Hyperacusis and Overprotecting vs Underprotecting Hearing — Let's Discuss Specific Scenarios

[Mr_Orange_3737]

I listened to the Tinnitus Talk Podcast on hyperacusis where this subject was addressed. A takeaway was to slightly prioritize protection to avoid major setbacks.

There isn't enough elaboration on what specifically to protect against. I fully empathize with the idea that every person's tolerance level is different and you can't give one-size-fits-all advice. However, when reading through a lot of threads on this topic, I'm left with this vagueness that has caused me a lot of paranoia and I think we need at least more clarity from those with more experience.

For me, because of COVID-19 and working from home, it's currently not difficult to avoid the obvious loud scenarios (concerts, loud music, movie theaters, walking down busy streets, driving with the windows down, vacuuming, sounds over 85dB). Okay, got it.

However, there are plenty of irritating scenarios well below the obvious 85dB hearing damage limit. I'd like to provide a space in this thread to those new to sound sensitivity to ask questions about these gray-area scenarios where it is unclear whether they warrant protection or tolerance build-up. For those who have more experience with this, please leave some insight as to whether we should: use ear protection (low NRR 17 vs high NRR 32), build up a tolerance, or limit the amount of time in these scenarios. And also help distinguish whether we have just mild sound sensitivity or true hyperacusis.

I bought a dB reader so I've measured the actual loudness of some of my scenarios. I also have a few earplugs ranging from NRR 5 to NRR 32 to allow me to fine tune the level of protection.

I'll start off with a few good examples that I think are common:

Driving on the freeway (Windows up) for more than 30 minutes and listening to music: I measured this to be around 70-80dB. I generally feel okay but I do get a mild increase in my tinnitus after walking back into a room that's brief. I tried using the lowest level NRR 5 earplugs once and I noticed that it made listening to music and podcasts easier on the ears. Should I keep using earplugs or is this fine to build up a tolerance to this?

Listening to music/podcasts at home. Never above 70dB. This one has some unique qualities to me. Irritation can vary a lot depending on sound quality and time of the day. I also noticed that less powerful speakers like the one in your phone or in your laptop are less irritating. I've been listening to everything at the lowest level I can get away with. What do you think? Build up tolerance since it is below 85dB or remain cautious?

Loud clanking like doing dishes, putting down a glass cup, and putting down silverware. This one is a common symptom you read a lot about. It's an interesting one because these moments can be brief but are often the most irritating. I've been putting silverware and dishes down as gently as I can and have actually gotten sort of good at it. But should I actually try to take on these noises more and more? There so many things like this too like the sound of your car doors locking, someone slamming the apartment gate? Are these brief but somewhat frequent encounters throughout the day able to cause setbacks?

Shower. 70-80dB. I've been shortening my time in there to 3 minutes. Again, not hearing loss damage levels but close. Is it worth the caution?

 

[MindOverMatter]

@Mr_Orange_3737

This is an interesting thread. You do not have pain hyperacusis?

I can relate to your post in many ways, and on a general basis I'd say slowly building up your tolerance is the way to go. There will be setbacks along the road for sure, but only minor once as long as you protect against loud sounds over your tolerance level.

Using ear protection for everyday noises will make your ears even more sensitive. Expose your ears slowly to sounds that makes you feel uncomfortable. Take a step back if needed. The process is by no means linear.

A tip is to add a positive sound alongside with the negative loaded sounds that makes your ears react. For instance, if you are at the kitchen with clanking and so on, listen to a podcast or music you prefer, on a low level, and try to concentrate towards the positive sound. This is a desensitization tool that over time teaches the brain to tune out the sounds you react negatively towards.

If you do not expose yourself, you will risk developing phonophobia to everyday sounds. Taking a longer shower for instance will not harm you in my opinion.

 

[Mr_Orange_3737]

Thanks for the tips. I'll definitely try the positive/negative loaded sounds advice.

Ya, I figured that if anyone is really suffering from this, it's going to be pretty obvious you're not going to the 3 day music festival. What we need to sort out is the gray area. If we're going to say things like 'don't ever use earbuds even at low volumes' then yes, it's worth sifting through the minutia.

I do not have pain but those clanking sounds especially do seem to make me tense up a bit. They basically sound almost 3 times as sharp as they use to. A good way to put it is: when you have ear plugs in, you actually get to experience those sounds more like you use to before the H.

