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The sound environment has changed since the Industrial Revolution.

Our systems were not meant to absorb the amount of sound and other sensory stimuli around us.

As a result people with misophonia live in continual sound overload and experience auditory fatigue.

If you think of sounds as calories, those with misophonia are consuming way too much.

I have been writing this blog since 2018, reporting on misophonia research and helping others with the disorder. As the research develops, there are always new topics to write about. Yet I also strive to find new ways to examine and contextualize this still-mysterious condition.

Recently, I read a post by audiologist Michael Piskosz that piqued my interest. Piskosz works with people who have hearing loss, and I was intrigued by his different viewpoint. His post is about “auditory fatigue,” a construct subsumed by the larger concept of auditory health. According to Piskosz, “Auditory fatigue is what happens when our ears and brains get tired of processing sound. It’s not hearing loss (though that can come later in life). It’s not tinnitus (though the two can be related). It’s more like a sensory overload; the result of being constantly exposed to sound without enough breaks, silence, or recovery and reset time.”

Sound familiar? Feel familiar? As a person with misophonia, are you relating to this as much as I am?

The concept of auditory fatigue has been studied in the fields of audiology and otorhinolaryngology (Holman and colleagues, 2021; Juaristi and colleagues, 2015; Venet and colleagues, 2024), but mostly associated with hearing loss. For example, Holman and colleagues explore how musicians who have been exposed to louder and more sounds may be vulnerable to auditory fatigue. Yet, when those of us with misophonia think about our auditory health, we think we “hear too well.” And we certainly notice sounds that other people don’t, but I don’t think we think about our auditory health the way that people with hearing loss do. Researchers are investigating how the misophonia-brain differs and trialing ways to treat the disorder. In hearing loss research, investigators also focus on how the outdoor environment has affected our auditory health. For example, before the industrial revolution, we did not live with the continual sound of machinery, nor did we live in cities where we shared walls with others, or in suburbs with our neighbors so close that we could hear their dogs barking. We know that very loud sounds can damage hearing, but how do we know that the overabundance of sound we live with hasn’t made some of our auditory systems more sensitive?

Piskosz states that, “Auditory fatigue is common in open-plan workplaces, retail settings, airports— anywhere that constant background noise becomes ‘normal’, and we’re required to hear, listen, and process important communications. But it doesn’t have to be loud to be exhausting. Even low-level, persistent sound can wear us down. The brain gets worn out from filtering what’s useful from what’s not.” Auditory fatigue may result in mental fog, causing a person to need silence (even from one's own family members).

Sound familiar? Feel familiar?

Piskosz showed me an interesting exercise. Please be careful doing this if you have misophonia. He asked me to close my eyes and track the number of sounds I heard in 30 seconds. Within 30 seconds, I heard over 12 sounds, including a passing car, soft unidentifiable hums, ringing in my left ear, birds, wind, and more.

Was our auditory system meant to be processing this many sounds at once? Probably not.

We are overloaded with sound, even when we are not consciously aware of it. Sound is vibration and does not simply affect our auditory system. Sound is an elusive entity that we take into our whole bodies. Sound, as many of us with misophonia know, also connects to our visual system. The senses all work together. Sound penetrates the whole body.

With approximately one in five people having the disorder, it is difficult to eliminate the effects of the overloading sound environment. But why are some of us more sensitive than others? Why do some of us have misophonia and others do not? Piskosz likened sound to the intake of calories. We all metabolize calories differently. Those of us with misophonia reach our optimal caloric intake more quickly than others and live in a state of continual auditory fatigue.

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Holman JA, Hornsby BWY, Bess FH, Naylor G. Can listening-related fatigue influence well-being? Examining associations between hearing loss, fatigue, activity levels, and well-being. Int J Audiol. 2021;60(sup2):47-59. doi: 10.1080/14992027.2020.1853261. Epub 2021 Jan 4. PMID: 33390065; PMCID: PMC8315207.

Sanjuán Juaristi J., Sanjuán Martínez-Conde M. Fatiga auditiva [Auditory fatigue]. Acta Otorrinolaringol. Esp. 2015 Jan-Feb;66(1):36-42. Spanish. doi: 10.1016/j.otorri.2014.05.004. Epub 2014 Aug 8. PMID: 25109540.

Venet T, Thomas A, Merlen L, Boucard S, Wathier L, Martin Remy A, Pouyatos B. Parameters influencing auditory fatigue among professionals working in the amplified music sector: noise exposure and individual factors. Int J Audiol. 2024 Sep;63(9):686-694. doi: 10.1080/14992027.2023.2240012. Epub 2023 Aug 25. PMID: 37622173.

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