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Misphonia: Small sounds causing big problems

By Ann L. Rhoten, Au.D., CCC/A

Misphonia: Small sounds causing big problems The term misophonia, which means hatred of sound, was coined by Drs. Margaret and Pawel Jastreboff.

The condition can make every-day sounds, which go unnoticed by most people, unbearable. Trigger sounds are typically soft noises related to the body that cause the sufferer to react. Most of us have certain sounds that annoy us, such as a neighbor’s dog barking, fingernails on a chalkboard or certain types of music.

However, what distinguishes misophonia from mild annoyance is the reaction to the trigger sound. The response is immediate and intense, like a reflex. The list of sounds that can elicit the response is long and varied and includes, but is not limited to:
• Sounds generated by the mouth, including chewing, crunching, popping, and spitting
• Respiratory sounds, such as snoring, hiccups, nasal whistling
• Vocalizations, such as “oohs,” “aahs,” singing, whistling, laughing
• Environmental sounds, such as clicking keyboards, papers rustling, ticking clocks, fingers tapping, and so on

When the misophonia sufferer hears a trigger sound, the typical response is anger, crying, acting out, mimicry, and/or fleeing the situation. The person who has misophonia is reacting to these soft sounds as if they were dangerous and scary. The reaction to the sound is similar to what might be expected upon finding a burglar breaking into one’s home or or a wild animal pursuing one in the woods.

Misophonia typically presents in patients beginning around the age of 10 to 12, triggered by the people closest to them, such as family members. Misphonia is perplexing not only because it seems to develop suddenly with very violent outbursts, but because the sounds that are triggers are not typically noticed by others.

The misophonia sufferer is often labeled as over-sensitive. Family members may try to desensitize the sufferer by exposing him or her to the trigger sounds. Not only is this approach not helpful, it can exacerbate the problem by strengthening the reaction.

When a primary care physician is consulted, the misophonic is often advised to wear earplugs during meal times. While earplugs may be helpful at first, over time they make the auditory system even more sensitive to sound, again exacerbating the issues.

There are strategies the patient can take on their own to battle the overreaction to trigger sounds. This includes deep breathing; explaining to others about their condition and trigger sounds; and leaving the room/situation. Consulting a professional who specializes in the treatment and management of sound sensitivity issues is highly recommended.

The good news is there is help right here in Lexington, at Kentucky Audiology and Tinnitus Services. In my practice, I offer Tinnitus Retraining Therapy (TRT), to help sufferers manage misphonia.

TRT consists of two components: counseling/education and sound therapy. During counseling/education, the sufferer and family members learn about the auditory system and the other brain structures responsible for the strong reaction to the trigger sounds. This helps to demystify the reaction, making it easier for all involved to understand and accept.

Sound therapy provides several benefits. First and foremost is it reduces both the perception and reaction to trigger sounds. Sound therapy involves using soft, steady-state noises, such as the wind, rain, and motors, delivered by either an iPod or ear-level device that looks like a small hearing aid. Although sound therapy does not cure misphonia, it does allow the sufferer to participate in activities that were previously avoided.

For more information about treating misphonia, please contact Kentucky Audiology & Tinnitus Services at (859) 554-5384. KATS is located at 1517 Nicholasville Road, Suite 202 in Lexington. Visits Kentucky Audiology & Tinnitus Services online at

Dr. Ann Rhoten Au.D., CCC/A is an independent audiologist in Lexington.  If you know someone suffering with hearing loss, assure them there is help. With nearly three decades of experience, Dr. Rhoten offers the knowledge and the professional service each patient needs.

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