Increased sensitivity to noise, causing discomfort or pain.
At a glance
What it is
Increased sensitivity to noise, causing discomfort or pain.
Commonly experienced as
Evidence context
Context
Sensitivity to sound (phonophobia or hyperacusis) describes an uncomfortable or painful response to sounds that others find tolerable — or an enhanced auditory perception in which ordinary environmental sounds feel intrusive, jarring, or overwhelming. Phonophobia (fear or avoidance of sound during headache) is a diagnostic criterion for migraine. Hyperacusis (reduced tolerance to a wide range of everyday sounds) is a distinct auditory condition occurring in those with hearing loss, noise trauma, Lyme disease, and certain neurological conditions. Sound sensitivity also occurs in autism spectrum conditions, PTSD (where certain sounds may be trauma cues), and post-concussion syndrome. Management depends on cause: migraine management, tinnitus rehabilitation programmes, sound therapy, and desensitisation are the relevant approaches for different presentations.
The Evidence
What research and clinical practice currently tell us about sensitivity to sound and the approaches used to support it.
A real and varied symptom with condition-specific support
Sound sensitivity spans several distinct conditions — from migraine and hyperacusis to post-concussion and autism spectrum presentations. Evidence for management varies by cause, with some approaches better supported than others.
Seek urgent care if sound sensitivity appears alongside sudden weakness, numbness, or speech difficulty, as these may indicate stroke. A severe headache described as the worst ever experienced, seizures, loss of consciousness, or vision changes with other neurological symptoms also require immediate attention. Do not self-manage these presentations.
Phonophobia in migraine is well-documented and recognised in clinical guidelines. Hyperacusis has a growing evidence base supporting sound therapy and tinnitus rehabilitation programmes. Evidence for sound sensitivity in post-concussion syndrome and PTSD is emerging. Relaxation-based and complementary approaches have limited but plausible supporting data.
Clinicians distinguish between phonophobia, hyperacusis, and sensory sensitivity linked to neurological or psychological conditions before recommending a path forward. Approaches include migraine management, audiology-led sound therapy, desensitisation programmes, and psychological support for trauma-related presentations. Accurate professional assessment is essential before starting any programme.
Sound therapy — including white noise, pink noise, and structured listening programmes — is used in audiology settings and as a complementary tool. Relaxation techniques such as breathwork and mindfulness may help reduce the stress response that amplifies sound sensitivity. These are best used as part of a broader plan, not as standalone replacements for professional assessment.
An audiologist can assess hyperacusis and recommend sound therapy. A neurologist or headache specialist is appropriate for migraine-related phonophobia. Post-concussion presentations benefit from a multidisciplinary team. Sensory sensitivity in autism or PTSD contexts may involve occupational therapists or psychologists. A GP or primary care provider is a good starting point for referral.
Many complementary and self-directed approaches for sound sensitivity have limited high-quality trial data. Individual responses vary significantly depending on the underlying cause. Inflated outcome claims from any single product or practice should be viewed with caution. This content is educational and is not a substitute for professional assessment of a persistent or worsening symptom.
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