Sound tolerance
When normal sounds feel painfully loud
Hyperacusis — reduced sound tolerance — affects around four in ten people with tinnitus. It often improves with structured sound exposure. a six-week ladder for hyperacusis, based on the sound-therapy components of jastreboff’s trt and aazh / moore’s decoupled cbt protocols.
Start with the screen
The Khalfa Hyperacusis Questionnaire — fourteen items, four minutes. A score of seventeen or more suggests clinical hyperacusis and points to the six-week sound-tolerance protocol below.
Sound-tolerance retraining — six weeks
- 1
Week 1 · Off the brakes
Re-enter your sound environment
3 daily exercises
- 2
Week 2 · Kitchen and home
Reclaim quiet domestic sounds
3 daily exercises
- 3
Week 3 · Out of the house
Add varied environments
3 daily exercises
- 4
Week 4 · Midway
Re-take the Khalfa
3 daily exercises
- 5
Week 5 · Speech and rhythm
Music and conversation
3 daily exercises
- 6
Week 6 · Forward
Maintenance and life-after
3 daily exercises
The three rules
- · Do not wear ear protection in everyday environments. It makes hyperacusis worse over time.
- · Add low, varied sound to every room. Silence trains the brain to over-amplify.
- · Discomfort during exposure is acceptable. Pain is not.