A reason I wanted to start this thread was because I noticed my hyperacusis getting worse. I didn't know if it was because I was over or under protecting. I'm only 2 months in since my mild tinnitus started from syringing and the hyperacusis is something that gradually crept in. In the last week or 2, I noticed more things were being added to the list of annoyances. My pen dropping, doors locking in my car, paper tearing, plastic bottle scrunching, and the sounds of my neighbors upstairs (which never bothered me for 6 years) all were fine about a month ago. I've had very brief encounters with loud noises here and there like a loud car driving by, a train horn in the distance, a helicopter flying overhead, and a ice cream cart horn so I'm not sure if these would warrant a setback. Oddly enough, my tinnitus has been quieter for more parts of the day.

The shower is an interesting one because it never actually bothered me as I was taking it. It did increase the tinnitus afterwards in a brief way. It wasn't until I found it being close to 80dB that I began to worry.

A good thing to add here would be things that actually gave you a setback. Is it ever anything surprising under 85dB?

I'll throw in some more:

Windows partially open near a semi busy street:
I've been playing around with this one because I wondering if it's a way of conditioning you to city sounds. It also serves as a alternative to just constantly having nature sounds as enrichment. My instinct is this one might be okay since it doesn't increase the room volume by too much.

Riding a bike in the part with a cassette hub:
The hub is constantly making a clicking noise of about 70dB measured from the position of your head on a bike. I'm riding around for about an hour. This is similar to the car one; is 70dB for an hour too much for hyperacusis? Maybe throw on the lowest protection ear plug for a bit?

 

[MindOverMatter]

@Mr_Orange_3737

It is so difficult to advice on this because it's so individual. But I guess it's important to find your own balance with this.

If riding a car for some time makes your ears act up, its okay to use some protection for a while. But I would suggest use music high fidelity ones instead to filter the sound instead of partially block it. This is however just based on my own experiences.

The factor that makes the whole hyperacusis (+tinnitus) experience the most challenging is how it fluctuates in a way from day to day. As you describe, if hyperacusis is worse tinnitus seems lower. But it might be the brain playing tricks with us - brain plasticity is a complex matter.

I think it's important to know that even though 80 dB in the shower for instance seems loud/makes you uncomfortable, it can not damage your ears.

'don't ever use earbuds even at low volumes'... this quote has, as far as I know, no scientific evidence. That being said, I dont use them anymore. And my general advice would probably be not to use them. There Are better and safer alternatives.

 

[Juan]

Driving on the freeway (Windows up) for more than 30 minutes and listening to music: I measured this to be around 70-80dB.

Ok, so I am going to discuss your specific scenarios haha... windows up on a freeway. That's a no-no. I think it is louder than 80 dB, and the faster you drive, the louder it is. But the real risk is getting overtaken by a very loud bike or truck. That would hurt like hell.

Listening to music/podcasts at home.

For me this was a no issue even with very bad hyperacusis. Just adjust the volume and be ready to mute if the podcast, video, music, could likely include some nasty sound (in terms of frequency / pitch). Your ears should be able to cope more and more with recorded sound over time.

Loud clanking like doing dishes, putting down a glass cup, and putting down silverware.

I'm also a master at the "quiet eating" and "quiet doing dishes" haha... the sound is nasty indeed, in pitch and volume. Either be very careful (dish or cutlery slipping... auchh) or the go the easy way: use earmuffs.

Riding a bike in the part with a cassette hub:
The hub is constantly making a clicking noise of about 70dB measured from the position of your head on a bike. I'm riding around for about an hour. This is similar to the car one; is 70dB for an hour too much for hyperacusis? Maybe throw on the lowest protection ear plug for a bit?

For me the trickiest part of this one is not the bike itself but the surrounding noises, traffic, construction works, etc So even if this is not a very good solution I use earplugs for biking. And on a bumpy surface, the earplugs maybe conduct sound, but this is an ok solution for two bad situations (no earplugs or earplugs and sound conduction).

The shower is an interesting one because it never actually bothered me as I was taking it. It did increase the tinnitus afterwards in a brief way. It wasn't until I found it being close to 80dB that I began to worry.

This one is tricky. It did sound like Niagara Falls to me at the beginning, so I would use foam earplugs. Be careful with water not entering your ears. After a while, I showered without any hearing protection at all. Sometimes water does fall in this way on the bathtub and makes that horrible slapping sound though... and by the way, I found trickier opening plastic shampoo containers etc than the water itself..

I am surprised you did not mention unpackaging stuff, even food items, as plastic produces one of the most annoying sounds.

 

[Mr_Orange_3737]

If riding a car for some time makes your ears act up, its okay to use some protection for a while. But I would suggest use music high fidelity ones instead to filter the sound instead of partially block it. This is however just based on my own experiences.

Yes, to clarify, those are the types I'm using. I have the EarPeace and Earasers ones.

