Hyperacusis: definition, causes, symptoms and treatments

Hearing a laugh, hearing a child's voice or a dog's happy bark, or going to a concert by our favorite band are aspects that most of us find pleasurable.

These are more or less common sounds of our day to day that accompany us and are part of our lives. But nevertheless, For people with hyperacusis, what seems normal and even pleasant to most people is real torture..

And it is that these people suffer a high level of annoyance before auditory stimulation. What is hyperacusis? In this article we proceed to analyze this affectation.

• Related article: "Tinnitus or tinnitus: causes, symptoms and treatment"

Hyperacusis: concept and symptoms

Hyperacusis is understood as that condition in which who suffers from it manifests a decrease in the threshold of tolerance to sounds. It is a type of hypersensitivity that generates that the person is not able to tolerate sounds that for other people are normative because they cause them a variable degree of pain or discomfort. It is common for reactions to occur especially to strong and sudden sounds or to repetitive and continuous sounds, which can be torture for those who suffer from it.

It is important to bear in mind an aspect that is often taken for granted: hyperacusis does not imply a greater hearing capacity for part of those who suffer from it compared to the rest, being said capacity normal or even being able to suffer from some type of problem auditory. In other words, it is not that they hear more than others but that their nerve pathways respond more easily and they have less capacity to resist sounds.

At a cognitive level, hyperacusis tends to cause problems when it comes to sustaining attention and concentrating. It can also generate an increase in irritability due to the persistence of sounds that they cannot avoid, as well as the behavioral avoidance of those sound sources that bother them. Symptoms such as headache, dizziness, nausea, tinnitus or physical and mental fatigue. Also sleep problems.

In addition to all this, people with hyperacusis often have social problems derived from their intolerance to sounds. This problem is not usually well understood socially, and can be very limiting. And it is that since the sounds of everyday life cause them suffering, they often avoid or are easily irritated by sound sources that for others are innocuous and even pleasant. In many cases they avoid places where there are crowds, which today in urban environments is difficult to achieve. In some cases they decide to isolate themselves by restricting social contact.

Causes

The causes of this type of affectation, which can occur both on its own and be a symptom of another medical problem (such as Williams syndrome), are not fully known. It is speculated with the existence of damage or deterioration of the auditory pathways, especially in the cochlea.

These lesions can be found at the level of the inner ear or at the brain level. The damage in question can have multiple causes, which can range from the presence of congenital alterations or malformations to acquired causes. Among the latter, exposure to a large amount of noise on a continuous basis stands out, which can damage nerve connections and sensitize them. It can also arise from damage caused by head trauma (which is why some subjects who have had car accidents would have said problem) or even the consumption of some substances.

At the hormonal level, it seems to be involved serotonin, being the alteration in serotonergic pathways another of the possible causes of this problem. In some cases, stimulus deprivation is also proposed as an aetiology, but this is unlikely.

Treatment

Traditionally, The advice given to those who suffer from hyperacusis is to avoid noises that bother them, or use barrier methods that muffle sounds. This avoids suffering, but in the long run it actually makes the auditory system more sensitive as it is not used to handling sounds. In addition, ultimately this makes it even more difficult to lead a normal life.

It is more advisable that the patient is exposed in a controlled manner to ambient noise levels. It is recommended that those who suffer from it have devices that help them generate a noise low enough so that it is not especially harmful but that keeps them stimulated, trying to make the nervous system gradually adapt to the most common sounds. That is, it is about generating a progressive desensitization that over time can decrease the sensitivity of the system.

Another fundamental aspect to deal with is the psychoeducation of both the subject and his environment. This last aspect is essential due to the great difficulty that it can cause to understand the patient's suffering when faced with stimuli considered "normal", demystify some aspects associated with this problem and contribute to generating patterns of behavior and socialization that make the subject feel socially supported.

At the pharmacological level, they are usually used benzodiazepines, SSRI antidepressants (remember that serotonin has been associated with some cases of hyperacusis) or even anticonvulsants. At the medical level, surgical methods have sometimes been used, although this is not common.

It may also be necessary to work on the possible appearance of depressive episodes or carry out training in anxiety management. anxiety and coping with stress, which can be both a product and a trigger element of noise sensitivity in these persons.