Smart Guide to Ear and Hearing Health

8. Take care of yourself

You know the drill: Eating a diet packed with produce, lean protein and good fats; getting regular exercise; sleeping well; limiting alcohol intake; and not smoking are good for your heart, brain, blood pressure and blood sugar levels. And in a 2022 study published in Mayo Clinic Proceedings of 61,958 U.K. adults who followed at least one or up to all five of those healthy behaviors lowered odds for hearing loss by 15 to 20 percent over 10 years.

Doing more was even better. A healthy lifestyle may guard against hearing damage by keeping tiny blood vessels in the inner ear working and by discouraging inflammation in areas of the brain that interpret signals from your ears, researchers from Harvard University and elsewhere speculated in a 2018 study in the Journal of Nutrition.

Poor sleep may be a sign of obstructive sleep apnea, which researchers say could harm hearing due to loud nightly snoring or reduced blood oxygen levels.

HEALTH CARE FOR YOUR EARS

9. Listen to ear pain

Take any new ear discomfort seriously. “Persistent infections can damage the structures of the ear, leading to conductive or nerve hearing loss,” Durakovic says.

It’s OK to treat an earache at home for a few days with a warm compress and an over-the-counter pain reliever like acetaminophen or an NSAID like ibuprofen, says Kristen Angster, M.D., an otolaryngologist and vice chair of care pathways and operations in the Division of Head Otology/Neurotology and Lateral Skullbase Surgery at Henry Ford Health in Detroit. After that, make an appointment with your primary care practitioner, who can treat outer- and middle-ear infections, often with drops or antibiotics.

If your ear pain is accompanied by new hearing loss, dizziness or weakness in muscles in your face, ask about a referral to an otolaryngologist, since those symptoms can indicate an inner ear infection. Seek emergency help “if the ear pain is accompanied by high fever or confusion,” Durakovic adds.

10. Address vertigo

Your ears are part of your body’s balance-control system. Inside your inner ear, fluid-filled canals and “otolith organs” containing tiny crystals floating in a thick gel detect movement and tell your brain about it. So if you’re feeling dizzy, the reason might well be your ears. Vertigo can be scary, but it’s often easily fixable. The most common ear-related cause is benign paroxysmal positional vertigo (BPPV), in which the patient typically has brief episodes where they feel like they’re spinning, often after moving their head. The cause: Otolith organs that have floated into the wrong spot in the ear. The treatment is a series of head positions called the Epley maneuver that your doctor, an audiologist or a vestibular physical therapist can perform, Angster says. You can even learn to do the maneuver at home.

But not all forms of vertigo are treated with the Epley maneuver, so it is important to first have a correct diagnosis for dizziness, Durakovic says. “Dizziness and balance problems are common symptoms in older adults and can be due to a variety of medical problems, including ones that relate to the heart and circulation, eyes, nerves or the ear,” he notes. “If necessary, the PCP can refer the patient to an ENT (ear, nose, and throat specialist) for more specialized testing and diagnosis.”

11. Know when to spring into action

If you develop sudden loss of hearing in one or both ears , call a local otolaryngologist’s office right away and describe your symptoms, Angster urges. You may be experiencing idiopathic sudden hearing loss or sudden sensorineural (“inner ear”) hearing loss (SSHL), which may be reversible if caught in time.

“An ENT may be able to recover your hearing if you receive oral steroids or, when needed, injected steroids, within three days,” says Angster. Too often, she adds, people wait to see if hearing will improve on its own and miss this window of opportunity for treatment.

“If you call a local ENT and say you have sudden hearing loss, they will fit you in,” she says. The cause of this condition is not well understood, Angster says, but steroids help by reducing inflammation in the inner ear. Hearing improves on its own only about half the time with SSHL, and the improvement may only be partial.

12. Take care of tinnitus

People between the ages of 50 and 79 are up to 40 percent more likely than younger adults to develop tinnitus — ringing, roaring, clicking or buzzing sounds in the ears — according to a 2024 Stanford University study published in The Lancet Regional Health-Americas. These sounds can be a mild distraction or make life unbearable, interfering with work, sleep, mental focus and relationships.

“If you have ringing in the ears, see an audiologist for an evaluation,” says audiologist Sarah Sydlowski, associate chief improvement officer and audiology director of the Hearing Implant Program at the Cleveland Clinic. One potential cause of tinnitus is undiagnosed hearing loss, which can prompt the brain to fill in missing sounds by making up phantom noises. “Oftentimes tinnitus can be well-managed by treating hearing loss,” Sydlowski notes.