Juan, a good point you bring up for the outdoor related scenarios is that it's more about the extra loud situations you may encounter here and there like the loud motorcycle or truck.

I had my dB meter on in the freeway and it's usually between 70-80 dB most of the time but this could depend on the car type and how loud your music is on top of that.

For biking, I'm either riding my mountain bike on easier flowy trails now or riding my BMX bike in a large park area and not near any busy traffic. I have the type of helmet (Giro switchblade) that covers your ears so it blocks some wind too. Also, EarPeace makes moto specific earplugs which may be ideal for biking too.

Opening plastic packaging (especially frozen veggies which I deal with a lot), opening zip lock bags, and dealing with packing tape are for sure a thing. I think similar to the dishes, you don't actually do these things for that long and often not all at once so it feels like it doesn't warrant putting earplugs in for.....but they actually are the hardest things on your ears. It's not like driving on the freeway where you know you'll be committed to a 30 minute chunk of time.

 

[LindaS]

Ok, so I am going to discuss your specific scenarios haha... windows up on a freeway. That's a no-no. I think it is louder than 80 dB, and the faster you drive, the louder it is. But the real risk is getting overtaken by a very loud bike or truck. That would hurt like hell.

Can you clarify your comment above please.

I have pain hyperacusis. My son and his family live 1 hour and 40 minutes away. Since the onset of tinnitus and hyperacusis I have not gone to visit them.

Are you saying that anyone with hyperacusis should not be travelling on freeways at all?

I can see why but I don't want to miss out on seeing my son and grandchildren... it is easier for them for me to go there than to bring five children (one just a few weeks old) to my house.

What if someone else drives and I wear ear plugs and ear muffs? Would that work?

Any guidance would be greatly appreciated.

 

[weab00]

I don't know, people often say that over-protecting is detrimental to progress. But I literally can't walk on the street without earplugs, otherwise I experience sharp stabbing pain that radiates down my neck and it can be delayed up to an hour after the noise. So I don't understand what people who tout this methodology have to say in response to my pain? Am I supposed to grin and bear it? I think I will trust my ears first and foremost.

 

[Mr_Orange_3737]

I don't know, people often say that over-protecting is detrimental to progress. But I literally can't walk on the street without earplugs, otherwise I experience sharp stabbing pain that radiates down my neck

I can quickly appreciate how pain hyperacusis is just a different beast. It'd be great if someone who's made progress with this can lend some advice.

This morning I was loading some stuff into my van when suddenly my car alarm went off. Not sure what I did to trigger it but luckily I was able to turn it off within 4 seconds and also my head was sort of tucked into the middle door a bit. Later in the day, a loud plane flew right over me. When I got back home at night, someone set off a firework in the distance just as I opened my car door (I quickly closed it). It's just so unpredictable being outdoors. I totally get why you'd prioritize protection.

However, there's something to the idea of building tolerance too. I used some NRR 11 earplugs (higher than the NRR 5 Earasers I normally use) driving 30 minutes on the freeway to a friend's place today. This was in the afternoon and earlier in the day I was in a much quieter environment. As soon as I started hanging out, my friend's voice was so hard to listen to. We were watching some stuff on the TV and that was bugging me so much too. Everything was piercing. I had to go lie down and take break in another room. I noticed that about an hour later though, we started talking again and the H had gone down. We were eating and I noticed that as I got more lost in conversation, even dishes and silverware clanking seemed easier to ignore.

There's also something about having ambient noise in the back while having conversation or listening to podcasts that dampens the hyperacusis too. When I'm outdoors or when I'm in a car with the engine noise going, it seems easier to tolerate speech and music than just being in a quiet room.

 

[Juan]

Can you clarify your comment above please.

I have pain hyperacusis. My son and his family live 1 hour and 40 minutes away. Since the onset of tinnitus and hyperacusis I have not gone to visit them.

Are you saying that anyone with hyperacusis should not be travelling on freeways at all?

I can see why but I don't want to miss out on seeing my son and grandchildren... it is easier for them for me to go there than to bring five children (one just a few weeks old) to my house.

What if someone else drives and I wear ear plugs and ear muffs? Would that work?

Any guidance would be greatly appreciated.

First of all, it is best to drive with windows up... that's pretty obvious.

When my hyperacusis was severe I had a hard time driving long distance. At the beginning I would feel sound by bone conduction when driving with earplugs (but mind, my hyperacusis was severe, really really bad!).

I just gave a brief try to driving with earmuffs and it was fine, but the downside is that driving with earmuffs is not allowed.

