Typically, people with sound sensitivity issues attempt to control their environments, trying to avoid allowing certain sounds to enter the ear canals. Commonly used devices that are mechanical or material include the following:
Ear Plugs
Ear Protectors
Ear Muffs-headsets
Hearing Aids
White Noise Generators/Sound Therapy Units
Music Based Therapy Approaches--mixed with overlay of therapy 'noise', i.e., Neuromonics. This is the latest generation of sound stimuli for treating auditory disorders and intended for tinnitus but has potential for hyperacusis treatment. Based on the neurophyisiologic model, this was developed in Australia and is just recently available in the USA. This unit has been used mostly for tinnitus management and treatment, but improvements in hyperacusis have been noted.
A few comments about each of the above....
Ear Plugs There are many choices available for earplugs, including foam types that roll up tightly and can be inserted deeply into the canals, silicone-putty types that can seal off the canal and the bowl of the ear, ones with handles and graduated soft rubber that can be forced deep into the ear, and caliper types that pinch the head with foam plugs inserted into the ears. There are also custom earplugs that come with cords, tubes, filters that can be changed, and ones with extraction handles. All sorts of color, swirls, styles, and more can be ordered from your local audiologists. Sometimes the fit is good and comfortable, sometimes not. Earplugs can run from 69 cents to over 250 dollars, depending on the style and degree of sophistication of the technology. I prefer the soft putty type ones which are kinder to the delicate ear tissues and can be more readily adjusted or flattened to allow just enough attenuation and not too much. I use them when I fly or go to noisy events. Use of earplugs does increase hyperacusis for many people, however, so be extremely selective about your usage time.
Ear Protectors Several companies make a type of hard earplug that is often called an ear defender. The acoustics are more finely tuned and predicted, and the units must be custom ordered from an audiologist. In addition, there are active hunter-style or shooter's units that can be used to boost up soft sounds while protecting one from sudden loud noises like gunfire or bus brakes. These can be ordered from an audiologist.
Ear Muffs Over the head or under the chin style ear muffs offer good sound buffering and avoids ear canal/wax impaction problems. These are very good for power tools and often used in driving or flying by people with hyperacusis. Active units have a battery operated phase-canceling capabilities that some people really love. Try to find ones that have a rating of 22 dB or higher for maximum usefulness. They can cause your head/ears to be rather sore if you use them too much. Put a cotton ball inside the bowl of the ear if moisture is a problem.
Hearing Aids People can have hearing loss AND sound sensitivity, as odd as that may sound. A big part of the problem is the loss of stimulation of the auditory pathways and central nervous system, and the resulting loss of tolerance for any sounds once they reach a certain volume. This is known as recruitment, and many people who have hearing loss also have recruitment. Hearing Aids must be carefully adjusted and checked to allow for amplification without over amplification! This is a tricky business and we do quite a bit of advising for hearing aid dispensers just about this very topic. People can also have a combination of hyperacusis AND recruitment and this makes the hearing aid setting even more difficult. Finally, hearing aids that are computer programmable and have more features are much easier to set for patients with these conditions.
White Noise Generators/Sound Therapy Units Dr. Pawel Jastreboff discovered and created the method of using broad band white noise in tinnitus treatment with his colleague, Dr. Jonathan Hazell, in the early 1980's. These units are not maskers, which attempt to use a slightly tuned sound to drown out or overcome the sound of tinnitus. Maskers are not useful in the treatment of hyperacusis, whereas white noise generators are the state of the art devices. Using gentle, low levels of white noise to desensitize the hearing of a person with hyperacusis does require a period of time, about six months on average, and patients generally tolerate these very well. Custom units fit behind the ears or in the ears, and come in a variety of models to meet individual needs. The setting and personal schedule for using these is something we provide in our clinical setting, and this is where experience and professionalism play a huge role for a positive treatment outcome. As far as I am aware, the use of these devices, when combined with counseling and proper evaluation, is the only current treatment method available in the world for hyperacusis, besides drug therapy which address the secondary complaints of depression, anxiety, panic, or insomnia related to hyperacusis.
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