Sound Sensitivity

Considerations for folks with sound sensitivity. A quick note as we get into it – you should use the tools you need, but know you are training your brain. If you use these tools all the time your brain will become more sensitive to sound and have more difficulty filtering out noise. For sensory sensitive folks, we can’t train or exposure therapy sound sensitivity away, which is why the tools are helpful, but we can make small shifts. Consider where you might be able to tolerate sounds.

Over ear vs in ear

The choice of over ear vs in ear might be guided by:

• Sensory preference
• How subtle you want to be
• Features available
• How old you are – typically in ear is not recommended below age 6 (and usually doesn’t make sense until a child can keep track of their ear plugs)

Passive vs active sound cancelling/reducing

• Passive sound cancelling/reducing is the sound being physically blocked by the headphones or ear plugs – no charging required
  • Examples of passive sound cancelling (intended for information, not as a recommendation necessarily)
    • For adults
      • In ear
        • https://www.alpinehearingprotection.com/en-ca/products/musicsafe-pro
        • https://us.loopearplugs.com/products/quiet
      • Over ear
        • https://www.3mcanada.ca/3M/en_CA/p/c/ppe/hearing-protection/earmuffs/
    • For kids
      • In ear
        • https://www.alpineearplugcanada.com/p/alpine-pluggies-kids-in-white-blue/
        • https://us.loopearplugs.com/products/engage-kids?country=CA
      • Over ear
        • https://purosound.com/products/purocalm
• Active noise cancelling/reducing is when the device plays opposing frequencies to cancel out incoming sounds
  • Active noise cancelling is better for consistent sounds is consistent (like traffic) and struggles more with inconsistent/changing frequencies (like speaking)
  • Active noise cancelling also has in ear and over ear options
    • Examples of active sound cancelling for adults (intended for information, not as a recommendation necessarily)
      • In ear
        • Airpods
        • Google pixel
      • Over ear
        • Many bluetooth headphones (bose, sony, skull candy, etc)
      • For children over ears are typically recommended and a volume limiter (no louder than 85dB) is recommended as that is the level at which hearing damage can occur
        • It would be good for adults to have sound limiters as well to prevent hearing damage, but we expect them to manage their own choices.
    • Check out this article that dives into active noise cancelling (for airplanes) and tests what frequencies they noise cancel best at
      • https://www.nytimes.com/wirecutter/blog/what-noise-cancelling-headphones-do/
  • Active noise cancelling often will have an ‘aware’ mode that has some noise cancelling but allows for speaking frequencies
  • Higher end noise cancelling headphone may have options to block out sounds by frequency range (e.g. high frequency, low frequency, etc)
    • Some examples of brands that have this customizability
      • https://www.bose.ca/en/p/headphones/bose-quietcomfort-ultra-headphones-2nd-gen/
      • https://www.sony.ca/en/headphones/products/wf-1000xm6
• Hearing aids can also have active noise cancelling. Include an audiologist on the team if this is a routine being considered.
  • Certain hearing aids can allow for selectively reduce amplification or limit output in specific frequency regions. Some devices also incorporate compression, impulse-noise reduction and transient-noise management, which could be helpful depending on the situation.
    • For low level broadband sounds (referred to as sound therapy delivered through sound generators) that are designed to help manage hyperacusis. The goal is usually not attenuation of specific sounds, but rather gradual desensitization and improved sound tolerance over time. This can be programmed through an audiologist with hearing aids, referred to as ear-level sound generators if there is no hearing loss being managed. One could also look at Shokz (bone conduction headphones) to stream low level sound therapy through to help mask the sharpness of those sounds. Examples would be low level brown noise, white noise, rain sounds etc. that are just mixing at a level where the high-frequency sounds are not perceived as too sharp. 
    • For high frequency sounds: filtered earplugs for situational use. Class B earplugs generally allow low frequency sounds to travel through, but attenuate high-frequency sounds. The downfall to this approach is that it could exacerbate sound sensitivity/make it worse by reducing auditory exposure of normal daily sounds, the brain may increase central auditory gain, causing normal environmental sounds to be perceived as increasingly loud or bothersome over time. Basically, it increases sensitivity by teaching the brain that these sounds are quieter than they really are, increasing sensitivity once earplugs are removed. 
  • Always from a clinical perspective, I would recommend an assessment with an audiologist experienced in hyperacusis, decreased sound tolerance, sensory processing differences, and tinnitus management. A full comprehensive assessment to understand the mechanisms (is there any hearing loss, which frequencies are most sensitive etc.) can substantially influence device recommendations.