Light and sound sensitivity

Over-sensitivity to Sound, Smell, Touch, or Taste in Preschoolers Predicted Higher Risk for Anxiety at Age 6

Monday, June 3, 2019

As researchers move closer to developing useful interventions for children at risk for anxiety before a full-blown anxiety disorder appears, one important objective is to identify factors or traits very early in life that correlate with elevated risk.

2015 BBRF Young Investigator Kimberly L. H. Carpenter, Ph.D., at Duke University School of Medicine, and colleagues, may have found one such factor: sensory over-sensitivity.

A child with auditory over-sensitivity, for example, might be bothered intensely by the experience of being out on a city street or in a crowded restaurant. This kind of response can lead to something doctors call “context conditioning,” in which over-response leads to hypervigilance and hyperarousal, which in turn can lead to the onset of anxiety disorder.

In a paper published in the Journal of Abnormal Child Psychology, Dr. Carpenter and a team that includes three other BBRF grantees and prizewinners report that sensory over-sensitivity in children of preschool age (2 to 5) is indeed a risk factor for subsequent anxiety disorder, and can predict the appearance of anxiety symptoms at age 6. The intensity of anxiety symptoms, in turn, was found to correspond with the seriousness of concurrent behavioral issues such as irritability, picky eating, and sleep problems.

Children’s sensory and anxiety symptoms (if any) were assessed in a sample of 917 children aged 2 to 5 drawn from the general community, 191 of whom were assessed again at age 6. The children’s condition was judged on the basis of interviews with their parents. Prior studies have found that sensory over-sensitivity is not uncommon, affecting 8% to 28% percent of children with no known disorders. The challenge, therefore, was to determine in which children sensory over-sensitivity might be a harbinger of anxiety. Previous research has linked it with autism spectrum disorder.

Sensory over-sensitivities that were reported in this study included physical contact with other people; contact with fabrics or clothes tags; food textures; visual experience such as bright lights; auditory experiences such as loud or high-pitched noises; olfactory experiences; tastes; and sensations of motion.

Fifty-two percent of children with at least one sensory sensitivity as preschoolers went on to meet criteria for anxiety disorder at school age. From this it is evident that not every child with sensory-overresponse goes on to develop anxiety symptoms. The team also noted that of the children in the study who did not have any sensory over-sensitivity at preschool age, 15% did have anxiety symptoms at school age.

The team does however find that sensory over-response is a risk factor for anxiety, perhaps one among several yet to be discovered.

Over sensitive hearing, smell and touch

Other things to consider, if your are grinding and/or clenching your teeth this cause inflammation of nerves in your face. Get a mouth cheaper one at the drugstore or 800 dollar one custom made by the dentist. Of course stress, caffeine and/or parasite can cause one to clench and grind teeth. Getting checked for hidden dental infections is good idea as well as getting checked for sinus infections or even swollen sinuses can cause issues, and make sure your ears are not infected .
Have an MD check for Temporal arteritis . And or pinched nerve can cause all sorts of issues. Another big one to get checked for is Candida MD do not have tests for this, but an ND will. It is good to get educated on it. I was told by a ND that patients were tested for candida test is negative, after the person passes away autopsy revealed the body was filled with candida! I’ve come to believe Candida is linked to many other illnesses, some very serious.
I talked to top scientist for pharma company who told me Candida is real, and also mentioned there is cell mediation I think that is what she called it , that you have an illness but the test shows you don’t. Talk about confusing.
In my case, the MD told me he suspected mycotoxin poisoning (black mold illness)so I began treatment. Then two months later sheet rocked cracked our newer house apparently had black mold hidden behind the wall , and you could not smell it or see it. The M.D. was right in hos diagnosis.
We remediated and my MD told me to never return there because once your sensitized you will react no matter how much remediation. He suggested we could burn the house down and then take three feet of the dirt to a contaminated dump site and then build a house. This made me realize the level of toxicity he was talking about . they do and 50% of new and old houses have mold. So, we built a new house.
25% of the population bodies do not tag this mold toxin like it is supposed to, so once it is in the body, IT keep recirculation. I had light, sound, smell and even movement, sensitivity, like car sickness, and I had wheezing, sinus were swollen and nausea at time. It took me a three months to detox, but 14 months to feel 100% normal it was quite a ride. But to detox and fix all the pathways that the mold had disrupted took time and I had to get on BEGS nasal spray for the mold had colonized in my sinuses. Thank God, for my family, and their love and support and my doctor.
Wishing all good health.

Sensory Processing Disorder

Sensory Processing Disorder (SPD) is a term that has gained widespread usage in schools across America over the last few years. The problem is that it isn’t easily understood, there is no magic cure and oftentimes adults without proper understanding of this challenge suggest kids have it. For example, one of my child clients is super bright and doesn’t sit still easily in his preschool circle. His teacher suggested to his parents that he be checked for SPD – but they wondered if he might be bored? Have attention deficit issues? Or just be a regular preschool boy?

Sensory Processing Disorder – Defined

Like many neurological challenges, sensory processing disorder is best understood as existing along a continuum from mild to more severe. Some kids display a heightened sensitivity to their senses such as light and sound where they either withdraw or act out. While other kids, may be under-sensitive so they bang into things not aware of their surroundings. The best definition of Sensory Processing Disorder comes from the SPD Foundation, it says:

Sensory Processing Disorder (SPD, formerly known as “sensory integration dysfunction”) is a condition that exists when sensory signals don’t get organized into appropriate responses.

In other words, a child with SPD finds it difficult “to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks” (SPD Foundation). The key point here is that a child with a sensory challenge like SPD cannot perform everyday tasks – their senses are either over or underwhelming them.

For example, I had a client whose seven year-old could not go outside any time of year without sunglasses or she would scream. Her sensitivity to light was acute and this interfered with everyday living versus solely being something that she preferred. Alex, the preschool child, mentioned in the first paragraph didn’t have SPD – he merely was bored with story time and was also allergic to some of the breakfast foods given in preschool (thus causing hyperactivity).

