Sound Sensitivity vs Hyperacusis vs Misophonia: Key Differences

Many people use the term “sound sensitivity” to describe discomfort with everyday sounds. Clinically, however, sound sensitivity can mean different things depending on the underlying cause.

Three commonly confused conditions are general Sound Sensitivity vs Hyperacusis vs Misophonia Understanding the differences between them is essential for accurate diagnosis and effective management.

At Novasound Hearing & Balance Center, we frequently assess patients who have been told they are simply “sensitive to noise,” when in fact they are experiencing a specific auditory or neurological condition that requires targeted care.

What Is General Sound Sensitivity?

1. General Sound Sensitivity

General sound sensitivity is an umbrella term describing an increased awareness or reduced tolerance to sound. It is often temporary and related to nervous system overload rather than permanent auditory damage.

Common features include:

Sounds feel annoying, tiring, or overwhelming but not painful
Symptoms fluctuate from day to day
Often improves with rest and pacing

It is commonly associated with:

Stress or anxiety
Fatigue or burnout
Migraine
Post-concussion recovery

2. What Is Hyperacusis?

Hyperacusis is a neurological sound tolerance disorder in which everyday sounds are perceived as excessively loud, uncomfortable, or even painful.

It reflects altered gain control within the auditory system and its connections with the limbic (emotional) and autonomic (fight-or-flight) systems.

Common features include:

Physical discomfort or pain with sound
Reduced Loudness Discomfort Levels (LDLs) on testing
Avoidance of normal environments such as stores, restaurants, or traffic
Increased anxiety around sound exposure

Hyperacusis is frequently associated with:

Concussion or mild traumatic brain injury
Tinnitus
Migraine
Noise trauma

3. What Is Misophonia?

Misophonia is a sound tolerance condition driven primarily by emotional and autonomic responses rather than sound loudness.

Trigger sounds are usually specific, repetitive, and provoke an immediate and intense reaction.

Common features include:

Strong emotional responses such as anger, anxiety, panic, or disgust
Triggers like chewing, swallowing, breathing, tapping, or clicking sounds
Loudness itself is not the primary issue
Often linked to conditioned brain responses

Key Differences at a Glance

Condition	Primary Driver	Typical Reaction	Loudness-Based
Sound Sensitivity	Stress/fatigue	Annoyance, overload	Sometimes
Hyperacusis	Auditory gain dysregulation	Pain, discomfort	Yes
Misophonia	Emotional conditioning	Anger, distress	No

Why Proper Diagnosis Matters

Each condition requires a different treatment approach:

Hyperacusis → Graded sound therapy and nervous system regulation
Misophonia → Cognitive-behavioral strategies and trigger retraining
General sound sensitivity → Education, pacing, and stress management

Incorrect management — such as overuse of earplugs — can worsen hyperacusis, while selective sound blocking may be appropriate in misophonia.

How Novasound Can Help

At Novasound Hearing & Balance Center, we provide comprehensive sound tolerance evaluations and individualized care, including:

Loudness Discomfort Level (LDL) testing
Hyperacusis and sound tolerance questionnaires
Post-concussion auditory assessments
Individualized sound therapy and desensitization programs
Education and counselling for patients and families

When to Seek Help

A professional audiological evaluation is recommended if sound sensitivity:

Persists longer than 4–6 weeks
Interferes with work, school, or social activities
Develops after a concussion or head injury

Final Thoughts

Not all sound sensitivity is the same. Identifying whether symptoms stem from hyperacusis, misophonia, or general nervous system overload is the key to effective treatment and recovery.

Accurate diagnosis prevents unnecessary suffering and helps patients regain confidence in everyday sound environments.