What Is Phonophobia?

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Introduction

Have you ever thought about being super scared of loud noises, like alarms or really loud music? That's what Phonophobia is – it's when everyday sounds feel scary. Sometimes, people might have something called phonophobia or misophonia. These can make certain sounds feel unbearable, and they might react with lots of fear or annoyance when they hear these sounds. Getting mad, having panic attacks, or feeling nervous are things that can happen because of these feelings.

  1. Definition of phonophobia 

Phonophobia, which is the fear of loud sounds, isn't just about not liking noise. It's like feeling scared when you hear a really loud noise all of a sudden. Some people might even get anxious if they know there's a chance they could hear a loud noise. It's not a problem with their ears but more about how their brain reacts to loud sounds. For example, if someone suddenly played really loud music after a quiet part, it could 

scare them. Even something like a balloon popping can be frightening for them because they expect a loud noise. It's interesting how these things can affect people, even though it might seem surprising to others.1

  1. Impact of Phonophobia on Lifestyle

If you're dealing with really strong Phonophobia, it might make you not want to go out much. And even everyday sounds can bother you a lot, like using a vacuum or watching TV. Going to noisy places like malls, restaurants, or movie theatres might be tough. It could also affect your job and hanging out with friends. But here's the good part – in most cases, you can do things to make it better.2

Understanding phonophobia

  1. How common is phonophobia?

Doctors are still trying to understand how many people have hyperacusis, a condition where sounds seem too loud. For kids and teenagers, it could be between 3.2% and 17.1%, and for adults, it could be from 8% to 15.2%. But it's a bit tricky to be exact, because everyone with hyperacusis describes their feelings differently. Also, there isn't a common test to measure it yet. So, researchers are still figuring out how many people have this issue.3

  1. Causes and triggers of phonophobia

Researchers are still trying to figure out why some people have hyperacusis, which makes everyday sounds seem way too loud. It might 

have to do with how the brain handles sound signals. Normally, the brain knows when to treat sounds as loud or quiet, like thunder, talking, or sirens. But with hyperacusis, the brain thinks almost everything is super loud.4

There are a few ideas about why this happens. One is that if the parts that carry sound signals in your ear and face get hurt, you might end up with hyperacusis. For example, if you're around really loud noises a lot, like musicians who play rock music or people working on noisy construction sites, your ears might get damaged. Even a sudden loud noise, like fireworks or a gunshot, could trigger hyperacusis in some people.5

Sometimes, hyperacusis comes along with other things like a ringing in the ears (called tinnitus) or certain conditions like Williams syndrome. Things like anxiety, autism, or ear infections can also be linked to hyperacusis. Even if you've had surgery or taken certain medications, hyperacusis could show up. It's a bit complicated, and there's no one simple reason that explains it all.

  1. Phonophobia as a specific phobia

There are different types of fears, like being scared of one thing or many things. One type is when you get very anxious about just one thing, like loud sounds, and you end up avoiding it. This might be because something bad happened in the past related to loud noises, and that's why you're so scared of them. To understand it better, doctors might ask you about what happened before.5

  1. Relationship between phonophobia and other disorders

Scientists have looked at kids with (autism), who might behave differently and cover their ears a lot. They found that some of these kids also have issues with certain sounds being too loud. This might happen because something in their brain is not working like it should. One part of the brain 

might not like these sounds and tell another part to feel scared, which makes the sounds seem even louder. It's like a chain reaction in their brain.6

"Autism is a way that some people's brains work differently. It can make them behave in unique ways, like being sensitive to certain sounds and sometimes covering their ears. This sensitivity might be connected to how their brain processes emotions and sounds".

Symptoms of phonophobia 

  1. Types of Phonophobia 

Phonophobia or hyperacusis, which is when certain sounds become a big problem, comes in different types for different people. Some might feel like regular sounds are way too loud (loudness hyperacusis). Others could get irritated by sounds (annoyance hyperacusis). There are even those who feel pain from sounds that shouldn't hurt (pain hyperacusis). And for some, certain sounds might make them scared or anxious (fear hyperacusis). Interestingly, having one type of hyperacusis might lead to another. For instance, if normal sounds feel too loud, it could start making someone feel stressed or annoyed, which then turns into fear of going to places where they might hear those sounds. It's like a chain reaction in the way their brain reacts to sounds.7

  1. Signs and Symptoms of Phonophobia

Hyperacusis, a condition where certain sounds become bothersome, has a main symptom: people can't handle everyday sounds like they used to. It's like they're living in a world where the volume is super loud. This makes their life less enjoyable, and they might even start wearing earplugs or earmuffs to block out noise when they're outside.8

For them, sounds that most people don't even notice can suddenly feel annoying and even painful. The worst ones are sharp, sudden noises like alarms, bus brakes, and loud clattering. They become so sensitive to noise that they might even get scared of sounds and avoid places where they think they might hear them. This can make them avoid going out and being around people.

