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⏱️ Estimated reading time: 12 min
On this page: Overview
Key Takeaways
Misophonia is a strong reaction to specific sounds, such as chewing or sniffing, at any volume. Hyperacusis is when everyday sounds in general seem much louder than they should, and can even hurt.
No. Researchers and the NHS describe them as separate kinds of sound sensitivity. They often turn up together, though, and the same person can have both.
Phonophobia is fear or anxiety about a particular sound, often before it happens. General noise sensitivity is a broad trait of finding busy, noisy places draining, whatever the exact loudness. Neither is the same as misophonia.
Used for a short, chosen moment, an earplug simply makes sound quieter while it is in. NHS guidance on hyperacusis says not to wear earplugs or muffs all the time, because this could make you more sensitive to noise.
Only a clinician can tell them apart. Start with your GP, who can refer you to audiology, ENT or psychology services for proper assessment.
No. Misophonia is a reaction to specific sounds, often made by other people, at any volume. General noise sensitivity is a broader tendency to find noisy surroundings overwhelming. Some people experience both, and a GP can help work out which applies.
Yes. Research shows the two are separable but often occur together, and misophonia can also sit alongside tinnitus, which we cover in misophonia and tinnitus. An audiologist or psychologist, reached through your GP, can tell them apart.
The NHS says not to wear earplugs or muffs all the time, because this could make you more sensitive to noise, though short-term use may help in very noisy environments. Speak to your GP or an audiologist before using earplugs regularly.
Misophonia vs hyperacusis vs noise sensitivity: three terms that get swapped around constantly, plus a fourth, phonophobia, that few people have heard of. They describe different experiences. Misophonia is about which sound it is, hyperacusis about how loud ordinary sound feels, and phonophobia is closer to dread, often before the sound has even arrived.
Getting the word right matters because the tools differ. An earplug can be a sensible short-term option in one case and something the NHS specifically cautions against using all day in another.
At Bollsen, we make reusable silicone earplugs trusted by 1,000,000+ people, and we hear the question “is it misophonia or hyperacusis?” a lot. This guide is the map. If you already know that particular sounds are the issue, our main page on earplugs for misophonia covers which earplugs suit short, chosen moments and how to use them well.
What is the difference between misophonia, hyperacusis and noise sensitivity?
Misophonia is a strong emotional reaction to specific sounds regardless of volume, hyperacusis is when ordinary sounds feel too loud or painful, phonophobia is fear or anxiety about certain sounds, and general noise sensitivity is a broad tendency to find noisy surroundings overwhelming.
A 2022 tutorial in the American Journal of Audiology (Henry and colleagues) grouped all four under one umbrella, sound tolerance conditions, and that is the frame we use here. The NHS hyperacusis page similarly lists misophonia, phonophobia and recruitment as other types of hearing sensitivity.
A quick way to sort them is to ask what sets the reaction off. If it is a particular sound, such as someone chewing, misophonia is the closer fit. If it is loudness in general, hyperacusis. If it is the expectation of a sound, phonophobia. None of that is a diagnosis, and only a clinician can confirm one.
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Misophonia is set off by the pattern or meaning of a sound rather than its loudness, so a trigger can be quiet or perfectly ordinary in volume. A 2022 expert consensus defined it as decreased tolerance to specific sounds or stimuli associated with those sounds (Swedo et al., Frontiers in Neuroscience, 2022).
Triggers are often repetitive and often come from another person’s body. The Oxford Health NHS misophonia page lists eating sounds, nose and throat sounds, keyboard tapping and rustling paper, and describes reactions such as disgust, anger, distress or a fight-or-flight response. It also covers misokinesia, a similar reaction to repetitive movements like leg jiggling.
It is more common than the name suggests. In a representative UK sample, 18.4 % of adults met the threshold for misophonia, yet most had never heard the word (Vitoratou et al., PLOS ONE, 2023). There is no stand-alone code for misophonia in DSM-5 or ICD-11, so clinicians describe and assess it in other ways.
One line we hear often is “quiet sounds bother me more than loud ones”. It feels that way because quiet triggers like lip smacking stand out in a calm room. A loud trigger is still a trigger, though. Our guide to common misophonia trigger sounds and what earplugs do with them goes through the usual culprits one by one.
What is hyperacusis, and why does the NHS caution against wearing earplugs all the time?
Hyperacusis is when everyday sounds seem much louder than they should, sometimes to the point of pain, and the NHS advises against wearing earplugs or muffs all the time because doing so could make you more sensitive to noise. Short-term use may help in very noisy environments.
The NHS hyperacusis page gives examples such as jingling coins, a barking dog, a car engine and a vacuum cleaner. The cause is often unclear. It can follow a sudden loud noise and can appear alongside tinnitus, migraines, Ménière’s disease or autism.
We sell earplugs, so we will say it plainly: for hyperacusis, more protection is not the answer. Tinnitus UK’s hyperacusis guidance agrees that ear protection shouldn’t be used for normal day-to-day activities, while still recommending it for really noisy jobs like using DIY tools. The NHS route is a GP visit and referral to a hearing specialist, with options such as sound therapy and CBT.
Loudness recruitment, where the ears struggle to adjust between quiet and loud sounds, usually comes with hearing loss. An audiologist can tell it apart from hyperacusis.
What is phonophobia?
