The Close Relationship of Tinnitus and Hyperacusis

Tinnitus is a fairly well-known condition.  It refers to a ringing in the ears.  While this is what the person experiencing it will hear, there is no measurable or “real” sound to be heard by anyone else.  For many people that is where the problem ends, but for about 40 percent of tinnitus sufferers, hyperacusis will eventually follow.

Many people suffer from tinnitus, about 17 percent of the general population.  It is even higher for older people—around 33 percent of them deal with it.  For some it is just a minor annoyance, but for others tinnitus is overwhelming.

There is a definite process at work when tinnitus occurs.  When sound falls on the ear, it travels along the auditory nerve.  As it travels, the information it carries is processed before the sound is heard.  This processing is also at work for the hyperacusis sufferer.  In tinnitus patients, the sound may be distinguished as new or negative and thus enhanced as a significant sound is.  This can begin a state of hyperacusis, in which all the sounds will be deemed by the processing to be negative and they all will be enhanced.  It has been shown that when the perceptions of the auditory system are enhanced, the level of sound a person will be able to tolerate is lowered.  Thus, tinnitus can lead to hyperacusis.

 It has been thought in the past that the auditory functioning was most important in tinnitus and hyperacusis.  Now it is believed that the fight or flight response is the most important part of the equation and the auditory apparatus is only secondary.  In other words, the emotion and automatic response to a signal is more important than the physicality of how we hear it.

Some tinnitus and hyperacusis patients in the past have been victims of negative counseling.  One instance of this is when a doctor will tell that person to just get used to it because there is nothing he or she can do.  Conversely, a doctor might cause negative emotions by suggesting that it is caused by a brain tumor or a serious psychiatric condition.  Neither types of counseling helps.  The ringing in the ears won’t go away, and everyday sounds won’t start sounding the way they should with this kind of advice.  The most successful method for treating both tinnitus and hyperacusis is now thought to be Tinnitus Retraining Therapy. 

Although much is still not known about tinnitus and hyperacusis, it is already evident that there is a link.  It has also been shown that Tinnitus Retraining Therapy can alleviate both.  With more time and knowledge, there may come even better therapies.  Who knows?