Then there was a period in which I would drive using earplugs only to get out of the city (a lot more noisy that the freeway, in terms of impulse noise like car horns, sirens and the like) and on to the freeway I would remove the earplugs and drive slowly (the faster you go, the noisier it gets inside the car) and only watch out for loud trucks or motorbikes overtaking (I would cover the ear closer to the window with my hand, best I could do, the other hand on the wheel).

Over time I have lost some hearing, so now I am fine wearing earplugs for driving if needed. Wearing earplugs for hours it is pretty annoying and the ears may get pressure, or tinnitus may go up a little etc

So for long drives nowadays I don't need to wear earplugs. I still wear them in the city and at urban surroundings just in case there is the odd loud noise.

In your particular case, I think driving 1 hour and 40 minutes is doable, even with severe hyperacusis, just using earplugs for the whole trip. Your ears may feel weird afterwards, maybe there is some pressure, or tinnitus spikes a little, or you hear muffled, but these things also happen to normal people when they drive long distance without hearing protection. For normal people is the constant noise of tyres on the freeway that produces this, together with any music they may be playing (loud, without noticing how loud it is). Inside the car, at 100 km / h the noise is maybe like 70 - 75 dB, depending on type of car, tyres, a few things... and it can go up maybe another 5 - 10 dB if you drive a lot faster, let's say 140 km / h.

 

[Juan]

Juan, a good point you bring up for the outdoor related scenarios is that it's more about the extra loud situations you may encounter here and there like the loud motorcycle or truck.

Hearing issues typically worsen due to the very loud noises, that can be very brief. Actually I have lose hearing due to those circumstances, like being exposed to the fire alarm at work for like 10 seconds, or to a very loud noise nearby, just for seconds too. Sometimes this is impossible to avoid, and one cannot be thinking the alarm is going to go off at work or somewhere else, but use hearing protection when it is reasonable to expect noise (for instance, at downtown, amid traffic, in a busy city). Be very careful with that.

For biking, I'm either riding my mountain bike on easier flowy trails now or riding my BMX bike in a large park area and not near any busy traffic. I have the type of helmet (Giro switchblade) that covers your ears so it blocks some wind too. Also, EarPeace makes moto specific earplugs which may be ideal for biking too.

Have you tried those EarPeace earplugs? I am having a look at their website and they seem very pricey for what they are. It is very much an standard earplug with a little hole in the middle (similar to the ones custom musician earplugs have). So in terms of noise reduction they are inferior to the foam earplugs for sure (apparently they are actually designed so that people can ride a motorbike and listen too). I am curious about how they would perform when cycling. I am using foam earplugs for riding my bike and the feeling is so so.. I wont say it's bad, but I feel weird when I get home and remove them, it is like I hear lower and there's a bit of pressure.. but that's pretty standard with any earplug too.

Opening plastic packaging (especially frozen veggies which I deal with a lot), opening zip lock bags, and dealing with packing tape are for sure a thing. I think similar to the dishes, you don't actually do these things for that long and often not all at once so it feels like it doesn't warrant putting earplugs in for.....but they actually are the hardest things on your ears. It's not like driving on the freeway where you know you'll be committed to a 30 minute chunk of time.

The sound plastic produce is unlikely to make lasting damage, but my hyperacusis was severe and it did alter my hearing perception for a few days, so I did not want any of those plastic trays popping or making squeaky noises... my solution for this (taking into account you will be home unpacking and storing groceries) is just to put earmuffs on for a few minutes while dealing with packaging.

 

[Mr_Orange_3737]

Hearing issues typically worsen due to the very loud noises, that can be very brief. Actually I have lose hearing due to those circumstances, like being exposed to the fire alarm at work for like 10 seconds, or to a very loud noise nearby, just for seconds too. Sometimes this is impossible to avoid, and one cannot be thinking the alarm is going to go off at work or somewhere else, but use hearing protection when it is reasonable to expect noise (for instance, at downtown, amid traffic, in a busy city). Be very careful with that.

Have you tried those EarPeace earplugs? I am having a look at their website and they seem very pricey for what they are. It is very much an standard earplug with a little hole in the middle (similar to the ones custom musician earplugs have). So in terms of noise reduction they are inferior to the foam earplugs for sure (apparently they are actually designed so that people can ride a motorbike and listen too). I am curious about how they would perform when cycling. I am using foam earplugs for riding my bike and the feeling is so so.. I wont say it's bad, but I feel weird when I get home and remove them, it is like I hear lower and there's a bit of pressure.. but that's pretty standard with any earplug too.

