Mild Hearing Loss? Hearing Aids Aren't the Only Answers
'Hearables,' specialized headphones and other tech tools can provide sound solutions at a lower cost
En español | Hearing loss is common as people age, but not everyone needs an audiologist-prescribed hearing aid. And not everyone can afford the thousands of dollars hearing aids can cost, especially since Medicare doesn’t cover them.
What’s more, federally approved and presumably less expensive over-the-counter (OTC) hearing aids that initially were expected to reach stores in 2020 may not show up until late 2021, if not next year.
Fortunately, hearing aids aren’t the only potential remedy if your hearing loss is mild to moderate. “When you start to feel like you’re struggling in certain situations, it may be premature to go see an audiologist and get a hearing aid,” says David Cannington, cofounder and chief marketing officer of Nuheara, an Australian company that makes audio-enhancing earbuds.
Several products, or features within products, can help you better hear what people within earshot are saying, at least in some environments. Here’s a sampling of options that could improve your ability to converse in noisy restaurants or make out dialogue on TV.
‘Hearables’: earbuds that amplify
Many hearing enhancements that aren’t classified as hearing aids fall into the category of personal sound-amplification products (PSAPs), which increase the volume of all the sounds in a given environment. Among these are “hearables,” loosely defined as Bluetooth earbuds with some hearing-aid-like features.
The Olive Smart Ear ($299 for one), from Tokyo-based Olive Union, is sold as a nonmedical grade PSAP. But a newer version, the Olive Pro, is billed as both a wireless earbud and a Food and Drug Administration (FDA)-certified smart hearing aid. The company says the Pro will retail for $299 a pair and is slated to hit the market in July.
The $349 Sound World Solutions CS50+ was rated the top PSAP by The New York Times’ product-review site Wirecutter in 2020. It’s an “over-the-ear” hearable: The earbud is connected by a small tube to a battery compartment that fits around the ear.
People with mild to moderate hearing loss found no differences among PSAPs, basic hearing aids and premium hearing aids for “speech perception, sound quality, listening effort and user preference,” according to a 2019 study published in the online medical journal JAMA Otolaryngology — Head & Neck Surgery.
There’s “such a range of quality that it’s impossible to make a blanket statement about the [PSAP] category,” says Tom Hannaher, chief executive of Zvox Audio in Swampscott, Massachusetts, which manufacturers VoiceBud hearing aids ($599 for a pair, but on sale now for $399) and TV sound bars that enhance dialogue.
There can be limits to some PSAPs’ effectiveness. Because they amplify sound all around, they may not help if you are, for example, trying to better discern a single voice in a noisy place. Consumer Reports warns that the cheapest PSAPs (some as low as $20 or $30) showed little benefit and could “cause additional hearing damage by overamplifying sharp noises, such as the wail of a fire engine.”
Hearing help meets AirPods
Nuheara’s rechargeable IQbuds2 Max ($399 for a pair), named one of Time magazine’s 100 best inventions of 2020, addresses some of these issues. They come with a mobile app that lets users calibrate the buds to their own hearing profile, and with situational settings that can help mute background noise and enhance audio focus on a particular speaker.
IQbuds2 even let you stream music or take calls via Bluetooth, as does the Olive Pro.
That might signal a trend: A recent survey by Qualcomm found that over 40 percent of consumers are interested in earbuds that can provide automatic hearing assistance as needed. The chipmaker is working with Jacoti, a Belgian medical device company, to build personalized hearing assistance into upcoming wireless earbuds and Bluetooth speakers.
Another fringe benefit of hearables: They can mitigate the supposed stigma that makes some people reluctant to wear hearing aids outside the house, for fear of being perceived as old. The growing ubiquity of AirPods and similar devices has “made it acceptable for everyone to wear weird things in your ears,” Nuheara’s Cannington says.
Nuheara, Olive Union and Sound World Solutions all offer money-back guarantees, typically lasting 30 to 45 days, so you can try their hearables out for comfort and audio improvement.