The point is that SPD isn’t black and white (despite everyone wanting it to be). It exists along a continuum of symptoms whether it is an over or under sensitivity to light, sound, temperature, food, spatial relations or visual stimuli. In addition, there is a high propensity for children with SPD to have other emotional, social, mental or behavioral challenges – like ADD.

Sensitive or SPD

Children that truly have SPD are experiencing difficulty in their daily lives. They cannot lead regular kid lives because of their sensory processing is challenging their system – some scream at mild sounds, cannot sit still under regular school lighting or tolerate traditional smells like peanut butter and jelly without throwing a full-out tantrum.

Such is a big contrast to highly sensitive children (see earlier blog) whose preferences regarding the world are keenly tuned.

Highly sensitive children are sensitive to lights, sounds, smells, words and their environments because they are born with heightened awareness. They can lead regular lives attending school, playing with other kids and expressing their creativity. For example, Melissa loves to draw and paint near the window with the natural light streaming in her classroom. This is her preference. She is sensitive to nature and light – it makes her happy. But if there is no window she would still paint. Her sensory experience is organized and heightened.

The goal with highly sensitive children is to guide them to see their sensitivity as a strength and use this strength to successfully navigate their worlds. The goal with sensory processing disordered children is to guide them to handle their disorganized sensory input into more organized and healthier responses so they can lead full lives.

Becoming Savvy

If you are a parent, educator or clinician then you are likely familiar with Sensory Processing Disorder. It is different than “sensory seekers” that are those kids that look for ways to feel their senses intensely like getting more hugs, and playing in the water longer. In addition, it is sharply different than kids that have organized sensory input but just heightened awareness of their senses called highly sensitive children. True sensory disordered children have difficulty doing regular activities due to their disorganized responses to sensory input.

Today, I have found the label of “Sensory Processing Disorder” used frequently and sometimes without any real understanding as to what it means. The good news is the most common treatment is occupational therapy so there is no drugs involved just a “re-training” of how to respond to sensory input in positive and healthy ways. The downside is that once you get labeled SPD it’s a challenge to un-label a child so my suggestion is to “get smart” on what’s really going on, look at a child holistically and if appropriate – then get a child screened for SPD.

By Maureen Healy
Growing Happy Kids, LLC

Follow me on Twitter: mdhealy

More Information:

Sensory Processing Disorder Foundation

Highly Sensitive Children

Noise or Light Irritation

What is noise or light irritation?

Do you find yourself squinting at any light — even when it’s not very bright? Do loud noises cause you discomfort? Have you had headaches that make lights or sounds more painful to experience? These are all signs of noise or light irritation.

Light sensitivity, sometimes called photophobia, and noise sensitivity may make it difficult or painful to deal with even average lights or sounds. Light sensitivity can be related to sun glare, indoor fluorescent lights, or glare from a computer monitor. You may also have sound sensitivity to either loud or persistent noises around you. Sometimes, hypersensitivity to sound or light comes with headaches.

You may wonder why you have noise sensitivity or light sensitivity. Some Veterans experience these symptoms because of whiplash-related injuries from combat or accidents in military or civilian life. Veterans who have experienced possible traumatic brain injury may also have hypersensitivity to sound or light. Someone might also be easily startled by sidden noises after they have been through a traumatic experience. Certain eye conditions can also cause problems with glare or light sensitivity.

“Sometimes the lights in stores can give me an immediate headache. My eyes will sometimes hurt after turning on a light or going outside in the sunshine.”

Sensitivity to light and sound can interfere with your work and daily activities. Being unable to tolerate average levels of light or sound can make it difficult to go outside, participate in social events, or do your job. Sometimes noise or light irritation is related to other health conditions that should be addressed.

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If I’m experiencing noise or light irritation, what can I do about it right away?

  • Learn what things trigger episodes of noise or light irritation so that you can avoid them.
  • Darken the room you’re in, or wear earplugs.
  • Make adjustments to computer and TV screens.
  • Take breaks away from settings that you find difficult due to light and noise.
  • Practice relaxation exercises, such as deep breathing or meditation.
  • Do your best to get the right amount of sleep.

Certain drugs or medications may cause vision or hearing problems. Talk to your doctor or pharmacist if you’re taking medication and want to know if it could be affecting your sensitivity to noise or light. You should never stop taking a prescription without first consulting a medical professional.

Talking to your family and friends can be a good first step. They may have already noticed that you have hearing or vision issues and might be able to provide support and help you find out what’s causing these sensitivities.

Take the next step to connect with care.

Every day, Veterans from all military service branches and eras connect with proven resources and effective treatments for managing noise or light sensitivity. Here’s how to take the next step: the one that’s right for you.

New to VA? Apply for health care benefits.

  • Getting started is simple. Create a free account online to help ease your enrollment process. To prepare to apply for VA health care in person, by telephone, or by mail, explore VA’s “How to Apply” page.
  • Not sure whether you are eligible for VA health care benefits? Read about eligibility for VA health care.
  • Unsure of what kind of help you need? Call 1-877-222-VETS (1-877-222-8387) to find the right resources to meet your needs, Monday through Friday, 8 a.m. to 8 p.m. ET. If you have hearing loss, call TTY: 1-800-877-8339.
  • Veterans’ family members and caregivers can see whether they qualify for VA medical benefits as a spouse, surviving spouse, dependent child, or caregiver. Explore family and caregiver health benefits.

Already enrolled in VA and interested in mental health support? Schedule a mental health appointment.

  • If you’re already enrolled and using VA health care, the fastest way to schedule VA appointments is to call the VA facility where you want to receive care.
  • With VA Appointments tools, you can schedule some VA health care appointments online, view details about upcoming appointments, and organize your health care calendar.
  • If you’re not using VA medical services, contact your nearest VA medical center or Vet Center to talk about your needs.