Phonophobia is a fear of, or anxiety about, certain sounds, and the dread often starts before the sound arrives. The NHS describes it simply as some sounds making you anxious, and audiologists note that it tends to lead to avoidance, such as skipping places where the feared sound might happen.
The difference from misophonia is the emotion. Misophonia usually brings anger or disgust in the moment. Phonophobia is closer to fear and anticipation. Neurologists also use the word for the sound sensitivity that can come with a migraine, which is a different thing again, so it is worth asking your GP which meaning applies.
Where does general noise sensitivity fit?
General noise sensitivity is a broad trait rather than a diagnosis: a tendency to feel annoyed, drained or overwhelmed in noisy surroundings, whatever the exact loudness.
Plenty of people who find open-plan offices or busy stations exhausting fit this description without hyperacusis or misophonia. It also comes up often alongside neurodivergence, and our article on misophonia, ADHD and autism in adults looks at that overlap with care.
Night-time brings its own version, from a partner’s breathing to a neighbour’s television. Our sleeping team covers it in misophonia and sleep and noise sensitivity and sleep.
How do the four compare side by side?
The table lines up the four sound tolerance conditions by what sets each one off, how loud a sound needs to be, what an earplug physically does, the caution that goes with it, and which of our guides to read next. Read it as orientation, not self-diagnosis.
| Condition | What sets it off | At what volume | What an earplug does | Caution | Which pillar |
|---|---|---|---|---|---|
| Misophonia | Specific sounds with a pattern or meaning, often another person’s chewing, breathing or sniffing | Any volume, including quiet and ordinary sounds | Lowers the level of every sound reaching the ear while it is in; does not change the reaction, and does nothing for visual triggers | Short, chosen moments only; see when to wear earplugs and when to take them out | Misophonia guides (this cluster) |
| Hyperacusis | Everyday sounds in general | Ordinary levels most people tolerate feel too loud or painful | Makes a very noisy setting quieter in the short term | NHS: do not wear earplugs or muffs all the time; see an audiologist first | earplugs for noise sensitivity |
| Phonophobia | Fear or anxiety about a particular sound, often before it happens | Any; the anticipation drives it | Can make a dreaded loud event quieter, but can also feed avoidance | Talk to your GP; psychological support is the usual route | Noise-sensitivity guides |
| General noise sensitivity | Busy, noisy surroundings as a whole | Not tied to a set level; it is about the overall environment | Gives a quieter break in a loud place | Use for breaks, not all day; stop on pain or itching | Noise-sensitivity guides |
Can you have more than one, and who can tell them apart?
Yes, the conditions often overlap, and only a clinician can untangle which ones apply. The 2022 consensus notes that misophonia can occur with normal hearing, alone, or alongside tinnitus and hyperacusis.
A 2024 study in the International Journal of Audiology (Smees and colleagues) found the conditions are separable even when they co-occur. A sound like stacking dishes pointed more towards hyperacusis, while chewing pointed more towards misophonia without hyperacusis.
Your GP is the place to start on the NHS. They can refer you to audiology, where loudness discomfort can be measured, or to ENT or a psychology service. Oxford Health’s psychological information centre uses a questionnaire called the S-Five when assessing misophonia, and our guide on where to find support for misophonia on the NHS walks through the referral route.
Where does an earplug fit, and where does it not?
An earplug is a short, situational tool: it lowers the level of sound reaching the ear for a chosen event, such as a meal, a journey or a focus block, and comes out afterwards. It does not change how anyone reacts to a sound, and for hyperacusis the NHS caution on continuous wear comes first.
Quieter, not silent. A passive earplug rated SNR 24 dB brings a 60 dB conversation down to roughly 36 to 40 dB, so a voice across the table stays audible because it is loud, not because the earplug picks and chooses. Attenuation rises with frequency, so higher-pitched sounds are lowered a little more than low ones.
For those chosen moments, our Life+ passive SNR 24 dB reusable silicone earplug (£29.95) is rated H 24, M 21, L 19 and uses a conical two-lamella design in hypoallergenic silicone that sits flush in the ear. One pair lasts up to 100 uses. Two packs cost £44.95, and UK delivery is free on orders over £35.
Whichever row fits, the same rule holds. Take earplugs out straight away if you feel pain or itching, and if you notice you are reaching for them all day, mention it to your GP. That is useful information for them, not a failure on your part.
If you saw yourself in more than one row of the table, that is common, and it is exactly what a GP appointment is for. Earplugs, used briefly and on purpose, can sit alongside whatever comes next.
His connection to hearing protection stems from personal experience with sound sensitivity during live events and work in noisy environments, an issue that made him more aware of the long-term risks of unmanaged noise exposure. Today, as both a communicator and a user of BOLLSEN products, he is passionate about raising awareness around the importance of proactive hearing care.
At BOLLSEN, he develops data-driven marketing campaigns, writes SEO-focused articles, and manages communication channels that connect customers with practical knowledge about hearing protection. His work ensures that BOLLSEN’s message—prioritizing health, performance, and sustainability reaches a global audience in an engaging and trustworthy way.
Passionate about writing since childhood, Timotej combines creativity with a strong analytical approach, continuously testing new ideas in digital marketing, performance advertising, and social media. He believes in learning through innovation and collaboration, balancing leadership with openness to new perspectives.
Beyond his professional role, Timotej is committed to a healthy lifestyle and finds inspiration in fitness, sports, and quality time with friends. His personal passion for well-being aligns with BOLLSEN’s core values, making his work not only a career but also a cause he deeply believes in.