Turn it down!

Turn it down!

Turn it down!

Don't shout.

Please whisper.

My family hears these phrases from me nearly every day. Even when migraine isn't actively trying to ruin my day, phonophobia is ever-present. It drives everyone crazy, especially me. Most of the time I try to cope by using silicone ear plugs. Recently my husband purchased an expensive pair of cordless Bose noise-cancelling headphones. I was complaining rather loudly one evening when he suggested I try them. I slipped them over my ears and noticed how comfortable they felt. There was nothing to pinch, pull, or otherwise irritate my sensitive scalp. At the very least, they would not trigger an attack like so many headphones I have tried. Then he showed me how to turn them on. One click and instantly all the background noise disappeared and the TV volume was cut by 25%. Even his voice, which is normally loud and booming, was much quieter. I could still hear him and the TV, yet the intensity was tolerable. The results have been so positive that I have resolved to get my own set.

What the research says

Most of us are sensitive to sound during an acute attack. A 2009 study on phonophobia found that 70-80% of migraineurs experience phonophobia during an acute attack1. A second study in 2013 reported rates of phonophobia during acute attacks to be 90%3. What these studies have in common are their findings that 100% of migraineurs with photophobia during an attack also experienced clinically significant phonophobia between attacks1,3.

I just love it when research proves our crazy symptoms are legit.

Many of us report that loud noises can trigger an attack. Dr. Todd Schwedt supports the idea that phonophobia can be present in both prodrome and acute phases as well as a trigger3. However, a more recent 2015 study challenges this idea. In this study patients who reported sensory input triggers experienced higher rates of phonophobia, photophobia, and osmophobia during the prodrome phase. Researchers concluded that patients may be mistaking early prodrome symptoms as triggers. They also postulated that sensory stimuli may only be a trigger in those with phonophobia, photophobia, and osmophobia between attacks when the threshold for noise tolerance is already low2.

Personal experience backs up their findings

I have noticed that my sensitivity to sound varies. Some days sound does not bother me at all. At more sensitive times, loud noise appears more likely to trigger an attack. Rarely is sound the only potential trigger, so the studies might be right. Something else may be triggering the attacks and I just happen to notice sound because my tolerance level is lower. Whether it's a trigger or prodrome symptom, it's still a problem.

How we cope

The studies did not address behavioral responses to phonophobia. One even mentions this as an issue for further research1. So let's help them out. Can you think of specific behaviors you do in order to cope with phonophobia? Here's a few ideas to get you started:

  • Cover ears with hands
  • Use ear plugs or headphones
  • White noise
  • Demands for silence
  • Lowering volume of TV, radio, etc.
  • …your idea

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