What about other options at VA? VA offers a variety of tools and resources.

  • The Veteran Training online self-help portal for overcoming everyday challenges includes modules on managing anger, developing parenting and problem-solving skills, and more.
  • Mental health apps for Veterans cover a variety of topics, ranging from PTSD to anger management to quitting smoking.
  • VA TeleMental Health connects you with a VA mental health provider through a computer or mobile device in your home or at your nearest VA health facility. You can learn more about this option from your local VA medical center.
  • Vet Centers provide support, counseling, and readjustment services for Veterans and active duty service members (including members of the National Guard and Reserve) who have served on active military duty in any combat theater or area of hostility or have experienced a military sexual trauma. Find a Vet Center near you or call 1-877-WAR-VETS (1-877-927-8387) to talk with a fellow combat Veteran about your experiences, 24 hours a day, 7 days a week, 365 days a year.

What about support beyond VA?

There’s a whole community of support ready to help with whatever you’re going through. Use this tool to find resources near you.

Explore these resources for more information about Veterans experiencing noise and light irritation.

Learn more about what you can do if you are experiencing specific concerns related to noise or light irritation, such as problems with headaches, effects of traumatic brain injury, and posttraumatic stress.

Photophobia: Abnormal sensitivity to light
Phonophobia: Abnormal sensitivity to sound

People with photophobia often complain of light being too bright or fluorescents being bothersome. Computer or device screens, outdoor sunlight and glare can also negatively impact people with this symptom.

Phonophobia similarly represents a strong intolerance to one’s environment, specifically sound. Although the term may evoke the concept of fear, for those with chronic illness it generally represents a sensitivity to loud noises—such as traffic, music or even talking.

How often do photophobia and phonophobia occur together?

The extent to which both of these symptoms are present depends on the specific condition which causes them. Here are a just a handful of the disorders that can bring on these issues:

  • Migraine and headache conditions
  • Traumatic brain injuries, concussions
  • Fibromyalgia
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Autism Spectrum Disorders

In the case of migraine, hypersensitivity to bright lights and loud noises are both included as part of the diagnosis for the headache disorder. Amazingly, these sensitivities are far and away the most common problems after headache, with more than 85% experiencing them during attacks.1 People with migraine also have elevated light- and sound-related discomfort between their attacks, more so than most other symptoms.2

Although less prominent than traditional migrainous symptoms, patients with other headache disorders (cluster headache, tension-type headache, etc.) are similarly affected by light and noise.3,4

Head or brain injuries can also be associated with photo- and phonophobia. These issues are more commonly linked with the longer term neurological effects of concussions but still negatively impact people in the first few days or weeks after an injury.5 Light tends to be a bigger problem for survivors, but at least one-quarter—and probably higher—are likely to have either or both symptoms. Veterans in particular who have suffered a mild traumatic brain injury (such as through blast exposure during combat) may be at even greater risk.

Lastly, people with fibromyalgia and other sensory processing disorders (ADHD, Autism) have to deal with heightened sensitivity to their environment. Other sensations also come into play with these conditions, including negative or painful responses to touch or smell—although people with migraine can also experience these problems as well.6

It is worth pointing out that light and noise have been separately identified as triggering factors for many patients too. This is likely an extension of these broader sensory sensitivities and are equally influenced by changes in the brain associated with their conditions. And although there is question over the extent to which they can bring about pain or other symptoms, we must take them into account given how common it appears to be.

Why do light and sound sensitivity co-exist?

It still remains a medical mystery as to exactly why these and other conditions jointly cause photophobia and phonophobia, but researchers have identified a few possible explanations.

Obviously, the main reason for these symptoms occurring in tandem is the result of the disorders themselves. Time and time again, studies have shown that one of their primary effects is to impair the central nervous system, which is responsible for how we interpret our surroundings. As a result, this can create a myriad of reactions that characterize photophobia and/or phonophobia, including:7,8

  • Stronger negative responses to environmental stimuli, including symptoms of light or sound sensitivity as well as of their condition
  • A reduced overall tolerance for light and sound, making even appropriate levels seem excessive or even painful
  • Overstimulation of the brain causing an inability to correctly process one’s surroundings, which may also be compounded by psychological distress

Recently, other experts have identified direct connections between the visual and auditory systems and related activity in the brain for people with migraine. These systems become activated during attacks and thus lead to the sensory symptoms that many patients describe. Interestingly, those with anxiety or panic disorders may also experience comparable activity, furthering the link with anxiety-related sensitivities.

Lastly, complicating factors can increase the likelihood of photophobia or phonophobia. Anxiety, stress and/or comorbid emotional disorders (such as PTSD) have been shown to amplify a person’s physiological response to their surroundings. It is unclear why this happens, but it may be enhanced by the avoidance behaviors—such as isolating in a dark room—that many adopt in order to steer clear of bright or loud places. Reducing one’s exposure can have the opposite effect over time by worsening sensory sensitivities.

Read More about Photophobia ➜

Read more about light sensitivity:

Photophobia, Light Sensitivity: Facts and Statistics

Post-Concussion Syndrome and Light Sensitivity

Neurological Symptoms of Fibromyalgia: Migraine, Light Sensitivity & More

How Does Light Sensitivity Affect Cluster Headache?

2Main A, Dowson A, Gross M. Photophobia and phonophobia in migraineurs between attacks. Headache. 1997 Sep;37(8):492-5.

3Vingen JV, Pareja JA, Stovner LJ. Quantitative evaluation of photophobia and phonophobia in cluster headache. Cephalalgia. 1998 Jun;18(5):250-6.

5Waddell PA, Gronwall DM. Sensitivity to light and sound following minor head injury. Acta Neurol Scand. 1984 May;69(5):270-6.

6Wilbarger JL, Cook DB. Multisensory hypersensitivity in women with fibromyalgia: implications for well being and intervention. Arch Phys Med Rehabil. 2011;92(4):653-6.

