Understanding Hearing Loss

First, let's talk about how hearing loss progresses. Various factors, including age, noise exposure, genetics, and certain medical conditions can cause hearing loss. However, we'll focus on the most common cause of hearing loss, age-related hearing loss, which affects almost everyone to some degree as they get older. Once hearing loss begins, it either remains or continues to progress. Age-related hearing loss typically progresses slowly over years. Often, it's so gradual that it may take years before it becomes noticeable. High-frequency hearing loss makes communication challenging. Age-related hearing loss usually starts with a loss of high-frequency sounds, such as speech consonants like "s," "f," and "t." Patients often report that others mumble a lot, the TV volume increases, and they struggle to hear conversations in noisy environments such as restaurants.

At this point, family members may initiate a conversation about hearing aids or getting a hearing test. However, the person with hearing loss may not perceive it as a problem worth addressing. As time goes on, they may realize that hearing difficulty is impacting their quality of life and wonder whether it's time to try hearing aids. Before making that leap, they may have questions about what it would mean for them to wear hearing aids.

What Hearing Aids Can (and Can't) Do

Now, let's discuss what hearing aids can and can't do. Hearing aids are designed to amplify sounds and improve speech understanding for individuals with hearing loss. They do not cure hearing loss or restore normal hearing. However, hearing aids can bring back sounds that were previously difficult or impossible to hear, making it easier to communicate with others and enjoy daily activities. Most people find that wearing well-fit hearing aids makes conversation less frustrating and more enjoyable.

Let's break this down and think of it like a risk-benefit analysis.

Do hearing aids improve hearing?

There are a few ways to think about this. Wearing a hearing aid can prevent further deterioration of your hearing, including higher-level processing, by providing auditory input that your brain needs to stay active and healthy. Additionally, wearing a hearing aid makes it easier to communicate with others, reducing social isolation and preserving cognitive function. While wearing a hearing aid won't reverse hearing loss, it can help preserve auditory processing and mitigate other downstream effects of hearing loss, such as social isolation, depression, and frustration.

Even the best hearing aid on the market won't restore normal hearing. However, while hearing aids take time to adjust to, the difference they can make is remarkable. I had one patient recently who came into the office and asked if I was aware that the turn signal in a car makes a noise. This patient was discovering all kinds of new sounds in their environment, feeling more connected, safer, and aware of their surroundings.

Ok, so we know that hearing aids are beneficial. Are there any drawbacks?

Will wearing hearing aids negatively impact my natural hearing?

When hearing aids properly fit your prescriptive targets, the volume when listening to normal conversation is safe. Audiologists ensure proper hearing aid fitting with Real-Ear Measurement to ensure the volume in your ear is safe, appropriate, and comfortable while wearing the hearing aids. One study from 1977 that examined 261 hearing aid patients over ten years found no hearing threshold change occurred in the aided ear due to hearing aid use. Today, hearing aids are much different than in the 1970s and utilize a technique called compression to amplify speech and make it audible without being uncomfortably loud.

On the other hand, if your hearing aid is set to a level that is too loud, it could cause damage. I had a patient come in with a pair of her relative's hearing aids, and she said when she tried to wear them, everything seemed much too loud and sounded distorted. I was glad that she brought them in because they were set inappropriately high for her hearing loss. Overamplification is one example that could cause damage to your hearing, and it's important to have hearing aids fit appropriately for your hearing loss. Additionally, wearing hearing aids in dangerously loud situations can result in hearing loss, with or without hearing aids. For example, if you go to the gun range, you'll need to take your hearing aids out and put in hearing protection.