Sound intolerance - Hyperacusis - Misophonia

Hyperacusis is a condition in which the person cannot tolerate simple sound or sound from everyday life. These sounds cause severe discomfort or even pain. Hyperacusis belongs to a broader group of pathological conditions associated with sound intolerance.

IMPORTANT CAUTION: Hyperacusis should be distinguished from misophonia which is a separate condition in which the person feels irritation and other strong emotions when associated with a particular sound e.g. the sound of chewing, the voice of certain people etc.

Reference:(McFerran et al., 2019) Modified.

How often does sound intolerance occur?

The incidence rate is different in the general population, in the age group or the occupational group. In general, it occurs at a rate of 3 to 17% depending on the study (Rosing et al., 2016). Hyperacusis is usually associated with tinnitus. It is estimated that 86% of patients with hyperacusis also have tinnitus and 30-40% of patients with tinnitus also experience symptoms of hyperacusis.

Are there any medical conditions associated with sound intolerance / hyperacusis?

Medical problems associated with sound intolerance / hyperacusis


  • Viral infections affecting the inner ear

  • Facial nerve palsy (Bell's palsy) etc.

  • Meniere's disease

  • Postoperative complications

  • Auditory stress etc.

  • Anxiety

  • Fear

  • Depression etc.

  • Head trauma

  • Tumors

  • Lyme disease

  • Medications

  • Temporomandibular joint syndrome (TMJ)

  • Autism

  • Down's syndrome etc.

What should the person suffering from sound intolerance/ hyperacusis expect during /after the visit to the clinic?

  • A detailed ENT / audiological assessment . Diagnosis and treatment options

  • Tailor made instructions to be given

  • Relief from tinnitus takes time and can take weeks or even months

  • Good cooperation between the therapist and the patient is of great importance for the outcome of this symptom

  • Individual effort under guidance is a helpful way of coping

  • Collaboration with other health care providers for optimal outcome

Dr Katerina Vardonikolaki

MD, PhD, Otolaryngologist (ENT)

Certified Doctor by Performing Arts Medicine Association

© Αll rights reserved Κ.Vardonikolaki

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