8Howe FEJ, Stagg SD. How Sensory Experiences Affect Adolescents with an Autistic Spectrum Condition within the Classroom. Journal of Autism and Developmental Disorders. 2016;46:1656-1668. doi:10.1007/s10803-015-2693-1.

Living with Extreme Sound Sensitivity

  • Occupational therapy. Those with sensory processing disorders often find occupational therapy beneficial. This approach helps a person’s neurological system integrate his or her senses so he or she can more appropriately process information. For example, an occupational therapist might have a person who is hypersensitive to certain noises gradually experience a wide variety of noises, including the offensive ones, to help their brains get used to and eventually dismiss them. These sounds are altered as needed to ensure the experiences are positive and within the patient’s comfort zone.
  • Psychotherapeutic hypnotherapy. Hypnotherapy with a certified hypnotherapist can help ease the symptoms of misophonia through the proven power of suggestion. Many individuals have been able to successfully overcome phobias and addictions through this method. A psychologist can best recommend a reputable practitioner.
  • Chelated magnesium supplement. Sound sensitivity sufferers have often been found to have an overabundance of a neurotransmitter called glutamate. Clinical studies have hypothesized that during periods of stress, endogenous dynorphins are released into the synaptic region behind inner hair cells. This is thought to increase the strength of glutamate, causing otherwise-tolerable sounds to be perceived with excessive loudness.

    In my practice, 85 percent of my patients came to me with a severe magnesium deficiency. A deficiency in this mineral often leads to anxiety, mood swings, personality disorders, sound sensitivity, light sensitivity, and insomnia. Magnesium has been shown to mitigate the neurotransmitter glutamate while easing the anxiety and anger experienced by someone with most types of sound sensitivity. Chelated magnesium is one of the best types of mineral supplements as it is very small and easy for the body to absorb and make use of.

  • Avoidance of neurotoxic chemicals. Multiple research studies have shown that certain food additives and household chemicals can trigger or exacerbate neurological conditions. Many with autism and ADHD have found great relief from removing these chemicals from their diet and immediate surroundings. Avoidance of MSG, food dyes, high fructose corn syrup, gluten, aspartame, BHT, and BHA in food and parabens, phthalates, BPA, formaldehyde, and dioxin in household chemicals can help ease neurological sensitivity.

    The most effective way to reduce the amount of neurotoxic chemicals in your environment is to eat more from the earth and less from a box. Clean with natural products such as vinegar, lemon, baking soda, and castile soap.

  • Misophonia, while rare, is a real neurological condition. You haven’t lost your mind. If you hate the sound of chewing and other common noises to the point of frenzy, there is real help and validation out there. Talk with a trusted medical professional about the therapeutic techniques mentioned above. They may help you better integrate your senses and help you enjoy the world around you.

    Resources

    Living with Extreme Sound Sensitivity

    04 May Heightened Brain Connectivity May Explain Light and Sound Sensitivity With Migraine

    Posted at 18:05h in News to Know, Uncategorized by headache

    Many people living with migraine disease experience light and sound sensitivity, and researchers recently determined they have heightened connectivity between specific areas of the brain. This finding may help in the development of migraine treatments, said lead author Amy R. Tso, MD, of the University of California at San Francisco.

    In a study of 15 patients with migraine without aura, researchers used a functional MRI to evaluate the areas of the brain involved in processing visual and auditory information. They found that there was increased connectivity between primary visual and auditory cortices, where visual and auditory information is processed; the pons, which serves as a communication center in the brain; and the anterior insula, a region involved in coordinating responses to matters of emotional importance.

    This heightened connectivity between the anterior insula and the visual and auditory cortices may explain why stimuli such as bright lights and loud noises that do not bother most people are problematic for migraineurs, the authors said. Particular sensitivities are found in other headache disorders, and Dr. Tso noted further research will be needed to determine if the brain wiring found in this study is also present in other types of headache.

    Additionally, the authors noted that anxiety is common among migraineurs, and this type of brain connectivity has been found in patients with anxiety disorders, but more research is needed to understand the picture clearly.

    “It isn’t clear whether this inter-insula connectivity is something that predisposes you to migraine and also to anxiety, or whether it’s just a marker of having both conditions,” Dr. Tso said.

    This study appeared in the journal Neurology.

    Fibromyalgia: Coping With Sensory Overload

    Sensitivity to environmental stimulation, including bright lights, loud noises, and even certain smells, can make living with fibromyalgia particularly challenging. You might wake up each morning wondering what new trigger may exacerbate your fibromyalgia symptoms.

    “I deal with everything on a day-to-day basis,” says Stephanie Parker of Dover, Del., who believes her symptoms are consistent with fibromyalgia but has not yet been formally diagnosed. The symptoms keep her from participating in daily family activities, such as watching her kids’ ballgames in the afternoons.

    Tina Pringle, who was diagnosed 16 years ago with fibromyalgia, says that her fibromyalgia symptoms have been overwhelming at times. “The symptoms all merge together, and because of the fatigue and brain fog, everything becomes a maze of sheer confusion,” explains Pringle.

    The United Kingdom resident says her eye doctor identified her light sensitivity, but it’s her sensitivity to sound that’s most troubling. “Loud bangs, a child crying, loud music, shouting, dogs barking, and my worst annoyance, whistling, are all an issue,” she says. “The noises resound in my head like a clanging cymbal and cause my whole body to tense up.”

    As her tension grows, so does her fibromyalgia pain, and she has to retreat to a darkened room to relax. Her reaction is particularly problematic at home, where her teenage daughter often loves to play loud music and behave in typically boisterous adolescent fashion.