Mindfulness-based stress reduction, education about the condition and a new treatment called bimodal neuromodulation can also help. This therapy uses two different types of brain stimulation at the same time — sounds you listen to, plus a second stimulation such as a very mild electrical current — to retrain how the brain pays attention to sound. In a study published in June 2022 in Scientific Reports of 191 people with mostly moderate to severe tinnitus, an FDA-approved bimodal neurostimulation system reduced symptoms for 70 percent of participants.

AMPLIFIERS AND HEARING AIDS

13. Recognize any resistance you may feel

If you think people are mumbling at you when they swear they’re not, you may be the one with the problem. Ditto if loved ones complain about having to repeat themselves, or about your setting the TV volume too high. It can be hard to admit that you’re having difficulty hearing, but it’s important to know if you are.

The American Academy of Audiology and other hearing-health groups recommend that adults age 50 and older get their hearing screened by a health care practitioner such as their primary health care provider. You may even find a convenient hearing screening at a local health fair. Get one at least every five years until age 64, then every one to three years after that, the World Health Organization suggests. For a quick prescreening, online options include AARP’s online hearing test, a free benefit for members. Others are the online questionnaire from the National Institute on Deafness and Other Communication Disorders (NIDCD) and ASHA’s online hearing screening. If results suggest you have hearing loss, the next step is a hearing exam with an audiologist or state-licensed hearing instrument specialist.

Early signs of hearing loss include difficulty hearing a conversation when there’s background noise and having trouble hearing on the phone.

14. Go to a hearing pro

If you think you may have hearing loss, or a screening suggests you do, schedule a hearing evaluation with an audiologist or state-licensed hearing instrument specialist. Most private insurance covers hearing evaluations without a referral; Medicare does, too, provided the evaluation is performed by an audiologist.

After a thorough evaluation that includes a family and medical history, a physical examination of the ears, and a series of hearing tests, the practitioner will give you a diagnosis and suggest a course of action. Some kinds of hearing loss can be treated with hearing aids. Your audiologist can recommend hearing-aid types for your level of hearing loss. For example, you’ll need higher-powered, prescription-only hearing aids for severe or profound hearing loss … and you may even hear about cochlear implants. These electronic devices don’t amplify sound like hearing aids. Instead, they send signals directly to your auditory nerve.

“People tend to think of cochlear implants for very young children [with severe hearing loss], but they can be beneficial for adults with very severe hearing loss who don’t get enough benefit from hearing aids,” Sydlowski says.

Hearing loss can have other underlying causes, such as changes in the brain’s ability to process language, that an audiologist can discuss with you — or may lead to a referral to an otolaryngologist or other specialist. Conditions such as stroke, Alzheimer’s disease or even depression can impact your ability to hear well, Durakovic says.

15. Understand over-the-counter aids

In 2022, the FDA approved over-the-counter hearing aids for mild to moderate hearing loss of between 20 and 60 decibels. Such devices can help with following a conversation in a noisy restaurant or catching high-frequency sounds like certain consonants — or the voices of your grandchildren. (If your hearing loss is more severe, you’re not a candidate for OTC hearing aids. Signs of severe hearing loss include not being able to hear conversations unless the speakers are very close to you and speaking loudly, or not noticing loud noises like power tools or car horns.)

Dozens of different OTC hearing aids are available in stores and online, for prices ranging from about $100 to several thousand dollars. Of note: Most private insurers and Medicare don’t cover them. Since you buy over-the-counter hearing aids direct, rather than through an audiologist, you’ll be in charge of setting them up. Some have “pre-sets” you can select — such as a setting to better hear conversation in a noisy environment. Others let you customize the output based on a hearing test you take on a smartphone app.

“The thing to understand about OTC hearing aids is that you’re going to be in charge of the device yourself,” Gaffney says. “There are people who will be drawn to doing this and others who want more help along the way.” If you’re the kind of person who would like more help, Sydlowski suggests looking at lower-cost prescription hearing aids sold by an audiologist, who will help you choose a model, program it based on your hearing loss and offer adjustments afterward. “A basic prescription hearing aid could be less expensive than a higher-priced OTC hearing aid,” she notes.

