Everyone gets annoyed by certain noises at times. You might wince at the screech of feedback from a microphone or want to scream at the construction worker pummeling a pneumatic drill outside your window. But for some people, the quietest sounds are the most excruciating.

For people with misophonia, every day sounds like slurping, tapping, or sniffing don’t just annoy—they trigger an intense fight-or-flight response. The condition, whose name means “hatred of sound” in Greek, hijacks the nervous system, making even the slightest noises feel unbearable. Scientists estimate that between 5 and 20 percent of adults experience this extreme sensitivity, yet misophonia remains poorly understood.

“When I was younger, one sound that made me feel the weirdest was that repetitive noise pigeons make,” says Jane Gregory, a psychologist at Oxford University and author of the book Sounds Like Misophonia, who has the condition herself.

“They used to live outside the window in my bedroom where I studied so I couldn’t concentrate. Pens clicking was another big one for me at school, like those four-color pens people would click every two seconds. It used to drive me insane.”

While the American Psychological Association does not formally recognize it, misophonia is increasingly being recognized by health professionals. In October 2024, the Misophonia Research Fund announced $2.5 million of funding for projects. “Misophonia is a disorder that has long been misunderstood and under-researched, leaving many affected individuals without adequate answers or support,” says the fund’s executive director, Lauren Harte-Hargrove.

Here’s what scientists are doing to understand why certain sounds trigger such extreme reactions—and what can be done to help.

Scientists are still unraveling the causes of misophonia, but one theory suggests it evolved from the brain’s instinct to detect hidden threats. For example, in the hunter-gatherer era, your ears pricking up at the slightest hint of harm could have saved your life, says psychologist and researcher Jennifer Brout, who founded the Misophonia Research Network (now part of advocacy organization soQuiet).

“If you hear chewing that other people don’t, that could mean someone has taken your food or there are predators chewing nearby that might be coming to get you next,” she says.

And “from an evolutionary psychology perspective, coughing, sneezing, sniffling and throat clearing [might indicate the presence of] pathogens,” Brouts adds.

But today, that same neurological wiring can make harmless noises feel unbearable. “It’s as though your brain misinterprets these sounds as toxic or harmful and therefore your attention stays on them. You can’t push them to the background like other people would,” she explains.

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Beyond its evolutionary roots, misophonia appears to have a complex relationship with other conditions. A literature review from 2022 found that misophonia co-occurs with a wide range of different conditions, including depression, anxiety, autism, ADHD, and OCD. However, scientists have yet to determine whether misophonia is a symptom, a separate disorder, or something in between.

Some cases also emerge after a traumatic event, raising questions about whether environmental factors can trigger misophonia. Meanwhile, evidence that the condition runs in families suggests a possible genetic component, though no specific genes have been identified.

There’s no standardized test for misophonia, but doctors use screening tools to assess its severity. One of the most common is the Duke misophonia questionnaire (DMQ), which helps determine whether a person’s sound sensitivity is severe enough to interfere with daily life—affecting work, school, self-esteem, or relationships.

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“Most people report having their first memory of misophonia somewhere between the age of eight and 12,” says Brout, which is why the Amsterdam Misophonia Scale was developed for assessing children.

Despite its growing recognition, misophonia remains absent from the DSM-5, the leading diagnostic manual for psychiatric conditions. Researchers hope for its inclusion one day, but their more immediate goal is to secure an ICD (International Classification of Diseases) code to enable private healthcare reimbursement.

“That’s really important because then misophonia will be more recognized,” Harte-Hargrove says. “[People] can actually go to a clinician, and it can be covered by their healthcare provider.”

Since no known cure for misophonia exists, treatment focuses on managing symptoms. Many patients rely on noise-canceling headphones or white noise to block out triggers, but psychological approaches can also help.

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The most common psychological intervention is cognitive behavioral therapy (CBT), a talking therapy that trains the brain to reframe its response to trigger sounds.

“It’s about taking control of sounds and interacting with them in different ways to help the brain update its learning and discover that these sounds are annoying but not harmful,” Gregory explains.

Unlike exposure therapy, which forces confrontation with fears, CBT for misophonia is tailored to what the patient can tolerate. “It’s also used to reduce self-blame, particularly for people who feel like, ‘I’m this angry person deep down inside and I shouldn’t be feeling this way’ or ‘People are doing it deliberately so the person making that sound can’t possibly care about me.’ It’s updating those narratives,” she adds.

Research shows promise for CBT, with studies from the Netherlands and the U.S. suggesting it can significantly reduce symptoms in about a third to half of patients. Meanwhile, scientists are exploring new treatment possibilities, including brain stimulation techniques used for other neurological disorders.

“We’re hopeful that sometime soon we will have better and more treatment options for people with misophonia,” Harte-Hargrove says.