    Noise is just the beginning of the sensory anguish that might be contributing to your fibromyalgia pain. People living with fibromyalgia report:

    • Chronic pain and tenderness
    • Increased sensitivity to touch or pressure
    • Increased sensitivity to loud sounds
    • Increased sensitivity to unpleasant smells
    • Increased sensitivity to temperature changes
    • Increased sensitivity to certain flavors

    What’s Going On Inside Your Head

    This heightened sensitivity may be difficult for you to understand, much less explain to friends and family members who see no outward problem. The uncomfortable and painful sensations of fibromyalgia may be part of your brain’s unusual way of processing pain, suggests fibromyalgia researcher Benjamin Natelson, MD, a neurology professor at the Albert Einstein College of Medicine in New York City and author of Your Symptoms Are Real: What to Do When Your Doctor Says Nothing Is Wrong.

    According to a study published in the Archives of Physical Medicine and Rehabilitation that compared and analyzed reports from women with rheumatoid arthritis, women with fibromyalgia, and women without a pain syndrome, those with fibromyalgia were much more likely to report intense, unpleasant responses to sounds, smells, tastes, and tactile sensations.

    Another study, published in the journal Pain Research and Treatment,suggests that changes in brain chemistry among people with fibromyalgia may be linked to sensitivity to stimuli such as sound and smell. Imaging studies have provided visual depictions of this altered response to sensations. In some respects, the brains of people with fibromyalgia may be hyper-responsive to even the possibility of pain or discomfort, Dr. Natelson says.

    Researchers have also tested tissue samples and found elevated levels of inflammatory markers in the skin of people with fibromyalgia — which may be linked to hypersensitivity to touch. Touch sensitivity is real for people like Pringle, who says that there are times when even holding hands with her partner is too painful to bear. Clothes that are too tight, massages, and even light touches all ratchet up her pain and stress. To make matters worse, Pringle says she occasionally even flinches involuntarily when touched by others, which can be hurtful to those around her.

    What to Do About Fibromyalgia Symptoms

    How can you address a problem that might stem from your brain’s wiring? Here are some practical steps you can take to manage these sensory symptoms:

    • Work with a supportive doctor. “If your doctor doesn’t believe you have fibromyalgia, get a new one,” stresses Natelson. Pain treatment will be most effective, he says, when you and your doctor are on the same team. Three prescription medications have been approved for treating fibromyalgia and could help you manage your fibromyalgia pain and reduce your hypersensitivity.
    • Be active. A review of exercise as part of fibromyalgia treatment, published in the journal Rheumatology International, showed that aerobic exercise may offset pain and minimize tender point sensitivity. Natelson advises gentle physical conditioning. His prescription: “Walk for 30 minutes every other day at about 1.5 to 2 miles per hour.” This increases blood flow to the muscles and tissues. Very gradually, increase your pace to about 3.6 mph. This level of activity “seems to downregulate pain perception,” Natelson explains. Walking outside is ideal, but if you’re sensitive to temperature changes, light, smells, and other sensations, start a walking program inside your home or at the gym.
    • Avoid your triggers. As much as you can, control your environment so that you limit potential causes of discomfort:
      • Ventilate your home well to remove strong smells.
      • Consider earplugs or noise-canceling headphones to minimize or eliminate loud sounds.
      • Take care of your skin and reduce irritation by using gentle products and avoiding temperature extremes, such as very hot or very cold water.
      • Wear loose-fitting clothes and dress in light layers that you can remove if the weight of your clothes starts to irritate your skin.
      • Set boundaries. When her sensitivity to light is especially intense, Pringle simply explains to family members that she can’t watch TV with them right at that moment.
      • Create a retreat. On particularly difficult days, a comfortable, cool, darkened room might be a soothing place to relax and recharge.
      • Wear sunglasses. Inside or out, if you feel sensitive to light or certain patterns, put on some shades and give your eyes a break.

    Fibromyalgia symptoms that affect all your senses can make every day a struggle, and when you experience difficulty managing your sensitivities, you may be tempted to stay home and avoid socializing and being outside. Even so, Natelson says this is not a good strategy in the long run. Instead, work closely with your doctor to develop strategies that limit your exposure to certain triggers without preventing you from enjoying the world around you.

    Phonophobia in Migraine (sound sensitivity)

    Timothy C. Hain, MD, Chicago IL. Page last modified: January 12, 2019

    See also: sensory sensitivity in migraine smell sensitivity light sensitivity pressure sensitivity sound sensitivity

    Phonophobia means “abnormal discomfort from sound”. Another way of thinking about this is that almost everyone will develop discomfort from loud noises (i.e. this is normal discomfort from sound. Persons with phonophobia have a more rapid growth in their discomfort level, or perhaps a lower threshold for discomfort, than other people. This way of phrasing things implies two groups – -one that has a steeper slope of discomfort vs. intensity, and another that has an earlier “wall” which defines the point at which they signal that they are uncomfortable. Here we are explicitly excluding people who hear better than other people do — this doesn’t happen very often, but might occur in a condition called “SCD”, where one can hear certain types of sounds better than normal people.

    Phonophobia is a common symptom with diverse causes. The closely related symptom of hyperacusis, has a prevalence of about 5% of the general population. It is also related to “misophonia”, which has to do with discomfort from relatively soft sounds (think smacking of lips).

    Sense Threshold Discomfort Measure Comment
    Light Light sensitivity Photophobia
    Sound Hyperacusis Phonophobia LDL Correlates with smell sensitivity (Rocho-Filho et al, 2016)
    Smell Smell sensitivity Osmophobia Upsit, Sniffit
    Weather Barosensitivity ? Barophobia ?
    Pain Allodynia
    Motion sensitivity kinesiophobia Motion sickness Various questionnaires Motion sickness can trigger smell sensitivity

    As is the case with smell and light sensitivity, with sound sensitivity there is an attempt to distinguish between having a lower sensory threshold, and having greater discomfort. Here, we are explictly not talking about lower thresholds. It is very clear that persons with migraine do not have better hearing than everyone else, but rather they can have greater discomfort than everyone else for loud noises.

