The progression of hyperacusis is unpredictable. Many patients' tolerance improves while some cases grow steadily worse. The only factor we know of that unquestionably affects progression or regression is continued exposure to loud noise.
Proper guidelines must be followed especially when one first develops hyperacusis. The best source of information comes from The Hyperacusis Network. Many patients have seen improvement in sound tolerance through the use of sound generators (special hearing aids) that emit broad band pink noise. This retraining therapy suggests that the ear will become desensitized to sound by listening to broadband pink noise at barely audible levels for a disciplined period of time each day (usually 2-8 hours a day). This has been proven to help over 90% of hyperacusis patients maximize the tolerances in their ears. The name of this treatment is called Tinnitus (Hyperacusis)Retraining Therapy or TRT. To find a list of current hearing professionals who administer this treatment, go here:
Another method is to have the patient listen to a pink sound CD. To summarize, pink sound has been found to be very helpful in retraining ears to re-establish their tolerances to sound. This can be done through two delivery systems: special custom fitted hearing appliances called sound generators or listening to a CD player. These methods represent great hope and can help the hyperacusis patient but they are not a cure.
Individuals who suddenly come down with hyperacusis go through a distressing crisis period where it may be difficult for the patient to sleep restfully at night. Getting proper sleep and reducing stress levels are very important and some medication may initially be needed to help facilitate this.
The underlying reasons why some people are more susceptible to ear problems than others is not understood. Of the various catalysts for the onset of hyperacusis, noise is the most common and preventable one. Avoid loud sounds whenever possible and wear ear protection when needed.
Those who come down with hyperacusis may overprotect their ears because they have a fear of noise (phonophobia). For those who suddenly develop severe hyperacusis, it may be necessary to use ear protection so that the patient's ears have an opportunity to regroup and recover. After a few months however, over protection will only further collapse ones tolerance to sound. The patient is in a Catch 22 and walks a fine line between over protecting and under protecting their ears. Most, over a period of time learn to trust their instincts.
One major problem the hyperacusis patient must contend with are hearing professionals who, in their attempts to diagnose the problem, subject the patient to tests which involve loud sounds (MRI or BAER). Sound tolerances or LDL's (Loudness Discomfort Levels) must be known before an audiometric evaluation is performed. Some patients with hyperacusis have the ability to hear sounds at minus decibel levels. Many patients also complain of ear discomfort, a feeling of fullness or burning sensation in the ears. Some doctors have a hard time understanding this because they believe there are no nerve endings in the ears. This is just another area of misunderstanding between the doctor and the patient.