I haven't used the EarPeace for actual mountain biking yet. Just on the freeway and when I have to walk in a busy traffic area. I just got my trail bike set up and have been just test riding it around parks and roads to dial in my stance. I'll let you know how it goes because I think the wind sound it going to be an issue. Since the downhill portion of mountain biking is pretty short, I don't think anything would qualify as overprotection so I might as well just have plugs in.

Do you do road cycling or mountain biking? I get that road cycling can mean a long duration of wind and city traffic noise.

The EarPeace ones are 24 dollars but they're reusable unlike the foam ones. I've used the foams ones before and there's for sure a different kind of feeling. However, foam ones are rated at NRR32 where the highest rating for the EarPeace is NRR19. It sounds like your hyperacusis might be worse then mines in some scenarios so be careful with that.

There was one time a hiking trail spit me out into a busy road and the amount of cars with crazy mufflers was suprising. In those situations I would rather just go for the NRR32 foam ones and just not risk it. The EarPeace is more for these gray-area situations.

Juan you've had tinnitus for a while now. What's your history with hyperacusis? It sounds like it was once much worse for you.

 

[Juan]

Do you do road cycling or mountain biking? I get that road cycling can mean a long duration of wind and city traffic noise.

Hi Mr Orange, I do road cycling, if you can call it that way... it's basically an urban route along the promenade, near the sea, very quiet in general, except for the odd noise. There is not much traffic around, but still I wear foam earplugs all the time just in case. I took up cycling again recently and bought a folding bike; it is quite addictive and I will probably buy a better road bike. I like Bianchi and Pinarello bikes!

Juan you've had tinnitus for a while now. What's your history with hyperacusis? It sounds like it was once much worse for you.

My story with hearing issues started with severe hyperacusis and without tinnitus. Fast forward a few years, and now I have hyperacusis, some hearing loss, and tinnitus (not very bad, fluctuating), together with somehow fluctuating hearing. Things are going downhill in terms of hearing deterioration... but that's life.

 

[LindaS]

@Juan

Thank you for clarifying and the additional information. I think I am going to wait until the spring to visit to give my ears a chance to get stronger. (It's only been 5 months).

I am dismayed. I read that that hyperacusis goes away within 12-24 months but it does not appear this is necessarily true.

Anyway, really appreciate your posts/information. Thank you!

 

[ShaunR]

@Juan

Thank you for clarifying and the additional information. I think I am going to wait until the spring to visit to give my ears a chance to get stronger. (It's only been 5 months).

I am dismayed. I read that that hyperacusis goes away within 12-24 months but it does not appear this is necessarily true.

Anyway, really appreciate your posts/information. Thank you!

I had a mild but still awful case of hyperacusis about 10 years ago... It took 3 maybe 4 years to go away completely... I did nothing but protect my ear.

This time around it feels so much worse. Hearing loss is worse and I have some weird face pain and weird inner ear sensitivity that is driving me literally crazy.

Wish you quick healing.

Shaun

 

[Mr_Orange_3737]

Noticed an interesting one yesterday.

Loud clanking (outdoors vs indoors): When I set my car to drive, it locks all the doors and sounds super loud. However, when I have all the windows open, I doesn't sound too bad. There's something to this idea of have other sounds present to drown out the harsh ones.

 

[weab00]

Noticed an interesting one yesterday.

Loud clanking (outdoors vs indoors): When I set my car to drive, it locks all the doors and sounds super loud. However, when I have all the windows open, I doesn't sound too bad. There's something to this idea of have other sounds present to drown out the harsh ones.

Is it because the sound is less resonant when the windows are open and less to do with the ambient noise level.

 

[Juan]

Noticed an interesting one yesterday.

Loud clanking (outdoors vs indoors): When I set my car to drive, it locks all the doors and sounds super loud. However, when I have all the windows open, I doesn't sound too bad. There's something to this idea of have other sounds present to drown out the harsh ones.

Sound bounces inside the car when it is closed and windows are down.

You can experience this inside a room, depending on the type of flooring too. Sound bounces more on tile than on wood. There are also items that sort of absorb sound, make it quieter, like carpets... the overall perception depends on how sound bounces on surfaces.

For instance, you can notice this with restaurants too... if you go to these clonic modern restaurants full of tile, glass, modern furniture, sound bounces a lot. If the interior is mainly wood, there are booths, and depending of the type of other furniture too, sound may be perceived less loud.

 

[LindaS]

@Juan

You mentioned in one of the posts above that you had severe hyperacusis at one time.

Was it pain hyperacusis?
How long was it severe for you?
How did you cope during that time?
What did you do or what helped you?

I am hoping your story can give me hope and help me.

