Professional treatment – the earlier the better

Hectic everyday life, stress at work, constant traffic noise – a wide variety of influences affect our organism every day. The increasing speed in our life places an additional burden on us, which also puts our senses under pressure. This often leads to over-irritation of the hearing system and pronounced sensitivity to noise, hyperacusis. More than 40 per cent of tinnitus patients are affected by this. 

With the right therapy, however, there are good chances of recovery. Our specialists at Schoen Clinic have many years of experience in treating hyperacusis. Our goal is to give you back your quality of life. 

Causes & symptoms

Hyperacusis: Causes of this condition

Like tinnitus, hyperacusis has various causes. Organic causes primarily include sensorineural hearing loss. Certain forms of epilepsy, signs of a migraine or side effects of medication can also be considered triggers in rare cases. Hypersensitivity to noise is also an expression of overloading or psychological impairment (anxiety disorder, depression), which then manifests itself in this physical “overstimulation”.

Impaired auditory processing

A functioning auditory processing system involves the separation of disruptive and useful sound. Our hearing has certain filter mechanisms, which pass on the respective acoustic information accordingly or, if necessary, inhibit it. In the event of hyperacusis, attention can also turn to certain noises. During this, certain emotionally negative noises are perceived as unpleasant – although the volume is not very high (example: a squeaking door). Stress and psychological burdens can further increase this sensitivity. This is how a cycle of fear of noise and negative reinforcement is set in motion. Sensitivity to noise leads to a gradual withdrawal from social activities, since normal volume levels are also increasingly perceived as unbearable. The stress load on the nervous system increases. Those affected get into a vicious circle in which the sensitivity virtually increases by itself. A state is eventually reached that you can often no longer break through by yourself.

Hyperacusis – symptoms: These symptoms may occur

Hyperacusis is an unusual sensitivity to normal ambient noise. The discomfort threshold drops to below 80 dB. It often triggers reflexive reactions such as perspiration or heart palpitations. 

Lack of loudness compensation in hearing-impaired people

Sensorineural hearing loss usually consists of damage to the outer hair cells. This changes the way the sound is processed and those affected have no loudness compensation. This leads to the paradoxical phenomenon that hearing-impaired people do not understand soft sounds, but react very sensitively to loud ones.
Loud noises often trigger a startle response with heart palpitations, perspiration, an increase in blood pressure and a dry mouth. In addition, increased neck tension can lead to headaches or earaches.


Phonophobia is the fear of certain sounds. This hypersensitivity is independent of the volume or frequency of the noise. The anxiety disorder is triggered only by the significance of the sound for the person affected. Abnormal sensations and acoustic misperceptions are also described. These noises are not really harmful. However, unpleasant feelings such as fear, shame or embarrassment arise in connection with them.

Social and mental consequences

Some people even wear hearing protection in order to avoid situations with unpleasant noises. Many reduce their social activities because they associate negative hearing experiences with other people’s company. This often leads to social isolation with far-reaching consequences. In addition, sleep problems, concentration difficulties, fears of deterioration and failure or depression can occur.


Diagnosis: How we diagnose hyperacusis

The diagnosis of hyperacusis results from the combination of audiological findings and medical history.

Audiological diagnostics

There are different audiological findings depending on the cause of the sensitivity to noise. A normal hearing finding can often be seen in the tone threshold and speech audiogram, but the threshold of discomfort is lowered. In the case of sensorineural hearing loss, a lack of loudness compensation (“recruitment”) can be the cause of noise hypersensitivity. However, with phonophobia/misophonia, the threshold of discomfort is without pathological findings. 

Further investigations

Hyperacusis can also be a symptom of a concomitant disease in the context of depression, anxiety disorder, burnout or another crisis. We therefore also carry out complementary psychosomatic and psychotherapeutic examinations.
The treatment concept at Schoen Clinic is comprehensive and versatile in the diagnosis and therapy of various auditory hypersensitivities.