Misophonia: Sound Triggers, Symptoms, and Support

What Is Misophonia?

The term “misophonia” comes from Greek and literally means “hatred of sound”. People experiencing misophonia have a strong emotional response to commonly occurring everyday sounds like chewing, pen clicking, or throat clearing. When hearing these sounds, a person with misophonia can become upset, angry, fearful, or disgusted, even if these noises are at a low volume. 

Misophonia is a lesser-known condition, but it can be debilitating for some. At the extreme end, in what’s known as “clinically significant misophonia”, it can make daily activities like going to work, college, or navigating the world extremely difficult. This is why misophonia awareness is so important. If we can educate others, we can help those experiencing it to feel less isolated or ashamed.

Common Misophonia Triggers

Misophonia is believed to affect around 1 in 5 people in the UK, and there are usually particular trigger sounds that bring on a misophonic response. This tends to include things like:

• Eating sounds
• People coughing or sneezing
• Breathing noises
• Knocking sounds
• Scraping sounds
• Throat clearing
• Tapping or ticking sounds

While these are some of the most commonly reported triggers, they aren’t the same for everyone. Some individuals may have more unique triggers, like visual cues or physical sensations that make them believe a sound is about to happen. For example, a person’s misophonia could be triggered by seeing someone grab a pocket tissue from their bag. Although no sound has happened yet, the visual cue may be enough to provoke fear or discomfort because the person expects a trigger sound, such as nose blowing or sniffing, to follow.

What Causes Misophonia?

Nobody really knows for sure what causes misophonia, but experts believe it may involve differences in how the limbic system, autonomic nervous system, and auditory cortex interact.

These areas of the brain are responsible for processing sound, regulating emotions, and controlling the body’s automatic stress responses.

There can also be an element of anticipation. Someone with misophonia may begin to feel anxious or on edge in environments where they expect to encounter a trigger sound, such as a café or restaurant. Over time, certain places or situations may become associated with those sounds, meaning the person can experience distress before the trigger even occurs. This anticipation may lead them to avoid particular environments altogether.

Researchers have linked misophonia to a number of different conditions, including autism, ADHD, anxiety, OCD, depression and PTSD, although it can occur independently of any other diagnosis. In fact, one particular review found that misophonia occurs in roughly 12.8–35.5% of autistic participants, but the evidence base is still developing and more research is needed.

Signs and Symptoms of Misophonia

Misophonia can look different in different people; however, some of the most common signs include:

• Feeling extreme disgust, anger, sadness, or rage in response to specific sounds
• A quick onset of physical sensations in the body, like rapid heartbeat, stress, sweating, or a need to get away from the sound
• Avoidance of certain people, environments, or situations where the sound might occur 

Although misophonia usually begins in childhood or adolescence, symptoms can also appear later on in life. 

Misophonia vs Hyperacusis: What’s the Difference?

Misophonia isn’t the only condition that makes certain individuals more sensitive to particular sounds. Another is “hyperacusis”. This is where everyday sounds can feel much louder than they should. Some people find these sounds physically painful. 

Unlike with misophonia, hyperacusis isn’t about emotional responses to specific sounds or sound patterns; it’s about an increased sensitivity to the sound’s intensity. With hyperacusis, everyday noises may seem excessively loud, uncomfortable, or painful, regardless of what the sound is.

According to research, hyperacusis is more common in people with conditions such as tinnitus, autism spectrum disorder, and Williams syndrome.

Hyperacusis might look like:

• Everyday sounds seeming much louder than they do to other people
• Clattering dishes or cutlery feeling uncomfortable or painful
• Vacuum cleaners, hand dryers, or alarms seeming unbearably loud
• Traffic or busy public places becoming overwhelming
• People speaking at a normal volume sounding too loud
• Having to cover the ears or avoid certain places because of noise
• Feeling pain, pressure, discomfort, or distress in response to ordinary sounds

Sometimes hyperacusis co-occurs with misophonia, but they are two distinct conditions. 