 

[weab00]

@Juan

You mentioned in one of the posts above that you had severe hyperacusis at one time.

Was it pain hyperacusis?
How long was it severe for you?
How did you cope during that time?
What did you do or what helped you?

I am hoping your story can give me hope and help me.

Respectfully I don't think you'll find any hope in Juan's story. He said that overtime his hyperacusis faded into hearing loss due to repeat exposure to unexpected loud noises. All the while still having some level of pain hyperacusis, I believe. He can clarify of course.

 

[Mr_Orange_3737]

Sound bounces inside the car when it is closed and windows are down.

You can experience this inside a room, depending on the type of flooring too. Sound bounces more on tile than on wood. There are also items that sort of absorb sound, make it quieter, like carpets... the overall perception depends on how sound bounces on surfaces.

For instance, you can notice this with restaurants too... if you go to these clonic modern restaurants full of tile, glass, modern furniture, sound bounces a lot. If the interior is mainly wood, there are booths, and depending of the type of other furniture too, sound may be perceived less loud.

I see, thanks for the explanation. I began to take on some of the advice I found in this video for those types of situations:



There's some good tips in there.

He talks about how you should breath and stay calm when encountering these types of clanking sounds (under 85 dB) and not be hypervigilant in always bracing yourself for impact.

I think it's been working for me. My tolerance has definitely been improving.

Here's a few more things I picked up on:

Adjusting EQ levels: If you have trouble listening to videos and podcasts, try adjusting EQ. I've noticed certain presets for listening to speech have the bass much lower and the treble higher. This seemed to help me.

Ear plugs with wearable cords. I just ordered some of these:
https://www.amazon.com/gp/product/B07S7DMXG5/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1
I never use to use wireless earbuds was always use to have earbuds hanging around my neck. I think this will give you much quicker access. My area has so many small planes and trains with their loud horns coming by. I can't be panicking fumbling through pockets all the time. Hopefully this works better.

Building up throughout the day: I've noticed that listening to something softer in the morning, going for a quick drive and run for something outdoors, keeping the windows slighting cracked open, and slowly ramping up the volume throughout the day helps. My sound tolerance is always better by the end of the day.

 

[Juan]

I see, thanks for the explanation. I began to take on some of the advice I found in this video for those types of situations

There's some good tips in there.

He talks about how you should breath and stay calm when encountering these types of clanking sounds (under 85 dB) and not be hypervigilant in always bracing yourself for impact.

I think it's been working for me. My tolerance has definitely been improving.

Here's a few more things I picked up on:

Adjusting EQ levels: If you have trouble listening to videos and podcasts, try adjusting EQ. I've noticed certain presets for listening to speech have the bass much lower and the treble higher. This seemed to help me.

Ear plugs with wearable cords. I just ordered some of these:
https://www.amazon.com/gp/product/B07S7DMXG5/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1
I never use to use wireless earbuds was always use to have earbuds hanging around my neck. I think this will give you much quicker access. My area has so many small planes and trains with their loud horns coming by. I can't be panicking fumbling through pockets all the time. Hopefully this works better.

Building up throughout the day: I've noticed that listening to something softer in the morning, going for a quick drive and run for something outdoors, keeping the windows slighting cracked open, and slowly ramping up the volume throughout the day helps. My sound tolerance is always better by the end of the day.

I suspect that guy on the video never had true hyperacusis...

 

[Alessandro Rossi]

As an ex-musician I really think that I would need an audio device (earplugs or something) that reduces ONLY peaks of volume, like a real time limiter/compressor. Like for dishes, horns, motorcycles, etc. (motorcycles are the worst situation for me, luckily winter is coming...).

Like, setting up this device to my tolerance and than slowly reduce the limiting/compressing after some months.

Is there something like that?

 

[Mr_Orange_3737]

I suspect that guy on the video never had true hyperacusis...

I think mines may even be milder than his.

Juan, I remember thinking it was odd that you said listening to speech and podcasts wasn't a big issue for you even though your overall hyperacusis seemed greater. It think symptoms can vary for people in certain areas.

I was thinking of something that can quickly help narrow things down for a lot of people: When people generally warn against over-use of ear protection on these forums, are you imagining someone who is wearing ear plugs for over a hour at a time, multiple times a day, everyday? Describe to us what you're actually picturing.

