. Potentially, your brain could adapt and become even more sensitive to sounds. 

Be Aware of Avoidance Tendencies

The other thing you should be aware of is that hyperacusis may lead you to avoid certain social situations. Resisting social isolation and avoidance can help your hyperacusis and well-being in the long run. It exposes you to noise and ensures you have a fulfilling and rich social life. A strong circle of support is often key to overcoming unpleasant times.

Watch and Listen: Staying On Top of Medical Care

Hyperacusis is a condition that isn’t frequently talked about, but that can really disrupt your life. Having a hypersensitivity to the sounds in your environment can lead to a severe decline in your overall wellbeing and happiness.

Taking the necessary steps, like seeking out care, can be the toughest part, but it is the one that will allow you to seek treatment and get past it. 


Hyperacusis | NCBI

Cognitive Behavioral Therapy For Alleviating The Distress Caused By Tinnitus, Hyperacusis And Misophonia: Current Perspectives | NCBI

The Audiogram | ASHA

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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