Practical Support for People with Misophonia

If you think you might have misophonia and it’s interfering with your work, education, relationships, or everyday activities, you should speak to your GP. Depending on the symptoms and services available locally, they may refer you to audiology, ENT, hearing therapy, or psychological services for further assessment and support. If misophonia is confirmed, you may then be offered therapy to help you manage your condition.

There are also some practical changes that can make everyday situations easier. For example, you might benefit from:

• Noise-cancelling headphones in busy environments
• Access to quiet spaces
• Altered seating arrangements
• Short breaks when overwhelmed 
• Background sound to make triggers less prominent

While it may be tempting, completely avoiding everyday sound or wearing hearing protection constantly might not always be helpful, especially if you also experience hyperacusis. So, if possible, try not to make any drastic changes until you’ve received a diagnosis and talked things through with a specialist.

How Misophonia Can Affect Work and Study

At times, misophonia can make working or studying particularly tough. Environments like offices and shared study spaces are often full of unavoidable sounds, from keyboard tapping and coughing to eating, sniffing, or people talking nearby.

If these noises trigger a strong misophonic response, it can become difficult to concentrate or remain in the environment for long periods of time. Some people may even start avoiding certain spaces altogether, while others might find that their productivity or ability to participate begins to suffer. Luckily, adjustments can be a big help.

Workplace and Education Adjustments

If you’re finding it hard to cope with misophonia at work or in education, you may find that reasonable adjustments make things feel more manageable. The right adjustments always depend on the person and their particular triggers, but some of the most useful include:

• Working or studying in a quieter area
• Changing where you sit to move away from common trigger sounds
• Using noise-cancelling headphones or earphones where appropriate
• Having access to a quiet room when you become overwhelmed
• Taking short breaks away from noisy environments
• Flexible or hybrid working arrangements
• Completing exams or assessments in a quieter room
• Adjusting meeting, lecture, or classroom arrangements where possible

There’s no single adjustment that will work for everyone. Someone who’s triggered by chewing sounds, for example, may need something very different from someone who struggles with repetitive tapping or breathing noises. If you’re not sure which adjustments would be best for you, you might benefit from a workplace needs assessment. This looks at the challenges you experience in your particular role and working environment and can help identify practical strategies or equipment that may make things more manageable.

If your misophonia has a substantial and long-term impact on your day-to-day activities, you may also be entitled to additional support at work or in education. What support is available will depend on your individual circumstances, so it’s worth speaking to your employer or education provider to find out what would be feasible for you.

FAQs

Is misophonia inherited?

There’s no clear answer to this. Although there’s some evidence that misophonia appears to run in some families, no single gene has been identified as the cause. The current consensus is that a mix of different things may contribute to misophonia, including genetics, how the brain processes certain sounds, a person’s environment, and their life experiences. More research is needed to find out just how heritable the condition really is.

Is misophonia common in individuals with neurodivergence?

According to research, there does seem to be an association, but being neurodivergent doesn’t necessarily mean someone will have misophonia. There is stronger evidence for a link between hyperacusis and neurodivergence, particularly autism, although research into misophonia is growing. Misophonia has also been associated with conditions such as OCD and anxiety, but the relationship between these conditions is still not fully understood.

Is misophonia a lifelong condition?

Misophonia isn’t definitively “life long”. Although symptoms can begin in childhood or adolescence and continue into adulthood, the length of time someone experiences symptoms isn’t the same for everyone. Some people may find their misophonia improves with age, while others may develop new triggers in adulthood. Misophonia varies from person to person and whether it improves depends on whether or not they’re receiving support.

Can you have misophonia and hyperacusis together?

Yes. Despite the fact that misophonia and hyperacusis are two separate conditions, they can and do occur together. This can sometimes make it tricky to recognise whether someone is negatively affected by a sound because it feels too loud or uncomfortable, or because it’s a specific sound that triggers a strong emotional reaction. A specialist can help to distinguish between the two and help a person understand the most appropriate way to manage their symptoms.