Why does the Sound of Chewing Trigger Me? 😡

I know I’m not the only one who experiences this, but the other week I mentioned during dinner with friends, that sometimes I had to leave the dinner table due to the noise my boys make when chewing. The discussion that ensued was very entertaining.

But, as an Audiologist, I have been assessed so I know the sounds that trigger me are purely psychological. But is it always psychological? And why do some people react differently to different noises?

There are two different things we are talking about here: Hyperacusis and Misphonia. They are both a reduced tolerance to sound, or where certain sounds cause physical pain or make you cringe. They are different conditions though, and they occur for different reasons.

Hyperacusis

When an ‘ordinary sound’ feels like it is too loud. While it may not bother the person next to you, you may find it overwhelmingly loud, and feel discomfort or pain. This may be caused by damage to the auditory system, and the incoming sound signal is over amplified. There is a psychological element as well which is quite understandable. When your body turns up the volume to a sound others perceive as normal, your stress levels will rise.

Ear related causes include:

• Hearing loss (especially noise-induced hearing loss),
• Head injury
• Medications that damage hearing
• Viral infection
• Bells Palsy
• Lyme disease
• Menieres disease
• Stapendectomy
• Recruitment
• Acoustic trauma
• Perilymph fistula

Central nervous system causes include:

• Depression
• PTSD
• Spinal problems
• Brain lesions
• Migraines
• Epilepsy
• Chronic fatigue
• Autism

Other causes include:

• Temporomandibular joint disorder
• Over-active immune system

(Note: Recruitment is an inner ear condition where there has been severe damage to the outer hair cells of the ear. The person would have hearing loss, and their auditory system has trouble regulating incoming sound signals due to damage in the cochlea. There is not a psychosomatic relation in this).

Misphonia

You have normal hearing, have been medically assessed, none of the above conditions exist, but certain sounds trigger you. So why does it happen? Because there is an abnormally strong reaction between the auditory system and the emotional brain.

In the case of misophonia, the strength of the reaction is determined by the physical characteristics of the upsetting sound and is dependent on the previous exposure to, and recollection of the sound (e.g., is the sound a potential threat? Can it be harmful,? Did someone I really dislike make that sound previously?). It is related to your personality and the context in which the sound was presented.

High-pitched sounds are particularly bothersome, even if you have normal hearing. Studies have shown that high pitches trigger the amygdala, the emotional part of the brain. The amygdala is responsible for processing emotions, emotional behavior, and motivation, so it’s understandable that when a certain sound triggers it, it will elicit an emotional response such as discomfort, fear, panic……. or in my case: utter disgust when I hear chewing.

How common is it?

• 66% of the population suffer from sound sensitivity for one reason or another
  Of those:
• 86% of hyperacusis patients also have tinnitus
• 30 – 40% of tinnitus patients also have hyperacusis.
• 1/3 of patients with sound sensitivity have normal hearing thresholds (misphonia)
• 17% of patients have hearing loss and hyperacusis

Now what? Get assessed

A medical evaluation may be worthwhile if you suffer from noise sensitivity to rule out any of the above issues. treat the cause, treat the symptom. You should consult an audiologist for a full hearing assessment and your GP for a full medical assessment. Your GP may refer you to an Ear Nose and Throat Specialist (ENT) for further evaluation.

Treatments

Treat the cause of the problem and you will assist the symptoms if there is a medical problem. Aside from that, there is no magic pill to make it go away. Treatments are beneficial, but finding out which works best for you can be a matter of trial and error.

Avoid Hearing Protection

Whilst hearing protection is advisable for all individuals when exposed to excessive noise, wearing it every day in normal noise conditions, can increase your sensitivity to all sounds.

Sound therapy

Seek assistance from a specialist trained in sound desensitisation. This involves wearing a device in one or both ears with a sound that is so soft you won’t be bothered by it. This signal sits in the back of your mind, teaching your mind that it is not a threat, so you begin to ignore it. Gradually the sound is increased to allow tolerance to the sound. This can take 6-12 months because it takes time and patience as you slowly retrain the auditory part of the brain to accept everyday sounds. This is also what specially trained clinicians can use for Tinnitus Retraining Therapy.

Cognitive Behavioural Therapy (CBT)

If you suffer from misphonia, this can help alleviate the anxiety surrounding your condition. It aims to change problem emotions, thoughts, and behaviors. Depression, anxiety, and insomnia can also be assisted with this.

Counselling

Auditory Integration Therapy

Listening to music at different volumes can also be effective for people with autism and hyperacusis.

Tinnitus Retraining Therapy (TRT)

Involves a combination of directive counselling and desensitization sound therapy.

So, the good news is, in most cases, sound sensitivity can be managed, but you need to know the cause. In my case, my ‘trigger’ is purely psychological. Even when my boys are chewing quietly, I am tuned into that sound so it still irritates me. I turn on background noise to dull it’s effect, or I try to tolerate it, or sometimes I just leave the room depending on what other stress I have dealt with that day. What can I say, I’m a work in progress.

 

 

REFERENCES

1. Hesse, G., Schaaf, H. and Laubert, A., 2005. Specific Findings in Distortion Product Otoacoustic Emissions and Growth Functions with Chronic Tinnitus. International Tinnitus Journal, 11(1), pp.6-13.
2. Jastreboff, P. and Hazell, J., 2008. Tinnitus retraining therapy. Cambridge: Cambridge University Press.
3. Vault of my brain and random notes from lectures where I didn’t note the source