    LDL

    The technology of measurement of both thresholds and discomfort is very well worked out for sound, where assessment of “LDL” or loudness discomfort levels are routine when fitting hearing aids. This is a crude and subjective process of just asking patients when they think a sound is too loud.

    One would think that for LDL, one should “adjust” the discomfort level for the sensory threshold — or in other words, attempt to differentiate between the input to the brain and the response to the brain. For hearing, this can be done by subtracting the pure tone threshold from the LDL.

    Recruitment and how it differs from other types of phonophobia:

    In patients with hearing loss, it is also possible for the mapping between percieved loudness and presented loudness to be steeper. The term “recruitment” refers to the perceptual phenomenon of sounds becoming rapidly louder with increasing sound level, leading to the somewhat paradoxical but common request of people with cochlear disorders “to speak louder” followed by the complaint to “stop shouting” (Cai et al, 2009). Another definition is abnormal growth in loudness with increases in stimulus intensity (Carver, 1972). Thus patients with recruitment have a lower sound threshold for discomfort, and have a type of phonophobia. In recruitment, the ear is damaged and there is hearing loss. So the same core symptom of phonophobia can be called “recruitment” when there is ear damage and reduced hearing thresholds.

    Classic loudness recruitment is best demonstrated by comparing the ear with sensory hearing loss to the ear in the same subject with no hearing loss. If one is to attempt to balance the loudness between the two ears by alternating stimulus presented to one ear and then the other, notable differences are observed at the lower levels but this difference disappears at higher levels.

    The SISI test is a clever method of detecting recruitment without comparing two ears — it depends on the ability of a subject to discriminate between small changes in sound intensity — patients with cochlear disorders can discriminate smaller steps in sound intensity, because the loudness grows more rapidly.

    Recruitment is presumably mediated by adaptive changes in the brainstem, and would not be expected to occur in patients with migraine.

    Triggering of migraine with sounds

    Loud noise is often reported by our patients to cause migraines. However, the headache literature seems to be rather unsympathetic to the general concept that noise is a migraine trigger.

    Schulte et al (2015) suggested that rather than sound being a trigger, sound sensitivity was part of a “premonitory phase” of migraine. Harriott (2014) reported that 70-90% of migraine patients report sensitivity to or aversion to noise durin an attack.

    Harriott (2014) also stated that about 2/3 of migraineurs report sensitivity to sound between migraine attacks.

    Martin et al (2006) suggest that migraine patients cause their own sensitivity by avoiding loud noises, and seemed to propose that migraine patients need to experience more loud noise. We are dubious.

    Somewhat similarly, Andersson et al (2005) suggests (without any proof) that psychotherapy might be a useful treatment for hyperacusis of any variety. Again, while we have nothing against psychotherapy, we are dubious that this is the answer for migraine sound sensivity. CBT (cognitive behavioral therapy), the subject of this article, was a fad for a while, that now seems to be waning.

    Rojahn and Gerhards (1986) suggested that migraine subjects showed a “higher level of general stress sensitivity”, and implied that their greater noise “aversiveness” was in essence a personality characteristic.

    Sound discomfort as a diagnostic criteria for migraine

    Ashkenazi et al (2009) reported “sound aversion thresholds”, which appear to be “LDL” measurements under a different name. In 60 migraine patients, the mean SAT averaged at 1000, 4000 and 8000, was roughly 15 dB lower than 52 non-migraine patients. This was between attacks. During migraines, the SAT was also about 15 dB lower. We are surprised that the gap did not become larger during migraines attacks, as generally speaking light sensitivity and allodynia grow during a migraine headache.

    Vingen et al (1998) also reported more sensitivity to “sound-induced discomfort”.

    Main et al (1997) similarly reported more discomfort to sound both outside of attacks as while having a migraine.

    Woodehouse and Drummond (1993) reported that both auditory and visual discomfort thresholds were reduced during attacks in migraines. They stated that the findings do not support the view that phonophobia is a manifestation of loudness recruitment.

    In a related measure, Joffily et al (2016) reported that women with migraine and phonophobia exhibited deficits in OAE suppression, suggesting a disorder of their ability to suppress outer hair cell responses. As OAE’s are used to dampen sound, this study in essence says that migraine patients keep their outer hair cells turned on – -which would be a reasonable thing to do if one was troubled by loud noises.

    Intensity of sound perception in migraine subjects.

    There are no claims that migraine subjects can hear better than non-migraine subjects. In other words, migraine patients just feel as if their hearing is “supersonic”. It may have more to do with attention than how well their ear is functioning.

    Fibromyalgia and Noise Sensitivity

    Dealing With Noise Sensitivity

    As I write today’s article, I’m sitting in my living room in total silence. This is a rarity for me; there’s normally the sound of people in the house or the TV in the background, and if I’m home alone then I’ll normally play some music while I work.

    Today though, I wanted to see how I felt writing in silence — especially as I’m writing about the impact of noise on fibromyalgia.

    It felt eerily quiet when I turned off the TV, but before long the sound of the traffic outside and the people in the flat next door were all I could hear. In fact, those background noises jumped to the foreground and they were suddenly very loud. Right now I’m contemplating putting the TV back on just to drown out those other sounds.

    Noise has a big impact on a lot of fibromyalgia patients. We experience heightened sensitivity to touch, light, smells, temperature and noise. Noise can increase our pain, cause headaches and leave us feeling exhausted. So why does noise affect us in this way, and how can we cope?

    Distraction

    I’m easily distracted and not very good at focusing, so the smallest noise or change to noise patterns will stop me in my tracks. That’s partly because I suffer from anxiety, so sudden noises make me flinch, but it’s partly because it interrupts a state of calm I’m trying desperately hard to achieve.

    All those times I’m trying to relax, unwind or rest, the change in noise interrupts me. I stop feeling relaxed and instead my mind is engaged in whatever is happening next door or outside. This can be really frustrating, especially when you’re trying to take control of your condition and block out the outside world.

