What are auditory hallucinations?

Hallucinations can happen to anyone, and they’re often more common than people realize. You might hear a sound, a voice, or even music that seems completely real—only to discover there’s no external source at all. Experiences like these can be surprising, confusing, or even unsettling, and it’s natural to want to understand what’s going on. 

Hallucinations can involve any of the five senses, but this article focuses specifically on auditory hallucinations, which include hearing noises or voices that aren’t actually present. By learning more about what causes them and how they’re treated, you can get a clearer sense of when to seek support and what steps to take next. 

• What are auditory hallucinations?
• What can cause auditory hallucinations?
• How are auditory hallucinations diagnosed?
• How are auditory hallucinations treated?
• Understanding the bigger picture

Note: Our Hearing Care Providers (HCPs) are here to support your hearing health and provide personalized guidance. However, if you're concerned about medical issues affecting your hearing, always consult your healthcare provider first. 

What are auditory hallucinations? 

Auditory hallucinations are the perception of sounds or voices that other people cannot hear. While they are strongly associated with schizophrenia and other psychiatric conditions, research suggests that 10-15% of people may experience auditory hallucinations occasionally without having a diagnosed mental illness. These experiences can also appear in children, especially during periods of stress or emotional change. 

For some individuals, auditory hallucinations take the form of clearly defined voices. For others, they sound more like indistinct noises, music, whispering, or environmental sounds. These perceptions may be neutral, comforting, confusing, or distressing depending on the situation. 

Common forms of auditory hallucinations include: 

• Hearing one or more voices, either familiar or unfamiliar.
• Perceiving sounds coming from inside or outside the head.
• Hearing tones, buzzing, humming, or mechanical noises.
• Experiencing music or songs that are not actually playing.

Although experiences vary widely, auditory hallucinations can impact concentration, mood, and overall well-being, making assessment an important step when occurrences become persistent or intrusive. 

What can cause auditory hallucinations? 

Auditory hallucinations can arise for many different reasons. Some of the possible causes of auditory hallucinations are temporary and easily treated, while others are associated with long-term health conditions. Because symptoms overlap across so many areas, a proper medical assessment is essential. 

Mental health conditions 

Schizophrenia, bipolar disorder, depression, post-traumatic stress disorder, and borderline personality disorder are all known to involve auditory hallucinations. In these cases, hallucinations may occur alongside changes in thinking, mood, and perception. Voices may seem critical, directive, or simply conversational, depending on the individual. 

Infections and high fever 

Severe infections—such as meningitis—or very high fevers can trigger short-term hallucinations. People often describe hearing sounds or voices during periods of confusion. Treating the underlying illness typically resolves these symptoms. 

Neurological conditions 

Neurological conditions can affect how the brain processes sound: 

• Parkinson’s disease: Many people with Parkinson’s experience hallucinations as part of Parkinson’s Disease Psychosis (PDP). While visual hallucinations are most common, auditory experiences can occur.
• Dementia and Alzheimer’s disease: Hallucinations may appear in later stages and can seem very real to the person experiencing them.
• Epilepsy: Seizures affecting the auditory cortex may cause buzzing, ringing, or distorted voices.
• Migraines: Some people experience auditory disturbances during migraine attacks, particularly when migraine occurs alongside depression.

Substance-related causes 

Alcohol misuse can lead to alcoholic hallucinosis, especially after prolonged heavy drinking or during withdrawal. Hallucinogenic drugs like LSD, PCP, and ecstasy can cause auditory or visual distortions both during use and afterward.  

Some prescription medications—including certain antipsychotics, antidepressants, and epilepsy drugs—can also trigger hallucinations as a side effect. 

Sleep-related causes 

Sleep-related hallucinations, known as parasomnias, often occur when someone is drifting into sleep or waking up. Sleep deprivation, irregular sleep patterns, or extreme fatigue can increase the likelihood of hearing sounds or voices during these transition periods. 

Sensory conditions, tinnitus, and hearing loss 

Tinnitus, often described as ringing, hissing, or buzzing in the ears, is not itself a hallucination, but it can increase the risk of experiencing voice-hearing episodes, especially when combined with depression. Hearing loss can also trigger auditory hallucinations, and research shows that symptoms often become more intense as hearing loss becomes more severe. 

Musical hallucinations (MH) 

Musical hallucinations involve hearing melodies or songs that are not actually present. This phenomenon is most common in older adults, particularly women, and is more likely to occur in people who live alone or have hearing loss. 

Across all causes, what matters most is identifying the underlying reason so the appropriate treatment can begin. 

How are auditory hallucinations diagnosed? 

Diagnosing auditory hallucinations involves exploring when the symptoms began, what they sound like, and whether any medical or emotional changes occurred around the same time. Your healthcare provider will review your health history, medications, mood, sleep patterns, and any substance use to help narrow down the cause.  

Common diagnostic steps may include: 

• A comprehensive hearing test to rule out hearing loss.
• A psychological evaluation to assess for mental health conditions.
• A medication review to identify possible side effects.
• An electroencephalogram (EEG) to check for seizure activity.
• Laboratory tests to identify infections or metabolic concerns.

Because auditory hallucinations can stem from many unrelated conditions, your healthcare provider may coordinate care across audiology, psychology, or neurology to create a clearer picture. A hearing test is often one of the earliest steps, especially when symptoms occur alongside reduced hearing, tinnitus, or difficulty understanding speech. 

How are auditory hallucinations treated? 

Treatment depends entirely on the underlying cause. For some people, adjusting a medication dosage or switching to an alternative prescription can resolve symptoms quickly. When symptoms are linked to a psychotic disorder, treatment often includes antipsychotic medication, psychotherapy, and ongoing support. 

Other treatments may focus on addressing medical issues such as infections, fevers, thyroid disorders, or neurological conditions. Improving sleep quality, reducing substance use, and managing stress can also have a meaningful impact. When hearing loss is involved, properly fitted hearing aids or other audiological treatments may significantly reduce hallucination frequency. 

Understanding the bigger picture 

Auditory hallucinations can stem from many different factors, and while they may feel overwhelming, they are often manageable once the underlying cause is identified. Recognizing when symptoms begin, how they present, and whether they coincide with changes in hearing or health can help guide you toward the right type of support. 

Key takeaways 

• Auditory hallucinations involve hearing sounds or voices that are not present.
• Causes range widely across mental, neurological, medical, sensory, and sleep-related conditions.
• Hearing tests are an important early step in diagnosis.
• Many causes are treatable once identified.

Auditory hallucinations can be confusing or distressing, but support is available. If you’re noticing new or recurring symptoms, speak to your healthcare provider. You can also book a free hearing test or find a clinic near you to get a better sense of your overall hearing health.