Here's another way to phrase this question: When you say that over-use of ear protection can increase your sensitivity to sound, have you ever had ear plugs in one hour, and then notic

I've noticed that the majority of what I'm protecting against is just loud cars and motorcycles in-between getting out of my car and going into a building. Luckily for where I'm living, I don't have to do much long walking down busy streets. If I make it a rule to put on ear protection anytime I'm outdoors, it may seem like I'm doing this a lot or obsessively but I don't even think this adds up to a total of 1 hour per day. So does this actually qualify as over protection? There might need to be a distinction between frequency and duration when we're talking about ear plug use.

This needs to be cleared up because even in the few amount of times I'm actually outdoors, it's amazing how many of those extra loud yet sounds (motorcycles, honking, car alarms going off, planes, helicopters) you encounter. When people say don't overprotect, maybe this shouldn't be confused with not being cautious.

So what do you think: use earplugs as often as you need to if it doesn't actually add up to that much time?

An analogy I thought of is: Yes, definitely put on sunglasses if you happen to be facing the sun for a long period, but don't keep those sunglasses on even when you're indoors.

 

[Juan]

Juan, I remember thinking it was odd that you said listening to speech and podcasts wasn't a big issue for you even though your overall hyperacusis seemed greater. It think symptoms can vary for people in certain areas.

That was not a big issue because it would not produce lingering pain for days or weeks. In order to listen to music or the computer I would set the volume low. Speech was ok in general, although some people talk loud sometimes it was painful too... but again, the difference is that the pain would not linger for a long time, like it is the case with very loud noises, like traffic noises, construction, power tools, sirens, loud beeps etc.

So what do you think: use earplugs as often as you need to if it doesn't actually add up to that much time?

Yes, you need to use earplugs as often as you need, for the time you need.

For me overprotection would be wearing earplugs at night if one lives in a quiet neighbourhood. Or having earplugs on at home when there is not noise around. Or using earplugs when talking to someone, as even if someone speaks a bit loud, that will not make damage.

A person with severe pain hyperacusis needs earplugs to go out pretty much anywhere, not because of actual loud sound but because of the possibility of loud sound. And this does happen.

For instance, I have been on a forest track by myself, without earplugs, surrounded by dense vegetation, trees around everywhere, so it is only possible to stay on track, not to get off the track... and suddenly I hear a noise that comes towards me and gets louder... and this is a super loud dirt bike, and I can only cover my ears because there is not even time to put earplugs on properly.

So these things happen, the possibility of noise in quiet places. Of course there are places where this is likely to happen and others where it is very unlikely... but my example was for a situation in which it was unlikely to happen, and then there was deafening noise by any standards, which was really bad.

 

[Mr_Orange_3737]

That was not a big issue because it would not produce lingering pain for days or weeks. In order to listen to music or the computer I would set the volume low. Speech was ok in general, although some people talk loud sometimes it was painful too... but again, the difference is that the pain would not linger for a long time, like it is the case with very loud noises, like traffic noises, construction, power tools, sirens, loud beeps etc.

Yes, you need to use earplugs as often as you need, for the time you need.

For me overprotection would be wearing earplugs at night if one lives in a quiet neighbourhood. Or having earplugs on at home when there is not noise around. Or using earplugs when talking to someone, as even if someone speaks a bit loud, that will not make damage.

Thanks for clarifying this Juan. I suspected this might be the case. I never have earplugs on for long periods of time indoors.

Another thing that needs clarity is the idea of a setback. Juan, in your case you unfortunately receive a pretty clear indicator in the form of pain.

For those who do not have pain hyperacusis, what do you mean by a setback? Is it a spike in your tinnitus? Is it a significant increase in sensitivity of hyperacusis? Is it an increase in ear fullness? Are the setback symptoms immediate or delayed?

You might think that this should be obvious, but since starting this thread, I've had a few run-ins with louder sounds. My car alarm went off for 4 seconds. One of those store entrance sensor alarms went off. My house firm alarm got triggered by ants. An ice cream cart horn was a bit too close. These were all fairly brief. I've never really noticed a huge spike in tinnitus or hyperacusis immediately afterwards. Is this an indicator that the loudness wasn't significant enough to qualify as a setback or cause real damage?

The one sound incident since getting my tinnitus just 2.5 months ago where I actually felt an immediate effect was putting on a pair of headphones (this was like week 1 when I didn't know to avoid headphones) and not realizing the volume was accidentally on full. I obviously ripped them right off. My tinnitus went up slightly for 5 seconds.

It's kind of hard to tell too because both my tinnitus and hyperacusis would fluctuate constantly anyways.

Please share some examples of an actual setback.

 

[MindOverMatter]

Yes @Mr_Orange_3737, it is hard to tell with hyperacusis and tinnitus as it often fluctuates - as you've pointed out.