    The solution, though easier said than done, is to keep practicing and learn to block out those external noises. Learning to meditate is an effective way of doing this, or so I’m told, and over time you can learn to center yourself and block out the surrounding noise.

    Migraine

    I’ve suffered from migraine for over 20 years, and noise is one of the most powerful triggers. Migraine is also a common symptom for fibromyalgia patients, so it’s likely that many of you will be experiencing some form of intense headache as a result of heightened sensitivity.

    There are some environments that just aren’t good for migraine sufferers; football matches, music concerts, loud meetings/debates, the theater/cinema, children’s playgroup — the list goes on.

    A few years ago I was looking at a new career. I spent a week in a school for children with autism. The week was completely rewarding and everything I had hoped it would be, and I felt really confident about my new step.

    That was until I realized I’d had a migraine almost every day. I’d put it down to stress to begin with but soon realized that shouting over noisy children in the hallway, classroom, lunch room — it was exhausting, and I knew I wasn’t a person who could cope with that level of noise every day.

    One of my family members suffers from ME and migraine. He finds the powerful elevated noise in a theater or cinema so sharp that it triggers his migraine every time. Over the years he’s realized he can no longer watch films and plays in the arena they are intended — he can’t cope with it.

    It’s not the case for everyone, but if you’re someone who notices increased head pain in relation to increased noise then you need to take yourself out of these situations. I’m not suggesting you run away — it’s always worth trying these things on more than one occasion — but if it repeatedly causes you pain then it may mean a career change for you or a change to your weekend hobby.

    Sometimes that realization can be quite devastating, but it is nonetheless essential if you want to gain control over your pain.

    Exhaustion

    There are some noises that will be painful to your ears, whether you have fibromyalgia or not. That ambulance siren, the pneumatic drill in the pavement, the screaming baby in the waiting room — anyone who can hear is likely to flinch at these sounds. But fibromyalgia patients are likely to do more than flinch.

    Not only is the sound likely to cause us physical pain, but they take their toll on our mental state as well. Our bodies tense at these sharp sounds and we struggle to remain calm or relaxed around heightened noise.

    We’re also exhausted; fibro fatigue means we’re less able to remain strong and deal with these noises rationally. We don’t have the physical strength or the mental strength to ignore the sounds like our non-fibro friends might.

    The familiar coping strategies for fibromyalgia will help with them. Remaining well-rested and doing gentle exercise is one good way of trying to balance your fatigue. Positive energy in your body makes you stronger and more capable of dealing with these strains.

    You May Also Like:How to Prevent Fibromyalgia Headaches

    The Voice in Your Head

    Noise isn’t always about what’s going on around you — sometimes it’s about what’s going on inside. The voice in my head is noise I can often do without. She’s the voice that pushes me forward and keeps me going, but she’s the also the voice that tells me I’m useless and holds me back. Silencing that noise is an important part of dealing with pain so that you can move forward, cope better, and be stronger.

    Meditation can often help with this, but so can the creation of a retreat or hideaway. For those of us who struggle with meditation, going to a part of the house or somewhere in your local community that gives you a sense of calm and peace can help to silence the noise in your head.

    Find Good Noise

    Not all noise is bad. Sometimes the ticking clock or the hum of the dehumidifier (two irritating sounds I am battling with as I write this article) can create more frustration, distraction or pain than the noise of TV or the radio.

    Find a station that you enjoy listening to or a piece of music you love, and use it as a way to block out the more negative noises. Sometimes one person’s noise can be the sound that eases someone else’s pain.

    Certain medical conditions have symptoms that are annoying to the person who has the condition, just as it is annoying to their loved ones who have to hear about it. I suppose all medical conditions have symptoms that are at the very least, annoying, if not completely intolerable. However, that is not my point. I really want to talk about one thing in particular.
    I have sound sensitivity. My experience with sound sensitivity puts a huge damper on certain aspects of my life at times. It may not seem like that big of a deal, but trust me, it is.
    First and foremost, I never know when it will happen. One day I will be sitting on my patio, listening to the birds sing, the wind gently ruffling the leaves as it blows through the trees, the children playing and laughing. Ahhh, how relaxing it is to hear the wonderful sounds of life.
    But hark! In a matter of moments, suddenly and quite out of the blue, I am feeling as if my head is going to explode because of how loud all of those lovely sounding sounds are!
    The only thing I can do to alleviate the problem (the symptom) is to make the area I am in as quiet as possible. Here’s where the annoying part comes in. As fast as lightning, there is an intense grating sensation inside of me. Grating as in, nails on a chalkboard sort of feeling. My entire body begins going nuts. I grind my teeth. I can’t take it!
    Everything is too loud! I have to ask my family to please turn down the TV. Or music. Or whatever UNBELIEVABLY, INSANELY, OVERLY LOUD, UNBEARABLE NOISE they have going on. Sometimes it is just them talking. Or laughing, walking, chewing — you get the idea.
    I have been home alone and suddenly the normal sounds of silence are maddening. I cannot stand to be in the room where the fish tank is. The water filter that everyone says sounds like a relaxing waterfall drives me nuts. Even worse than the fish tank, is the ticking of the clock. More than once, I have removed it from the wall and put it in a drawer, under clothing, in a different room behind a closed door so I won’t totally lose my mind over that sound.
    I don’t know why this happens. I don’t know when it will happen. All I know is that it DOES happen. I find it truly disturbing. Not just the part that grates through my system, but also the part where I have to bother everyone in my household and plead with them to please be quiet. Of course, I could just wear earplugs (as has been very, shall we say, “lovingly” suggested to me.)
    It is my understanding that sound sensitivity is yet another piece of my medical condition puzzle. Obviously, I don’t like it and I feel badly that it affects my family and friends as much as it does. I do try to see the benefits of it though, even when I can hear people rolling their eyes as I ask them to turn down the volume. Here are some advantages to being sensitive to sound:

    1. I can hear EVERYTHING. It is like having a super power. I almost know what is going to happen before it happens!
    2. My neighbors never have to make noise complaints about me.
    3. My home can be very Zen-like. Without even the tick-tock of a clock to hear, one can gain amazing insight by listening only to ones own thoughts.
    4. I am becoming masterful at reading lips, a skill that deserves more credit than it gets.

