Noise Sensitivity In Patients With Post-Concussion Syndrome

One common post-concussion symptom is an over-sensitivity to sound. Situations, in which noise levels had been previously tolerable, may now be unbearable, painful and even cause more symptoms– often immediately. Dining at a favourite restaurant or shopping at usual times are avoided as noise levels are deemed to be unacceptable, possibly leading to mental exhaustion or headaches.

The effects of sound, or the lack of it, is well-researched and can lead to a wide range of negative issues, including cognitive problems affecting concentration and memory, if too intense, to a substantially increased risk of dementia or Alzheimer’s, if too little.

To reduce over-stimulation and better manage noise exposure, there are smart phone apps, many free of charge, that can map noise levels, allowing people to alter their schedule and environments. Coupled with recovery time and the advise and expertize of other health professionals, the limiting effects on lifestyle can, in part, be mitigated.

As with injuries to other parts of the body, limiting activity or its duration can go a long way to reduce the recuperative process. In limiting exposure to “all that dam noise”, as a patient of mine so succinctly stated, when asked about her experiences, one can hopefully reduce this process.

Normally the brain gleans from the environment what is necessary for survival and interaction and filters out what is not, whether it is processed consciously or subconsciously. Post-concussion patients often have a reduced ability to do so: physical, visual and aural (hearing) stimulation bombards them in ways that can run the gamut from distracting to outright immobilizing.

With all this in mind, it’s no surprise that many sports teams have ‘quiet rooms’ at arenas and stadiums: to prepare for a match, digest a coach’s orders, or just to clear the mind before the ‘big game’, these rooms allow athletes to better focus on the task at hand. 

In determining what has the greatest effect, consider not just what the sound is, but also its loudness (or intensity). The following is an example of the intensity or ‘decibels’ of common situations and noise producers. 

Very quiet room 40dB: closed door/windows, no electronic devices, no HVAC sound, no traffic, etc.

Quiet Home/office 45-55dB: no TV/radio with perhaps a computer running and windows closed.

Average Home/office 50-70dB: add TV/radio, relaxed conversation, HVAC running and windows open in suburbs.

Loud Home/office 60-75dB: mealtime preparation, TV, printers and ‘lively’ co-workers/family members.

Busy restaurant/supermarket/daytime downtown core 70-90dB: add loud clatter of dishes, overhead music, food preparation machines, construction, traffic, etc.   

The Centers for Disease Control (CDC) in the United States lists some common decibel levels. School cafeterias are noted to reach 85 dB, which is also the same level that hearing loss is said to occur.  Workplace hearing protection is recommended at this level, often by law.  That being said, there is a big difference in exposure for workers 8 hours per day and 40 minutes for lunch.  

I will stress again that those with post-concussion syndrome should seek out the assistance of other health professionals and utilize multiple resources to better manage the recovery process.

The following summarizes the experiences of a patient at our clinic which, to a large extent, was the genesis behind this blog entry. 

“One of the most difficult symptoms of my brain injury was the hyper-sensitization of my senses, especially hearing. The world is a very noisy and chaotic place when the brain’s filters are impaired. My musicians ear plugs were the single best investment I made during my recovery. By helping my injured brain filter the ambient noise, I was able to continue to partake in normal life activities as I healed. An expert once told me hypersensitivity to sound is often the longest lasting symptom of brain injury. I highly recommend musicians ear plugs to assist in this lengthy recovery process.” A.T.

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