Some audiologists will even help you choose, set up and check OTC hearing aids, says Catherine V. Palmer, director of audiology at the University of Pittsburgh Medical Center and a professor of otolaryngology at the University of Pittsburgh.

“Some audiologists are providing OTC hearing aids directly to consumers (you may interact with an audiology assistant for these purchases),” she says. “Many audiologists are offering services for individuals who have purchased OTC hearing aids and are finding they need assistance. Expect to pay for the time involved in this assistance when you see the audiologist or an assistant.”

16. Find out whether your AirPods can help

In 2024, the FDA approved software for Apple iPhones, iPads and Mac computers called “Hearing Aid Feature” that enables Apple AirPods Pro 2 to work as OTC hearing aids for people with mild to moderate hearing loss. The software, which works on devices with Apple’s most recent operating system, lets users take a hearing test, then customize settings and adjust volume, tone and balance on their own.

AirPods may work best for people who don’t like the look of conventional hearing aids, McCaslin says. “They can also be a good option for someone who only wants hearing help in short-term situations, like meeting a friend for lunch or hearing better on a phone call.” Since the battery life is only about six hours, he notes, using AirPods for hearing help all day could be “a challenge.”

17. Determine your hearing-aid “type”

Hearing aids come in five basic forms, ranging from tiny, nearly undetectable ones to larger models that are more visible but often have more features. Each type has its pros and cons — and some work better for those with more severe hearing loss:

• Completely-in-the-canal (CIC): Smallest and barely visible to those around you, CICs may not have Bluetooth streaming for your smartphone or devices, may have a shorter battery life than bigger types and usually do not have directional microphones that help amplify the sounds you want to hear in a noisy environment. Their small size can make adjustments and removal more challenging. And they typically are not loud enough for adults with severe or profound hearing loss, but can be fine for mild to moderate hearing loss, the NIDCD says.
• In-the-canal (ITC): These fit in your ear but are bigger than CICs. That means they’re somewhat more visible but more likely to offer directional microphones and longer-life batteries. Like CIC hearing aids, they may be a good choice if you have mild to moderate hearing loss but not for severe or profound levels of hearing loss.
• In-the-ear (ITE): These also fit in your ear, but not entirely in the canal. Their larger size means they may have more features and may be easier to take in and out and adjust than smaller models, a plus if your hands are stiff or painful. ITE hearing aids may come with a telecoil, which can be used with some telephones and in some public places (like some movie theaters, concert halls, airports and churches that have induction loop systems that send sound directly to the telecoil). These are good for mild to severe hearing loss, according to the NIDCD.
• Behind-the-ear (BTE): These hook over and rest behind your ear, with a tube that delivers sound from the receiver (speaker) behind your ear to your ear canal. They usually have directional microphones and may have a telecoil that is able to receive sound directly from public venues like movie theaters. Bigger means they may be easier to maneuver if you have arthritis in your hands. These are an option for any level of hearing loss, from mild to profound, according to the NIDCD.
• Receiver-in-canal (RIC): Similar to BTEs, but sound is delivered not through a tube but through a receiver directly in your ear — in a cage-like silicone earpiece. Advantages are that this may deliver more sound than BTE models and doesn’t block your ear canal completely, the way completely in-the-ear hearing aids may. So the sound may be clearer, more natural, and louder in high frequencies — where many adults with age-related hearing loss have problems — while allowing natural, low-frequency sound in. One downside — they may also distort sound more in noisy places, like at a restaurant. Versions with custom-made ear molds may work well for people with moderate to severe hearing loss.

18. Make sure to get the features you need

Hearing aids, both OTC and prescription, can come with lots of high-tech features — from blocking out background noise to hooking up to your smartphone, TV and laptop. But not every device has every feature. Before choosing a model, Zappi suggests, “write down the places or situations where you feel like you would need the most support hearing and choose features based on those.”

To help hear voices in a noisy restaurant, Gaffney points out, the only thing that works in a stand-alone device is a directional microphone. “To me, it’s one of the most important features,” she says. Potentially even clearer: a remote microphone that the person you’re dining with can wear. Many hearing aids offer such a microphone as an add-on accessory.

“Rechargeability and battery life are also important,” Gaffney adds. So is telephone use: Make sure hearing aids are compatible with your phone and will stream calls into your hearing aids. Finally, Gaffney adds, if you’re attracted to a set of very small hearing aids, ask yourself whether your fingers are nimble enough to handle them.