    I am pretty certain that my loved ones do not find this quirky symptom as easy to deal with as I do. After all, they are the ones who have to sit right in front of the TV in order to hear it. I can simply leave the room and plug my ears while relishing in the knowledge that I have ultrasonic hearing abilities. *See above reasons for why this is cool.
    Regardless, we all have to adjust and adapt when this situation arises unexpectedly. I know it is a huge imposition that I place on my family. They suffer in silence while I am the one who has the incredible fortune of being able to hear the TV at the lowest volume setting there is. Heck, I think I can hear it even when it is on mute. Super power indeed!
    Check out more of Michele’s posts, musings, and incredible insight on her page here!

    Surprising Symptoms

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    By Bruce Campbell

    ME/CFS and fibromyalgia (FM) come with many unexpected and disconcerting aspects. You may feel relatively well one day, then spend the next day in bed. Your fatigue or other symptoms may be out of proportion to your activity level.
    You may have cognitive problems such as trouble finding words, poor memory or a general feeling of mental fogginess. Or you may experience symptoms triggered by noise and crowds.

    We have come to call these puzzling aspects of ME/CFS and fibro “surprising symptoms.” This article describes nine and offers ideas about how to deal with them.

    Delayed Effects

    A central aspect of ME/CFS and FM is delayed effects from activity. You feel fine when you are doing something, but fatigue, pain and other symptoms hit you a few hours later or even the next day. The solution is to find your body’s limits and then live within them.

    A way to determine limits for individual activities is to try different lengths of time and note how you feel afterwards. You can get a more comprehensive understanding of limits by spending a few minutes a day keeping a health log. Records reveal patterns and help you to discover the many different factors that contribute to symptoms.

    Once you know your limits, you can live within them using pacing strategies that include reducing your overall activity level, taking daily rest breaks, having short activity periods, switching between tasks, making use of your best time of the day, using reminders, and having personal rules.

    Post-Exertional Malaise

    This term means fatigue out of proportion to the energy expended. For example, you might have to rest for an hour after a trip to the grocery store. Or you may be able to walk for 10 minutes with no increase in symptoms, but walking for 20 minutes results in fatigue so severe that you have to lie down afterwards. Pacing strategies can help.
    One is to take frequent rest breaks, stopping to recharge your batteries before you reach your limit (“stop before you drop”). Another is to modify how you do things. For example, one person who used to rest after grocery shopping was able to eliminate the rests after she began using a scooter in the store.

    Brain Fog (Cognitive Problems)

    Most people with ME/CFS and many people with fibromyalgia are troubled by cognitive problems, often called “brain fog” or “fibro fog.” The difficulties include being forgetful, feeling confused, difficulty concentrating and the inability to speak clearly.

    Brain fog can have several causes: overexertion, stress, poor sleep, multi-tasking (doing more than one thing at a time), sense overload, and the side effects of medications.
    Strategies for reducing fog include pacing, stress management (see next section), improving sleep, doing one thing at a time, avoiding overstimulation and changing medications or dosage levels. Additional strategies include using lists and other reminders, having an orderly house, using routine, doing mental activities during hours of greatest alertness.

    Stress Sensitivity

    ME/CFS and FM both increase the amount of stress in most people’s lives and make people more vulnerable to the effects of stress. We call the latter factor “resetting the body’s stress thermostat.” The effects of a given level of stress are greater than they would be for a healthy person. Vulnerability to stress makes managing stress a high priority. There are two main approaches to controlling stress: stress reduction and stress avoidance.

    Sensory Overload

    People with ME/CFS and FM are often sensitive to noise, light, movement or sensory input coming from several sources at the same time. You can reduce sensory overload by making adjustments in how you live. For example, you may be able to understand what you read better if you turn off the TV while reading or move to a quieter place.
    If noisy restaurants bother you, try visiting during quiet times. If large groups feel overwhelming, try getting together with only a few people. If media bother you, limit your exposure, especially to movies and TV with frequent scene changes.

    Emotional Sensitivity

    ME/CFS and fibromyalgia often make emotional reactions stronger than they were before and harder to control. The technical term is labile. One person in our program wrote, “My emotions are much more sensitive than ever before. I cry more easily, and I have less emotional reserve.” The intensification of feeling occurs even with positive emotions. Any experience that triggers adrenaline seems to intensify emotions.

    Three strategies for dealing with emotional sensitivity are: 1) distraction: turn your attention to something other than the trigger of your emotions; 2) rest: see your reaction as a sign that you’re outside your limits and take a time out; and 3) communication: tell your family and close friends about the effects of your condition on your emotions, so they will better understand your reactions.

    Irritability (Crankiness)

    Irritability is common aspect of ME/CFS and FM, one related to emotional sensitivity. Often crankiness is triggered by overactivity and overstimulation; the antidote is a time out. In the words of one person, “I take crankiness as a sign that I am outside my energy envelope and need rest.”
    Another said, “When irritability and impatience settle in, I know I’ve exceeded my limits. At this point, it’s best I take a step back, rest, distract myself with a book or music, take something for pain and mostly keep to myself.”

    Tired But Wired

    This is the combination of exhaustion and a racing mind. Many people attribute the wired sensation to the overproduction of adrenaline and respond with meditation or listening to quiet CDs. If the experience occurs consistently at night, one solution is to have a winding down period of an hour or so before going to bed.

    Medication Sensitivity & Side Effects

    People with ME/CFS and FM are extremely sensitive to medications, so patients are usually started on dosages that are a small fraction of normal dosage levels. Many medications cause fatigue and mental confusion, so patients and their doctors have to monitor side effects closely.

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