Composer Andrew Hugill describes how a little-known hearing condition has made listening to music exhausting for him
Andrew Hugill has spent a lifetime immersed in music as a composer, performer and academic. Yet he now finds listening profoundly difficult after developing diplacusis, a condition in which each ear perceives the same sound differently.
At 68, he can usually tolerate only a few minutes of music before, as he puts it, his brain becomes fatigued from the effort of processing conflicting signals.
What diplacusis sounds like
Diplacusis can take several forms. For some people, sound reaches one ear slightly later than the other, producing an echo-like effect. For others, including Hugill, the pitch itself differs between ears, so a single note sounds out of tune.
The result can be disorientating and mentally draining. Music that was once a source of pleasure can become confusing or even distressing.
Causes and clinical context
Clinicians link diplacusis to a range of causes, including long-term exposure to loud noise, head injury, age-related hearing loss, ear infections, earwax blockage and certain medications. It is also seen in some people with Ménière’s disease, where diplacusis can also fluctuate day to day.
Some cases are temporary and resolve once the underlying problem is treated. Others reflect permanent damage to the inner-ear hair cells that transmit sound to the brain.
Hugill’s hearing problems are associated with Ménière’s disease, a disorder of inner-ear fluid pressure that causes vertigo, tinnitus and fluctuating hearing loss.
The cognitive toll on musicians
The mental effort required to reconcile mismatched signals from each ear can be considerable. Performing-arts clinicians say diplacusis can range from mildly irritating to severely disabling, with a significant impact on quality of life.
Musicians appear to be at particular risk. Estimates cited by specialist clinicians suggest that approximately 3-8% of professional musicians experience diplacusis, likely reflecting prolonged exposure to high sound levels.
“Many people are surprised to learn that hearing loss isn’t always about volume,” said Micaela Stonestreet, a Clinical Audiologist at Hearology®. “With diplacusis, the perception of sound itself changes. Something that once felt effortless, such as music, becomes hard work. Patients often describe a real sense of loss, not just of sound quality, but of enjoyment and identity.”
Adapting to altered hearing
Hugill now uses hearing aids and often wears earplugs or headphones over them at live events. He avoids concerts and extended listening at home because his symptoms worsen with prolonged exposure.
In radio interviews, he has spoken about trying to digitally recreate his altered hearing to help others understand the experience, and to argue for greater inclusivity in how music is created and presented.
Prevention and early action
Audiology bodies and charities stress the importance of hearing preservation. Advice includes taking regular breaks from loud sound, keeping personal listening devices at safe volumes, using ear protection at concerts and avoiding close proximity to loudspeakers. Noise-cancelling headphones can also help by reducing the need to increase volume.
While some forms of diplacusis are reversible, permanent cases pose long-term challenges. Prompt assessment by an audiologist or ENT specialist is advised when symptoms first appear.
References
- 'I can't listen to music any more. It's ruined my life' - Daily Mail interview with Andrew Hugill
- Getting help if your world is in a spin - Ménière's disease-based case study of Hugill’s affliction
- Diplacusis: Understanding double hearing - This resource provides an overview of diplacusis, a hearing condition where each ear perceives different pitches, leading to distorted sounds
