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Misophonia: When Ordinary Sounds are Upsetting

Summary: Misophonia is a condition where people are exquisitely sensitive to certain sounds, reacting with extreme distress, anger and even rage. Misophonia is also known as Selective Sound Sensitivity Syndrome (“4S”).
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Is This You?

Do you get upset, irritated or very angry when you hear people:
  • Eating or chewing with their mouths open?
  • Sniffling?
  • Typing on a keyboard?
  • Making other soft sounds that others aren’t bothered by?
If so, you may have misophonia.

What is Misophonia?

Many of us have had the experience of hearing sounds that make us feel uncomfortable. The sound of fingernails scraping across a chalkboard makes many people cringe. Sirens or smoke alarms make our hearts beat faster. Being very aware of certain sounds, and reacting strongly to them may have been very helpful to early humans. This may have helped them survive, by being alert to warning signals of possible danger.
Today, some people feel overwhelmed by their sensitivity to certain sounds. And this can cause problems with their everyday lives.
Misophonia is a fairly new term. It’s a condition where people develop an intense dislike of certain sounds. They can react to these sounds with distress, anger and even rage. Misophonia is also known as Selective Sound Sensitivity Syndrome (“4S”).
Family and friends may find misophonia hard to understand. Since they don’t have the same problem, the sounds that bother you don’t bother them at all. They may feel that you’re just being difficult. They may say things like, “Just get over it!” or “Stop being so sensitive!”

What Causes Misophonia?

It is not yet clear what causes misophonia. Although your ears hear the annoying sounds, hearing doesn’t seem to be the cause of the problem.
It seems that in people with misophonia, their ‘trigger’ sounds activate the limbic system in the brain. The limbic system is responsible for our ‘fight or flight’ reaction.
Misophonia is more common in children entering their ‘tweens’. It is more likely in children or adults with differences in the limbic system of the brain. This happens more often in people with:
  • Sensory Processing Disorder (SPD);
  • Autism Spectrum Disorder (ASD);
  • Brain injury;
  • Post-traumatic stress disorder (PTSD);
  • Obsessive compulsive disorder (OCD).

Other Related Conditions

Misophonia is part of a group of sound tolerance difficulties (decreased sound tolerance). 
Other conditions in this group are:
  • Hyperacusis: where people are more sensitive to all sounds in general (for example, normal sounds seem too loud).
  • Phonophobia: Fear of certain sounds.

Where To Get Help for Misophonia

Start by seeing an audiologist with experience in misophonia or tinnitus (ringing in the ears). The audiologist should take a careful history, and check your hearing. It’s helpful if the audiologist works with a team of professionals fa-miliar with misophonia and sensory processing disorder, autism spectrum disorders, post-traumatic stress disorder and brain injury. Examples of other professionals might include an occupational therapist (OT) with experience in sensory processing disorders.

Treatment for Misophonia

There isn’t yet a clear treatment for misophonia, and researchers haven’t yet studied how effective possible treatments are. In the meantime, audiologists have found some treatments that may help:
  • Counselling with family members and cognitive behavior therapy (CBT). CBT helps people with misophonia change the way they think about and respond to disturbing sounds. Counselling can help with problem solving, and can help people express their needs and distress in more helpful ways.
  • Neurofeedback: This involves checking brain wave activity over the different parts of the brain. There is a range of brainwave activity which is considered normal. The neurofeedback specialist will assess whether misophonia is linked to either under or over active brain wave activity in different areas. Neurofeedback training can help return brain wave activity to more normal levels.
  • Misophonia Retraining Therapy (similar to Tinnitus Retraining Therapy) uses soft broadband noise to help reduce the importance of the trigger sound for the nervous system.
  • Other treatments that may help:
    • Desensitization Therapy
    • Hypnotherapy (hypnosis)
    • Relaxation or mindfulness exercises
    • Dozier Trigger Tamer App, is a mobile application created by Thomas Dozier of the Misophonia Treatment Institute ( The app is designed to help the brain ‘rewire’ itself to overcome the sound sensitivity. The app uses soothing music along with ‘trigger sounds’ to help the user to gradually become less sensitive to distressing sounds.

Self-Help For Misophonia

Take good care of your brain 

  • Get enough sleep
  • Eat well
  • Get enough exercise (at least 60-minutes a day)

Misophonia strategies 

  • Avoid the triggering sounds. This usually means moving away from the sounds that are bothering you.
  • Wear hearing protection or ear plugs. This can help for a short while, but using hearing protection for a long time can cause other problems.
  • Share information with family and friends about misophonia. Explain that your distress caused by certain sounds is a condition known as misophonia, and it is due to the way your brain is wired.

Useful Websites

Further Reading

  • The Misunderstood Misophonia: Audiology Today Jul/Aug 2014. Retrieved from:
  • Misophonia: Beyond Irritation to a Hatred and Aversion of Sound. Hearing Review. Cassie D. 2012;19(05):52-53. Retrieved Dec 1, 2014 from: pmfXgnqj.dpuf
  • Living with Extreme Sound Sensitivity .Retrieved Dec 1, 2014 from:
  • When Normal Sounds Are Excruciating. Retrieved Dec 1, 2014 from:
  • When a Chomp or a Slurp Is a Trigger for Outrage. Retrieved Dec 1, 2014 from:


Written by Caryn Bursch, Doctor of Audiology, and members of the Mental Health Information Committee of the Children’s Hospital of Eastern Ontario (CHEO), an interdisciplinary group that includes psychiatry, psychology, child/ youth care, social work, nursing, and occupational therapy.


Under a Creative Commons License. You are free to share, copy and distribute this work as in its entirety, with no alterations. This work may not be used for commercial purposes. View the full license at:
Contact the Mental Health Information Committee if you would like to adapt these for your community!


Information in this fact sheet may or may not apply to you. Your health care provider is the best source of information about your health.

Date Posted: Jan 15, 2016
Date of Last Revision: May 14, 2018

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