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One thing that helped, went into mixer settings and did a sound reset. I now get intermittent sound can't hear audio tapes or radio at all. Most conversations are also silent. Other than that, sound cuts in and out at random.
Edit: You can supposedly disable this by lowering your pc's audio output settings to anything below 44,000 Hz, but screw that. Modern game shouldn't have such a stupid problem, but... Todd said it works, so...
Ditto for Corsair/Razer audio software (not sure about with Fallout 4 specifically, but I know they cause problems in some games).
Program Files(x86) | Steam | steamapps | common | Steamworks Shared | _CommonRedist | DirectX | Jun2010 | DXSETUP
It looks like this https://imgur.com/gallery/JTd1wCo
I'm currently reinstalling the program from scratch.
I did the DirectX reinstall as well.
"oooooooooooom!" <- Doppler of a cow running backwards. :)
"" <- Sound of a cow in my game :)
https://help.bethesda.net/#en/answer/42161