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Association between Hyperacusis and Tinnitus

Cederroth, Christopher R.; Lugo, Alessandra; Edvall, Niklas K.; Lazar, Andra; Lopez-Escamez, Jose-Antonio; Bulla, Jan; Uhlen, Inger; Hoare, Derek J.; Baguley, David M.; Canlon, Barbara; Gallus, Silvano

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Christopher R. Cederroth

Alessandra Lugo

Niklas K. Edvall

Andra Lazar

Jose-Antonio Lopez-Escamez

Jan Bulla

Inger Uhlen

Associate Professor in Hearing Sciences

David M. Baguley

Barbara Canlon

Silvano Gallus


Many individuals with tinnitus report experiencing hyperacusis (enhanced sensitivity to sounds). However, estimates of the association between hyperacusis and tinnitus is lacking. Here, we investigate this relationship in a Swedish study. A total of 3645 participants (1984 with tinnitus and 1661 without tinnitus) were enrolled via LifeGene, a study from the general Swedish population, aged 18-90 years, and provided information on socio-demographic characteristics, as well as presence of hyperacusis and its severity. Tinnitus presence and severity were self-reported or assessed using the Tinnitus Handicap Inventory (THI). Phenotypes of tinnitus with (n = 1388) or without (n = 1044) hyperacusis were also compared. Of 1661 participants without tinnitus, 1098 (66.1%) were women and 563 were men (33.9%), and the mean (SD) age was 45.1 (12.9). Of 1984 participants with tinnitus, 1034 (52.1%) were women and 950 (47.9%) were men, and the mean (SD) age was 47.7 (14.0) years. Hyperacusis was associated with any tinnitus [Odds ratio (OR) 3.51, 95% confidence interval (CI) 2.99-4.13], self-reported severe tinnitus (OR 7.43, 95% CI 5.06-10.9), and THI ? 58 (OR 12.1, 95% CI 7.06-20.6). The association with THI ? 58 was greater with increasing severity of hyperacusis, the ORs being 8.15 (95% CI 4.68-14.2) for moderate and 77.4 (95% CI 35.0-171.3) for severe hyperacusis. No difference between sexes was observed in the association between hyperacusis and tinnitus. The occurrence of hyperacusis in severe tinnitus is as high as 80%, showing a very tight relationship. Discriminating the pathophysiological mechanisms between the two conditions in cases of severe tinnitus will be challenging, and optimized study designs are necessary to better understand the mechanisms behind the strong relationship between hyperacusis and tinnitus.


Cederroth, C. R., Lugo, A., Edvall, N. K., Lazar, A., Lopez-Escamez, J., Bulla, J., …Gallus, S. (2020). Association between Hyperacusis and Tinnitus. Journal of Clinical Medicine, 9(8), Article 2412.

Journal Article Type Article
Acceptance Date Jul 23, 2020
Online Publication Date Jul 28, 2020
Publication Date Aug 1, 2020
Deposit Date Jul 29, 2020
Publicly Available Date Jul 29, 2020
Journal Journal of Clinical Medicine
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 9
Issue 8
Article Number 2412
Keywords tinnitus; hyperacusis; TMJ; headache; migraine; hearing loss; subtype; somatosensory
Public URL
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