About Hyperacusis

Introductory Information About Hyperacusis

Dr. Marsha A. Johnson, TRT Specialist, Audiologist, member of TRTA



Abnormal sensitivity to everyday sound levels or noises, often sensitivity to higher pitched sounds, in the presence of essentially normal hearing.


At this point in time, there have been associations with certain disease processes as well as head injuries, i.e., closed head injury, even mild in nature. Noise induced auditory system trauma is another strong candidate for creating hyperacusis, but no definitive data has been accumulated. There is also some evidence that points to a brain chemistry dysfunction with poor uptake of certain chemicals, as well as another theory in which there is a disturbance in the part of the auditory system which brings information from the brain to the ear, thereby causing faulty amplification of sounds. As you can see, there is much to be learned about this condition.


Generally speaking, about 40% of individuals who visit this clinic have hyperacusis as well as tinnitus, and about 10% of individuals who receive treatment have only hyperacusis.

Treatment Protocol:

Patients who enroll in this clinic receive special evaluation for hyperacusis at the initial evaluation. If present, the hyperacusis is rated in severity from mild (loudness discomfort level thresholds are near normal at 90+ dB at all frequencies) to profound (thresholds for loudness tolerance are nearly identical to air conducted measurements for sound detection).

The Johnson Hyperacusis Quotient is used to rate severity and judge progress. Patients who have hyperacusis identified will always receive treatment for this​​ condition first, prior to therapy for tinnitus. Dr. Pawel Jastreboff's Habituation Therapy has been found to be the premiere treatment for hyperacusis at this time. Many patients find rapid improvement during the first 6 months of therapy.

Treatment requires intensive directive educational counseling, frequent follow-ups and office visits, and often, the use of two sound therapy devices. These devices, if prescribed, are worn at least 8 hours a day. The patient is advised to increase and maintain a constant environmental noise level, and to avoid silence.

Hyperacusis can often be found in children or young adults, and we offer a therapy for sub-categories including Soft Sound Sensitivity Syndrome, which often affects pre-pubescent children and can be very disruptive to home and school life. Children are welcome to enter our Pediatric Clinic Program to discover if our unique therapy will improve their sound tolerance. Since 1997, this clinic has pioneered in assessment and treatment of hyperacusis in children as young as 3 years old. New information will be added to this site as our clinical trials are completed.

The use of sound therapy combined with other protocols has helped over 100 children, returning them to the dinner table, to the classroom, and to a healthy social life where sound does not dominate their lives. Effective treatments are rare in this particular area, and we will be conducting more research.