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Id 31cccf65-97a3-49f2-83b0-631485d35091

Year 2026

Abstract

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Aliases

(Keenehan et al., 2026)

Import Date 05-04-2026

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Dv Authors Katelin R. Keenehan, Erin M. Gawel, Amanda G. Baanante, Gaayathri Varavenkataraman, Alexis Rondinelli, Ellen Piccillo, Michele M. Carr,

Dv Initial Source Misophonia MOC

Dv Status #status/Bare-bones-review

Dv Limitations N/A

Dv Future Directions • More research on long-term effects of white noise exposure given widespread parental use. • Continued physician and audiologist assessment of sound intolerance in children.

Dv Relevance • the article is note very well named as it is looking at if the use of white noise in childhood is associated with Misophonia or hyperacusis • the results have mild implications for the co occurrence and age of onset of Misophonia, relating Misophonia to broader sensory emotional processing phenotypes in overlap with ASD, , a strong relationship between Misophonia and hyperacusis, and ( funny enough) no link to the use of white noise to either condition.

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Factors associated with misophonia in children

Status:: #status/Bare-bones-review

Metadata

Item Type: #journalArticle
Authors:: Katelin R. Keenehan, Erin M. Gawel, Amanda G. Baanante, Gaayathri Varavenkataraman, Alexis Rondinelli, Ellen Piccillo, Michele M. Carr,
Date:
Date Added: 1769137303000
URL: https://linkinghub.elsevier.com/retrieve/pii/S0165587625004690
DOI: 10.1016/j.ijporl.2025.112681
Cite Key: keenehanFactorsAssociatedMisophonia2026
Topics: [object Object]
Tags:: #Misophonia, #Bare-bones-review-🦴, #clinical,
PDF Attachments

Abstract


Background/Purpose	Background- • White noise machines are increasingly used by parents to aid child sleep, sometimes throughout the entire sleep period. • Concerns exist regarding prolonged white noise exposure and its impact on sensory development, noise intolerance, misophonia, and hyperacusis. • Hyperacusis and misophonia often begin in childhood or adolescence. • Early noise exposure is a potential risk factor requiring exploration. Purpose- • Investigate whether white noise exposure in childhood is associated with symptoms of hyperacusis or misophonia.
Participants/samples	• Pediatric otolaryngology clinic patients at an academic tertiary care hospital. • Ages 3–18 years. • Parents completed paper survey. • Recruitment June 2024–December 2024. • Roughly balanced male/female; predominantly White/Caucasian.
Measures	• Demographic information (age, gender, race, ethnicity, household children). • Medical history (ADHD, ASD, hearing loss, recurrent otitis media, restless sleep/snoring, otalgia, abnormal hearing, white noise exposure in first three years of life). • Hyperacusis Assessment Questionnaire (HAQ) — loudness, pain, fear subscales. • Modified Duke Misophonia Questionnaire (DMQ) — emotional reaction to everyday sounds, trigger sounds, family impact, life disruption frequency, symptom onset.
Procedures	• Paper survey distributed to parents of consecutive pediatric otolaryngology patients. • Consent obtained at enrollment; survey separate from clinical visit. • Binary logistic regression for misophonia predictors. • Multivariate linear regression for HAQ score predictors. • Covariates: gender, age, ethnicity, ADHD, ASD, hearing loss, ear infections, restless sleep/snore, otalgia, abnormal hearing, white noise exposure as infant. • A priori power analysis indicated adequate sample for medium effect detection.
Results	• Hyperacusis present in a minority of participants; misophonia present in a similar minority. • Most common named misophonia trigger sounds: eating sounds, repetitive sounds, voices (background sounds and an 'Other' category also frequently endorsed in Table 5). • Majority of misophonia cases reported no or only very mild life disruption. • Otalgia associated with higher HAQ scores. • Older age, ASD, and otalgia associated with presence of misophonia. • White noise exposure not associated with HAQ score or misophonia. • Gender, ethnicity, ADHD, hearing loss, ear infections, restless sleep/snore, and abnormal hearing not associated with HAQ score or misophonia. • Patients with misophonia had higher HAQ scores than those without misophonia.
Discussion/Limits	Conclusion- • The findings indicate hyperacusis and misophonia prevalence in this pediatric cohort is consistent with prior literature. • The authors conclude otalgia may serve as both a symptom and a clinical marker of hyperacusis in children. • The findings indicate misophonia is more common in older children and frequently co-occurs with neurodevelopmental conditions, particularly ASD. • The authors conclude misophonia reflects a broader sensory-emotional processing phenotype with overlap with autism spectrum features. • The data show a strong relationship between misophonia and hyperacusis (higher HAQ scores in the misophonia group), suggesting shared auditory sensitivities; the authors interpret this as a possible overlapping neurobiological basis. • The findings indicate no association between white noise exposure and hyperacusis or misophonia symptoms in this cohort. • The authors conclude clinical assessment should include otalgia, emotional regulation, attention, family psychiatric history, and physical complaints, favoring a multidisciplinary individualized approach.
Limitations::	N/A
Future Directions::	• More research on long-term effects of white noise exposure given widespread parental use. • Continued physician and audiologist assessment of sound intolerance in children.
Relevance::	• the article is note very well named as it is looking at if the use of white noise in childhood is associated with Misophonia or hyperacusis • the results have mild implications for the co occurrence and age of onset of Misophonia, relating Misophonia to broader sensory emotional processing phenotypes in overlap with ASD, , a strong relationship between Misophonia and hyperacusis, and ( funny enough) no link to the use of white noise to either condition.

Notes

key terms and concepts

misophonia – strong emotional or behavioral response to sound, leading to distress or functional impairment.
hyperacusis – decreased tolerance to sounds that are perceived as normal to most people.
HAQ – Hyperacusis Assessment Questionnaire; 14 items, 5-point Likert scale, three domains (loudness, pain, fear), total score 0–56.
DMQ – Duke Misophonia Questionnaire; modified version used to evaluate emotional/behavioral responses to common environmental sounds.
otalgia – ear pain.

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Bookmarks

reading notes

Otalgia as marker

Prior work (Myne & Kennedy; Nemholt et al.) links otalgia and middle ear conditions to hyperacusis.
Wilson et al. proposed medial olivocochlear efferent inhibition as a physiological mechanism for sound-induced otalgia in ASD.

ASD and misophonia overlap

Rinaldi et al.: misophonia associated with autistic traits, impaired emotion regulation, broader sensory sensitivities.
Dwyer et al.: intensity-dependent auditory processing differences in autistic children.
McKenna et al.: high prevalence of hyperacusis and recurrent otitis media in ASD.

Psychiatric and family context

Guzick et al.: anxiety, depression, OCD common in youth with misophonia.
Storch et al.: parental accommodations linked to symptom severity.
Murphy et al.: increased attentional vigilance to triggers, distinct from anxiety disorders.
Bodo et al.: hypothesized gut-brain axis link to gastrointestinal issues.

White noise concerns in literature

Nigg et al.: benefits in ADHD, possible overstimulation in non-ADHD.
Soderlund et al.: arousal-state-dependent effects.
Hong et al.: infant white noise machines may exceed safe sound levels.
Schuler et al.: altered cortical excitability in adults.

contextual statement

In a 2026 study, Keenehan attempted to investigate whether early childhood white noise exposure is associated with hyperacusis or misophonia by surveying parents of 375 pediatric otolaryngology patients (ages 3–18) using the HAQ and a modified DMQ alongside demographic and medical history items.

zettlekasten

Keenehan 2026 finds Otalgia, ASD, and Age — Not White Noise — Predict Pediatric Sound Intolerance