An immersive ecological measure of noise-induced functional interference in adults with hyperacusis

Noise interfering with everyday activities is a common experience in many daily soundscapes. However, for individuals with intolerance to loud sounds, a condition called hyperacusis, these soundscapes can have a severe impact, greatly impairing lifestyle habits such as work, hobbies and social interactions. Yet, there is little experimental evidence documenting the functional impact of noise in these individuals. This study aims to validate a novel, ecologically relevant task designed to measure the functional impact of noise during a common daily activity: reading. Forty-nine participants (29 controls, 20 with hyperacusis) read a book excerpt while exposed to four different soundscapes. The sound level was gradually increased until participants reported that the noise interfered with their reading ability (called annoyance level), and then further increased until it became uncomfortable (called discomfort level). Participants then performed a 2-back cognitive task both in silence and in noise calibrated to their individual annoyance threshold. On average, individuals with hyperacusis reached these thresholds at sound levels 13 dB LAeq lower than controls. However, at their respective annoyance thresholds, both groups showed similar performance decrements (-3 %) in noise versus quiet. These findings support the validity of a novel ecological measure that integrates subjective annoyance thresholds with cognitive performance on a behavioral task, offering a reproducible approach to quantify the functional impact of hyperacusis.