Tinnitus & Hyperacusis
Hyperacusis + tinnitus
Tinnitus and Hyperacusis: When Ringing and Sound Sensitivity Happen Together
Some people live with ringing or buzzing in the ears and also feel overwhelmed by everyday sound.
If you’re experiencing both, you’re not alone—and it’s not “in your head.”
The right plan addresses internal sound (tinnitus) and
external sound tolerance (sound sensitivity) together.
Visits in San Mateo & San Carlos. Serving the Peninsula, San Francisco, East Bay, and South Bay.
Why tinnitus and hyperacusis often overlap
Tinnitus is the perception of sound (ringing, buzzing, hissing) without an external source.
Hyperacusis is reduced tolerance to real-world sound. They’re different experiences, but many people notice
they rise and fall together.
Here’s the common pattern: the auditory system becomes more reactive. Internal sound may feel more intrusive,
while external sound may feel sharper, louder, or threatening. That reactivity can be reinforced by stress,
poor sleep, and avoidance of everyday sound environments.
The “two-dial” problem
One dial is tinnitus loudness/awareness. The other dial is sound tolerance. When both are turned up, it can feel
like there’s no safe volume—quiet feels too quiet and noise feels too intense.
Avoidance can unintentionally amplify both
If you’re protecting your ears constantly or staying in silence, your system may become less accustomed to normal sound.
The goal is safe, selective protection—not all-day isolation.
Relief is possible with a structured plan
The most successful plans are clear and repeatable: education, sound enrichment, and gradual tolerance-building
that reduces reactivity without triggering major spikes.
What it can feel like day to day
If you have both tinnitus and sound sensitivity, you may recognize some of these:
- Quiet makes tinnitus feel louder, but everyday noise feels uncomfortable or painful.
- Restaurants, open offices, or transit feel overwhelming (even when you’re trying to “push through”).
- You monitor sound constantly—scanning for sudden volume changes or unpredictable triggers.
- Earplug reliance increases because it feels safer, but sensitivity still doesn’t improve.
- Sleep and stress become part of the loop, making sound feel more alarming.
A helpful mindset shift
The goal usually isn’t “silence” or “toughness.” It’s lowering reactivity so your brain treats sound as
less threatening—and building tolerance in a way that’s steady, safe, and sustainable.
What an evaluation looks like
A good tinnitus + sound sensitivity evaluation focuses on both the hearing system and your real-life experience.
You should walk away with clarity, not generic advice.
Hearing + tinnitus history
We’ll review when symptoms began, what makes them better or worse, and how they’re affecting sleep, work, and daily life.
Sound tolerance patterns
We’ll map your specific triggers (loudness discomfort vs pain vs anxiety/avoidance) and identify the patterns
that matter for a treatment plan.
Safety screening
Some symptoms require urgent medical evaluation (for example, sudden hearing change or severe vertigo). If anything looks concerning,
we’ll help triage next steps.
What helps (without making things worse)
When tinnitus and hyperacusis happen together, treatment usually needs to address both sides:
reducing tinnitus distress and rebuilding comfort with everyday sound.
The plan should be gradual enough to avoid painful setbacks, but consistent enough to create progress.
Sound enrichment (not silence)
Gentle, steady background sound can reduce the “contrast” that makes tinnitus feel louder and can support gradual tolerance-building.
Education + coaching
Understanding what’s happening reduces fear and helps you stop the cycle of scanning, bracing, and avoiding sound—without dismissing your symptoms.
Selective protection (the “right balance”)
Protection for loud settings can be appropriate. Constant earplugging can backfire for some patients. We help you choose a balanced approach
based on your triggers and lifestyle.
If you’re afraid of sound exposure
That fear is common—and it makes sense when sound has been painful. The safest approach is usually gradual and guided:
small, repeatable exposures below your “spike” threshold, then steady progress over time.
You don’t have to force yourself into uncomfortable situations to improve.
Next steps and related guides
Start with the page that best matches what you’re dealing with right now.
Hyperacusis overview
Learn what sound sensitivity is, how it differs from related conditions, and what treatment typically includes.
Coping & gradual exposure
Practical, safe steps you can start now—without pushing into major spikes.
Tinnitus Knowledge Hub
Understand tinnitus patterns, evaluation, and treatment options—especially if tinnitus is the main driver of distress.
Want clarity and a plan?
If tinnitus and sound sensitivity are affecting your sleep, work, or quality of life, we can help you understand what’s happening
and outline a plan that fits your day-to-day routines in the Bay Area.
If you have urgent symptoms (sudden hearing change, severe vertigo, new neurologic symptoms), review red flags first.
Set Up Your FREE Hearing Consultation with an Expert Today
SEE A HEARING DOCTOR IN SAN MATEO
San Mateo – Main Office
88 N. San Mateo Drive
San Mateo, CA 94401
Phone: (650) 342-9449
Fax: (650) 342-4435