Multiple Sclerosis and Noise Intolerance

Understanding Hyperacusis and Sound Hypersensitivity

Hyperacusis in a woman with multiple sclerosis
Ian Hooton/Science Photo Library/Getty Images

It is not unusual for people to become less tolerant to loud noises as they get older, and it's not just about being ornery or intolerant. Physiological abnormalities can cause an increased sensitivity to certain sounds even as you lose the ability to hear other sounds or frequencies.

Those sensitivities may be further aggravated in people with multiple sclerosis (MS) and lead to a condition known as hyperacusis in which a person can experience pain or discomfort in response to certain frequencies and sound volumes.

Understanding Hyperacusis

Hyperacusis is characterized by an increased sensitivity to everyday sounds which are unpleasant to the affected person but no one else. While any number of conditions can cause hyperacusis (ranging from ear infections or acoustical shock), it is most often seen in persons 50 and over. 

From a broad perspective, hyperacusis can be characterized as either:

  • Central hyperacusis, affecting the cochlea and the auditory nerves regulating hearing and sound amplification
  • Vestibular hyperacusis, affecting the inner ear and the nerves associated with balance

The causes of each can also vary. With central hyperacusis, a person may feel ear pain, discomfort, and annoyance when certain sounds are heard, even very soft or high-pitched sounds. With vestibular hyperacusis, a person is more prone to experience a loss of balance, nausea, or vertigo. Hyperacusis can affect one or both ears.

While it shouldn't be confused with phonophobia (the fear of loud sounds), hyperacusis can, in fact, lead to phonophobia in persons perpetually rattled by the abnormally amplified sounds.

Multiple Sclerosis and Hyperacusis

Multiple sclerosis is a demyelinating disease which strips away the protective coating on nerve cells (known as the myelin sheath).

This not only causes the nerves to function abnormally, it leads to scarring and progressive development of lesions on the brain and/or spinal cord. Hyperacusis is caused when lesions form on specific parts of the brain, namely the brain stem which regulates hearing and balance. 

The fallout from hyperacusis is not just physical. Persons experiencing pain, annoyance, or discomfort as a result of hyperacusis are more likely to isolate themselves. Anxiety and depression are common and may further complicate the psychological symptoms of MS.

More concerning yet is the fact that there is no specific treatment for hyperacusis. This doesn't mean there is nothing one can do. Many so-called "retraining therapies" have proven successful in reducing the emotional and physical impact of the disorder while improving a person's coping skills and overall quality of life.

Tips for Managing Sound Intolerance

Retraining techniques for hyperacusis consist of counseling and acoustic therapy. The aim is to reduce a patient's reactions to hyperacusis and to view sound in a more positive way.

In the past, people would often resort to using sound-blocking earplugs to treat the condition. The problem with this is that the constant blocking of sound recalibrates a person's hearing to compensate for the hearing loss.

Once the earplugs are removed, the over-amplification of sound may actually worsen rather and cause further distress.

Auditory retraining, by contrast, employs techniques by which a person becomes more mindful and less reactive to sound. The process involves certain basic principles and self-help techniques:

  • Start by segregating sounds in your environment. Get rid of the excess noises that we often forget are there (like a TV in the next room, a ticking clock, a spinning hard drive, a bathroom fan).
  • Learn to focus on one sound at a time. As you begin to do so in your own environment, you can slowly apply the same technique in other controlled situations with family or friends.
  • Identify the specific sounds that trigger hyperacusis. The more you become aware of these, the more you can anticipate them and avoid an emotional response.  
  • Tell others that you are especially sensitive to noise. In most cases, people will respond positively and lower the excessive noise in the room.

A Word From Verywell

While there are no easy answers for a condition like hyperacusis (or its cousin misophonia), there are options. If faced with an aggravating condition like hyperacusis, don't suffer in silence. If it's impacting your ability to function, ask your doctor for a referral to a qualified audiologist.

Alternately, you search the online directory of the American Academy of Audiology or contact your health insurer for professionals in your area. The audiologist will be able to conduct a complete hearing evaluation and discuss treatment options with you.

Sources:

Auerbach, B.; Rodrigues, B; and Salvi, R. "Central Gain Control in Tinnitus and Hyperacusis." Front Neurol. 2014; 5:206.

Valadbeigi, A.; Weisi, F.; Rohbaksh, N. et al.“Central auditory processing and word discrimination in patients with multiple sclerosis.”Eur Arch Otorhinolaryngol. 2014; 271(11):2891-96.

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