19. Beware of consumer pitfalls

Read descriptions of low-priced hearing aids closely; some may be Personal Sound Amplification Products (PSAPs) and not hearing aids at all. PSAPs are meant for people with normal hearing who want amplification for activities like bird-watching or hunting. They amplify all sounds equally and cannot be adjusted to your personal hearing needs, and according to the National Council on Aging, they “do not provide the same level of support or technology as a hearing aid.” Tip: If the package doesn’t say “over-the-counter hearing aid” on it, it does not meet FDA standards for an OTC device.

And steer clear of hearing aids without a money-back return policy; you may need several weeks to decide whether a new pair is right for you, according to the Hearing Loss Association of America.

20. Give new hearing aids some time

If you’re new to hearing aids, your brain will need a few weeks to adjust to them. At first, sounds that were muted will seem extremely loud, Gaffney says.

“You need to wear them all the time, even at home when you’re alone and the house is quiet, for your brain to acclimate and remap itself,” she says. “Don’t just wear them when you’re going out to dinner or watching TV.” Gaffney says it’s also important to have realistic expectations about how hearing aids will improve your hearing and ability to communicate with others. “People often compare hearing aids to glasses. But with glasses, usually you put them on and everything’s clear. With hearing aids, you’re running sound signals through a damaged system. It’s never going to sound perfectly normal again,” she says.

21. Keep up with maintenance

Your hearing aids are exposed daily to warm temperatures, high humidity, hair care products and a constant build-up of salty, corrosive ear wax — all of which can clog or damage the devices’ delicate parts and electronics.

“The most common issue in hearing aid function is power so the individual can make sure they are changing their batteries or recharging the hearing aids,” Palmer says. "The next two issues usually involve the microphone (where sound enters) and the loudspeaker (where sound is delivered into the ear). The microphone can get dust and debris (for example, hair spray) in it.”

Using a soft brush over the microphone can help keep it clear, she says. Use the one that came with your hearing aids or buy one at the drugstore. Wipe the loudspeaker — the part that goes into your ears — with a dry cloth or tissue every night when you remove your hearing aids, she says. “Most modern hearing aids come with a wax guard system that provides a small piece that fits into the loudspeaker and protects it from ear wax,” Palmer adds. “This wax guard can fill up with ear wax over time and can be removed and replaced by the user.”

If your hearing aids have tubing, a tubing wire cleaner that came with them can be used to clean its interior. If recommended by the manufacturer, a hearing aid dehumidifier can be used to get rid of moisture, too. Follow directions for regular, professional cleanings as well.

And use hair products — like hair spray, gel or leave-in conditioners — before you put in your hearing aids to minimize contact, Palmer says.

22. Know when to say goodbye

The average lifespan of these devices is five to seven years, but you may need new ones even sooner if the sound has grown weak or distorted, if they intermittently stop working, if you’re sending them out frequently for repairs, or if they’ve stopped working altogether.

“Many people will be able to use their hearing aids longer than five years if they are maintained well,” Palmer says. “A change in hearing rarely necessitates new hearing aids since the hearing aids can be reprogrammed to accommodate the change in hearing in most cases.” But your audiologist can test yours to see if they’re losing power and don’t put out as much sound as they used to, she adds. You may also want new hearing aids with new features you don’t currently have, such as rechargeable batteries or phone connectivity.

23. Ask your audiologist about aural rehabilitation and auditory retraining

People with hearing loss may find they’re having trouble understanding what other people are saying, even with their hearing aids. Extra training called aural rehabilitation, provided by an audiologist or another hearing-health practitioner like a speech-language pathologist, can help in this situation, Sydlowski says. Aural rehab helps you function better in the world — including strategies like learning new ways to ask people to help you optimize hearing — such as politely requesting someone speak a little more clearly or loudly or slowly, making sure you’re facing the person and reducing background noise.

Meanwhile, auditory training (AT) can improve your understanding of what others are saying by retraining your brain to pay attention to, process and keep words and phrases in your short-term memory. Recent research suggests AT is beneficial. Programs are available in person and online. Sydlowski suggests auditory training to her adult patients with cochlear implants for hearing loss. “Hearing technology is one piece of care for hearing loss,” she says, “but you’re going to do best with retraining or therapy to help your brain work at its best with new sounds.” She recommends the online program Angel Sound (also available as an app) or even listening to a recorded book as you follow along with the printed version. Slow it down at first to improve your accuracy at understanding what you hear.