Diagnosis and management of phonophobia

There aren't any tests to say for sure if you're sensitive to sounds. Doctors mostly rely on what you tell them about how you feel. They might do ear tests just to check if your ears are healthy. If you're sensitive to noise, it's usually because of things like too much loud noise or getting older, and there's no cure once it starts. But avoiding loud noise can help.

Sometimes, people might mistake other ear problems for being sensitive to noise. These can be treated, so it's important to get your ears checked.

For those who are sensitive to noise, there are different things you can do:

  • Using ear protection: Like when you're around really loud things. But you don't need it all the time.
  • Getting used to everyday sounds again: This can help you not feel so bothered.
  • Asking people to talk normally: Sometimes, loud voices can be annoying.
  • Talk to someone if you're struggling, like a counsellor or psychologist who can help you deal with the feelings.
  • Trying special hearing aids: These can make you get used to soft sounds, so you're not so sensitive.
  • Taking medicine to help you sleep: Sometimes, this can help, especially if you're having trouble sleeping.

Remember, knowing that it's not a dangerous problem can make you feel better about it.9

Summary

  1. Phonophobia is the fear of loud sounds, making everyday noises feel scary. Some people also have similar issues called phonophobia or misophonia, causing them to react with fear or annoyance to certain sounds, leading to emotional reactions like anger, panic attacks, or nervousness.
  2. Phonophobia isn't just about disliking noise; it's about feeling scared when there's a loud sound suddenly. It's not about the ears but how the brain reacts to loudness. This fear could even be triggered by unexpected loud music or a balloon popping.
  3. Strong phonophobia might make people avoid going out and find everyday sounds uncomfortable, like using a vacuum or watching TV. Noisy places, work, and socialising can also be tough. However, there are ways to make it better.
  4. Doctors are still figuring out how common phonophobia is. It could be linked to things like too much loud noise, how the brain handles sounds or other conditions like autism and anxiety.
  5. Phonophobia might happen if parts in your ear and face that carry sound signals get hurt. Other things like ringing in the ears or certain conditions might also be connected. It's not just one simple reason.
  6. Phonophobia comes in different types, making people scared, annoyed, or even in pain from sounds. Having one type might lead to another, like fear coming from being annoyed or stressed by loudness.
  7. People with phonophobia find regular sounds bothersome and might wear ear protection or avoid noisy places. There aren't clear tests to diagnose it, and there's no cure, but avoiding loud noise and talking to professionals can help manage it.

References

  1. Aazh H, Knipper M, Danesh AA, Cavanna AE, Andersson L, Paulin J, et al. Insights from the Third International Conference on Hyperacusis: Causes, Evaluation, Diagnosis, and Treatment. Noise Health [Internet]. 2018 [cited 2023 Aug 25];20:162–70. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122267/
  2. Fackrell K, Sereda M, Smith S, Sheldrake J, Hoare DJ. What Should Be Considered When Assessing Hyperacusis? A Qualitative Analysis of Problems Reported by Hyperacusis Patients. Brain Sci [Internet]. 2022 [cited 2023 Aug 25];12:1615. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9775019/
  3. Hyperacusis: Hearing Sensitivity Causes and Treatment [Internet]. Cleveland Clinic. [cited 2023 Aug 25]. Available from: https://my.clevelandclinic.org/health/diseases/24320-hyperacusis
  4. Services D of H& H. Hearing problems - hyperacusis [Internet]. [cited 2023 Aug 25]. Available from: http://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hearing-problems-reduced-tolerance-to-sound
  5. Hyperacusis Symptoms [Internet]. ucsfhealth.org. [cited 2023 Aug 25]. Available from: https://www.ucsfhealth.org/conditions/hyperacusis/symptoms
  6. Noise sensitivity (hyperacusis) [Internet]. nhs. uk. 2017 [cited 2023 Aug 25]. Available from: https://www.nhs.uk/conditions/hyperacusis/
  7. Four Types | Hyperacusis [Internet]. Hearing Health Foundation. [cited 2023 Aug 25]. Available from: https://hearinghealthfoundation.org/types-of-hyperacusis
  8. Asha’ari ZA, Mat Zain N, Razali A. Phonophobia and Hyperacusis: Practical Points from a Case Report. Malays J Med Sci [Internet]. 2010 [cited 2023 Aug 25];17:49–51. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216140/
  9. Henry JA, Theodoroff SM, Edmonds C, Martinez I, Myers PJ, Zaugg TL, et al. Sound Tolerance Conditions (Hyperacusis, Misophonia, Noise Sensitivity, and Phonophobia): Definitions and Clinical Management. Am J Audiol. 2022;31:513–27.

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