For those who do not have pain hyperacusis, what do you mean by a setback? Is it a spike in your tinnitus? Is it a significant increase in sensitivity of hyperacusis? Is it an increase in ear fullness? Are the setback symptoms immediate or delayed?

In my experiences, for me, a setback is an expression of setting back/delaying my progression / ongoing marathon of slowly getting better. And thus in a sense of normally a minor spike. It may be sudden or delayed. To me its often a combination of sudden om the sense of feedback/minor distortion (eeeeee), and delayed as it may cause a minor setback.

If you do not have the typical pain hyperacusis, and do not protect more than absolute necessary, your tolerance will (most likely) slowly get better. Given you do not stress too much, stay calm, get your needed sleep, eat healthy (low sodium, low sugar, low alcohol) and use sound enrichment. I do believe this, and try staying positive and not talk overly negative/associate hyperacusis + tinnitus with something negative (I know, it's hard), is the KEY for managing this condition.

And remember, normal, everyday sounds (like running water, clanking and so on) that my bother you in some degree, will not damage your ears.

 

[Juan]

Is it a spike in your tinnitus? Is it a significant increase in sensitivity of hyperacusis? Is it an increase in ear fullness?

These are only indicators that your ears were exposed to noise they did not like, but that does not necessarily mean a lasting setback.

A lasting setback, meaning permanent increase of tinnitus or hyperacusis, or permanent hearing loss, is usually triggered by exposure to objectively loud sounds (on a decibel scale, which is a logarithmic scale), and the impact of that exposure usually depends on the type of sound, whether it is impulse noise or other type of sound, the decibel level and the length of exposure.

Sounds that would bother anyone else can produce a setback for people with fragile ears. Sounds that would bother other people but would not cause damage for them, can make damage to people with previous hearing problems like tinnitus or hyperacusis, because the impact made by noise is cumulative. Objectively loud sounds can produce lasting setbacks. including sounds from power tools (brief exposure, impulse noise), firecrackers, sirens, etc.

The more damaged ears are the more unlikely it is to predict how they are going to react to loud noise and whether a certain noise can produce a setback.

Are the setback symptoms immediate or delayed?

Sometimes it is possible to get symptoms immediately, without getting a lasting setback; symptoms then fade away. Other times I get symptoms immediately but they do not look so bad and it is on the second or third day after noise exposure when I start feeling just awful... and for me this usually predicts a lasting setback. But again you have to 1) look at the sound that triggered everything objectively, on a decibel scale and 2) assess how much previous sound damage you have had (personal history of previous sound exposure and current state of hearing, tinnitus and hyperacusis).

I would like to add that not all sounds have the same qualities.. I am not a technical expert, but by personal experience, some sounds seem to carry like more vibration, and this together with loudness can make a sound more dangerous, like a door slamming by wind really close by, or the sound of a jackhammer (this one is terrible, due to vibration). A power saw is a higher sound, but the jackhammer is a killer (it is like high-pitched motorbike sounds vs low but vibrating motorcycle sounds... Harley like for instance).

To sum up, there is an objective part, loudness of sound, decibel level, vibration, impulse sound or not... and a subjective individual part (personal experience with previous sound exposure, current situation in terms of hearing loss, tinnitus and hyperacusis).

 

[Mr_Orange_3737]

Thanks for the feedback on setbacks guys. Seems like as with almost everything you encounter in this tinnitus world, there is such a variety of ways it can go.

I'm starting to think I might be actually recovering from a bit of a setback period (1-2 weeks ago). The reason is I've been able to listen to podcasts and speech more easily in the past few days. Clanking still sounds pretty sharp though but at least that's easier to avoid.

I've basically taken on all the typical precautions you hear about. Stopping alcohol, caffeine, and marijuana all at once has been pretty tough in itself. I'm starting to slow sip half a cup of coffee in the morning though. So far it seems okay.

Going to use the earplugs more often in those outdoor scenarios. So many motorcycles and mufflers in this world.

 

[Marin]

As an ex-musician I really think that I would need an audio device (earplugs or something) that reduces ONLY peaks of volume, like a real time limiter/compressor. Like for dishes, horns, motorcycles, etc. (motorcycles are the worst situation for me, luckily winter is coming...).

Like, setting up this device to my tolerance and than slowly reduce the limiting/compressing after some months.

Is there something like that?

There is a device being worked on in Florida that sounds similar: https://hyperacusisresearch.org/hyperacusis-device/

Hearing aids can also be programmed to do this by an audiologist experienced with hyperacusis. I trialed some aids that reduced and compressed high frequencies, but they unfortunately made my hyperacusis worse. So disappointing! I've read about these types of aids working really well for others, though.