From the Research
Hyperacusis treatment should prioritize sound therapy, as it has been shown to be effective in reducing auditory gain and increasing loudness tolerance, according to the most recent and highest quality study 1.
Treatment Options
- Sound therapy: gradually reintroduces sounds to desensitize the auditory system, typically using white noise generators or hearing aids with sound generators for 2-3 hours daily over several months
- Cognitive behavioral therapy (CBT): helps patients develop coping strategies and reduce anxiety associated with sound sensitivity through weekly sessions for 8-12 weeks
- Tinnitus retraining therapy (TRT): combines sound therapy with educational counseling in a structured program lasting 12-18 months
- Medications: such as low-dose antidepressants (amitriptyline 10-25mg daily), anxiolytics (lorazepam 0.5-1mg as needed), or anticonvulsants (gabapentin 300-900mg daily) may help manage symptoms but aren't curative
Lifestyle Modifications
- Using earplugs only when necessary (overuse can worsen sensitivity)
- Avoiding loud environments
- Implementing stress reduction techniques The underlying mechanism involves hyperactivity in the auditory pathways, which these treatments aim to normalize through neuroplasticity and habituation processes, as supported by studies 2, 3, 4. Additionally, a multidisciplinary approach to hyperacusis management is necessary, as highlighted by the lack of uniform education and barriers to evidence-based diagnosis and management reported by clinical audiologists in the United States 5.