KEY TAKEAWAYS
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For people with misophonia, certain sounds trigger default reactions are aversion and anger.
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Although it can be debilitating in everyday life, this condition is not simply a matter of heightened sensitivity to sounds.
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Misophonia manifests as a wide range of symptoms and disorders affecting several areas, both emotional and cognitive.
Most people find some sounds unpleasant, such as a baby crying or a siren, because of features such as their pitch/frequency or loudness. However, for some people, very ordinary sounds, such as chewing, sniffing, breathing, swallowing, finger tapping or clicking a pen, can cause an immediate, intense reaction that is difficult to control, a condition known as misophonia.
A real medical condition
Misophonia is not simply being “annoyed by noise”. It is a real condition, usually described as a reduced tolerance to certain sounds or to things associated with those sounds. These sounds can cause very strong emotional, physical and behavioural fight or flight reactions that can result in the form of anger, disgust, anxiety, panic, muscle tension, increased heartbeat, an urge to leave the situation or stop the sound, and, more rarely, verbal or physical aggression.
In most cases, the loudness of the sound is not the main problem. The reaction depends more on the type of sound, what it means to the person, the situation in which it happens and sometimes even who is making it. For example, the sound of someone chewing may be unbearable when it comes from a particular person, like a husband, wife, mother or father, but much easier to tolerate in another situation.
People with misophonia often notice that their reactions happen automatically and are particularly intense and out of proportion. Misophonia can, therefore, have a major effect on everyday life. Eating with family, attending a class, working in a shared office, using public transport or maintaining close relationships can become very difficult. Some people also react strongly to visual cues linked to sounds, such as seeing someone chew or make repetitive movements, known as misokinesia.
Misophonia is frequently associated with various psychiatric disorders, including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), depression and anxiety disorders. Interestingly, however, misophonia is not currently recognised as a separate disorder in the main international medical classification systems, and this remains an area of scientific debate.
Research into the causes
Researchers have been trying to understand misophonia for some years now. In hearing research, it has often been studied alongside other conditions involving reduced sound tolerance, such as hyperacusis and phonophobia. However, these conditions are different. Hyperacusis mainly involves being unusually sensitive to the loudness of sounds, which can sometimes cause pain. Phonophobia, by contrast, mainly involves fear of certain sounds.
Other researchers suggest that misophonia may involve an unusual connection between sounds and emotions. The brain hears the sound normally, but the emotional and physical response becomes much stronger than expected.
More recent research suggests that the condition is not simply about being sensitive to sounds. Trigger sounds are clearly important, but many people report that their reaction also depends on the situation, what they expect, how much control they feel they have, who is making the sound and what they believe the sound means. The same sound may be completely tolerable in one situation and unbearable in another. For example, many people with misophonia find it easier to tolerate a sound made by an animal or a young child than the same sound made by an adult, particularly someone close to them.
Is it linked to how well we adapt to situations and manage our emotions?
Our recent research explores this possibility. We studied whether misophonia is also linked to cognitive and emotional flexibility. Cognitive flexibility is the ability to change and adapt the way we think when a situation changes. Emotional flexibility is the ability to shift our attention or adjust our response when dealing with emotional information.
Our findings suggest that more severe misophonia may be linked to lower levels of both types of flexibility. In everyday life, this could mean that when a trigger sound occurs, it becomes harder to shift attention away from it, see the situation differently or return to a calmer emotional state. The reaction may then continue: the sound takes over the person’s attention, the emotional response becomes stronger, and it becomes difficult to move on from it, even when the person knows that the sound is harmless or was not made deliberately.
This difficulty may also help explain why some people continue to feel angry, tense or distressed even after the sound has stopped, or why they may keep thinking about the event for a long time afterwards. Misophonia may therefore not only involve strong sensitivity to certain sounds, but difficulty moving away from them mentally and emotionally.
Lower flexibility may also lead to stronger expectations about how other people should behave. As a result, behaviour that does not match these expectations may be more likely to cause a negative emotional reaction.
How we interpret other people’s behaviour plays a role in misophonia
Most trigger sounds are made by other people. The reaction may therefore depend not only on the sound itself, but also on how the other person’s behaviour is understood. Does the sound seem unnecessary, avoidable or deliberate? Is it seen as disrespectful?
This is why ideas such as theories involving mind and empathy may be important for future research. The mind is our ability to understand what other people may be thinking or intending while empathy is our ability to understand or share another person’s emotions.
Our future study (https://www.biorxiv.org/content/10.64898/2026.09.03.749152v1) will aim to understand these processes more clearly. This could help us move beyond overly simple explanations of misophonia as just being sensitive to noise or easily irritated. It may also improve public understanding, clinical assessment and support for people affected by misophonia.
For more information
If you think you might also display extreme sensitivity to sound and would like to find out more about related research and opportunities to take part in future studies, please contact: Mercedeh Erfanian