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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

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Ashkenazi, A, Mushtaq A, Yang I, Oshinsky ML. Ictal and interictal phonophobia in migraine – a quantitative study, Cephalalgia, 2009; 29:1042-1048, Blackwell Publishing, Ltd, London. Doi:10.1111/j.1468-2982.2008.01384.
  2. Schulte, Laura H, Jurgens, Tim P, May Arne. Photo-, osmo- and phonophobia in the premonitory phase of migraine: mistaking symptoms for triggers? The Journal of Headache and Pain (2015) 16:14. doi: 10.1186/s10194-015-095-7
  3. Schwedt, Todd J., MD, MSCI. Multisensory Integration in Migraine, Curr Opin Neurol. 2013 June: 26(3): 248-253. doi 10.1097/WCO0b013e328360edb1

Comments

  • Butterfly7
    4 years ago

    What a great idea. I never thought about wearing foam ear plugs. I’ve probably had phonophobia since a very young child (without other migraine symptoms).

  • Janet
    4 years ago

    Correction Tammy, phonophobia, ……however I have them all
    Janet

  • Janet
    4 years ago

    Tammy,
    Could you be specific on the Bose headphones. My husband is deaf and between me and constant photophobia and him not wearing his hearing aids we are constantly battling about everything involving noise (talking, tv, emptying dishwasher, etc) I hear him breathe, he hears NOTHING!! I’d love to get myself a pair.
    Thanks in advance
    Janet

  • Cathy
    4 years ago

    When I really feel unwell I lie down with a pillow over my head. This mutes the sound, cuts out some of the light, and somehow the feeling of a soft pillow on my sore head is soothing.

  • 1w3a0da
    4 years ago

    Huh!
    I live feet away from the highway and I have loud neighbors no one else can hear. My ears ring loud because of the loud level of sound my ears pick up. I wondered why the noises I hear only are heard too loud for me. I have earplugs to wear while my husband snores but I have to be in another room because I can still hear through the ear plugs. I knew I wasn’t crazy! I think I’m gonna look for the Bose noise canceling head phones you mentioned. Sound good to have less sound:-) Thanks

  • SheLlie
    4 years ago

    I have had some level of a migraine since Aug 31st. Just seeing the article today describing the phonophobia. That is so me! I have constantly for years been turning the tv down, muting, shushing people, not gone into crowds etc all because of noise. I hide in my bedroom with sleeping mask on to help. I have had so many treatments and nothing is helping. On two meds now and they “reduce” the pain but haven’t taken it away. I am going to look into doing something to protect my hearing and maybe that will help. I also have everything starting in my neck, going to look into that also. So much information in this site in just one day! Thank you everyone for your posts, you may have helped solved my migraines!!!!

  • Tim Autry
    4 years ago

    I avoid places that I could encounter loud noises.
    Make sure my migraine rescue kit (meds and other important things when I’m away from home) has ample foam earplugs to use if needed (Note: I always need them at church, even in the second level balcony seats).
    If possible, run to our bedroom sanctuary and cover my eyes, ears and nose and rest/sleep.
    Needless to say, it has been easier lately to retire to my safe spot as my disease has totally take over my life. I’m unable to work, can do menial tasks around the house, up to an hour before I have to stop and rest due to exhaustion, then pickup where I left off later.
    Having an Intractable migraine attack for the past 2 years makes for interesting surprises and/or events each and every hour of each and every day. The pain level isn’t constant, always at least a 2-3, but can rapidly jump to 5-6 quite easily and in noisy/loud situations in brightly lite surroundings can easily creep up to 8-9.
    I’m constantly drained fighting the pain and always in one or more stage of the migraine attack, prodrome, aura, headache and/or postdrome, mostly the headache stage with randomness of the other 3 stages.

  • Alison
    4 years ago

    ….where everything is so noisy. Traffic,aircraft, t.v, chainsaws etc.
    With the headphones I can go into shops/ restaurants with loud music also. Earplugs and sunglasses my other constant companions.

  • Alison
    4 years ago

    Tammy, when the neighbouring woodland gardeners start their 8 hour hedge-trimming every Wednesday my Bose headphones are a lifesaver. Now it is Autumn the leaf blowers are out. I find myself wondering if migraineurs have more to put up with in this technological world

  • 287l9kr
    4 years ago

    I simply use earplugs- the foam ones most of the time will soften the edges of daily sounds like television and voices.
    They are usually just enough to take the edge off, yet still allow me to hear. On my really bad days, the wax or silicone ear plugs are necessary to cut out as much sound as possible.

  • Lori
    4 years ago

    It becomes so annoying, both to me, and to my family, to constantly ask them to talk more quietly. Or to ask “Is it loud in here?” at a store, church, or a theatre. The phonophobia isn’t always with me; it comes and goes. I cannot denote any pattern, except of course I always have it with the pain phase of my migraine attacks. So my family cannot know with any certainty when they can act normal, and when they must be quiet, unless I tell them. How can this possibly come across w/o seeming to be nagging? It’s a downer for those who don’t have it. One of the by-products of living with a migraneur, kind of like 2nd-hand smoke with a smoker.

  • dizzyblonde
    4 years ago

    Sometimes when I have a migraine it never occurs to me that I can do something to help myself with this problem. I think it adds to the overstimulation my brain is already dealing with. Our toddler has been throwing temper tantrums lately in the evenings. I am working on taking more deep breaths and telling myself that she is in a normal developmental stage that isn’t about me personally and I’ve also been working with my husband to get her to bed earlier. This is a major victory because he tends to want to keep her up too late each night.

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