Not all hearing helpers go in your ears, though. Zvox’s AccuVoice AV157 TV speaker ($199.99) can isolate spoken dialogue without having an adverse impact on the way you hear music, explosions or other elements in a movie or television show soundtrack. It does this in part by making some frequency ranges louder than others.
The company also minimizes the bass output and uses other proprietary technology to bolster voice. Using the Zvox remote control, listeners can select among 12 levels of “dialogue boost” to customize their experience.
Other sound bars and some TVs also have built-in tools that will let you enhance dialogue. Check your TV settings under Sound or Audio.
Some headphones can help
Apple’s recent iOS 14 software update for the iPhone includes a feature called ”Headphone Accommodations” that lets users tweak audio frequencies and other settings with select AirPods and Beats headphones. To enable it on the iPhone, tap Settings, then Accessibility, Audio/Visual and Headphone Accommodations.
From there, you can drag a slider to slightly, moderately or strongly boost “soft” sounds or tune audio for a balanced tone or vocal range. You also can play a sample sound through your headphones to hear how altering the various settings affects what you hear.
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Choose custom settings for listening to phone calls, FaceTime calls and video calling apps, or for music, movies and podcasts. You also can customize settings through audiogram data in the iPhone’s Health app.
Android’s alternative of sorts is the Sound Amplifier app from Google. It’s installed on some Google Pixel phones and otherwise available free in the Google Play store.
Using wired or Bluetooth headphones and dragging simple sliders, Android users can customize sounds for conversations or to reduce background distractions. You also can apply settings for each ear independently and use the Sound Amplifier app as a remote microphone, allowing you to place the phone near a TV or speaker and listen through your headphones.
Your phone as a microphone
Apple’s Live Listen feature can similarly turn an iPhone, iPad or iPod Touch into a directional remote microphone that lets you hear conversations in noisy environments. Once enabled in Settings, you can turn on Live Listen from the phone’s Control Center.
Tap Settings, then Control Center and then the plus sign to the left of Hearing. You should now see an ear icon when you open the Control Center (by swiping down from the top right corner if you have an iPhone X or later, or by swiping up from the bottom edge of the screen for an earlier model). Click the ear icon to pair your AirPods or a compatible device to the phone. When you move your phone closer to the person, you’ll hear them better through your AirPods.
An app in development called HeardThat could provide a similar function for Android devices. (It’s in early release in both the Google Play and Apple stores.) Singular Hearing, the Canadian company behind HeardThat, says it is free for a limited time and could be unstable, but user feedback could help improve the experience in the long term. The app won the What’s Next Innovation Challenge in June 2020, a contest sponsored by AARP Innovation Labs.
Noopl, an iPhone accessory developed by a Sacramento start-up of the same name and unveiled at the 2021 CES (formerly the Consumer Electronics Show) in January, also aims to improve the way you hear the people around you. The compact device, launching in May at a price of $199, houses a trio of microphones and plugs into the Lightning port on an iPhone.
Noopl includes an automatic head-tracking feature that allows you to better hear the person you are facing, a feature that only works with AirPods Pro or AirPods Max headphones. (You can use Noopl with other Bluetooth headphones and earbuds that connect to an iPhone in manual mode, but without head tracking.) A version for Android devices is expected in early 2022.
When will we see over-the-counter hearing aids?
A federal law passed in August 2017 directed the U.S. Food and Drug Administration (FDA) to ease barriers for buying a nonprescription hearing aid. But nearly four years later, the agency still has not come out with rules on what can be marketed to the public as a hearing aid that doesn’t require fitting from an audiologist or other qualified clinician.
The FDA missed an August 2020 deadline to issue guidelines. COVID-19 was a factor in the delay, but there were also still questions around packaging, state licensing laws and the technical specifications around how much amplification manufacturers can safely put into OTC hearing aids.
“The category is intended for mild to moderate losses,” says Thomas Powers, a former president of the American Auditory Society and the managing member of Powers Consulting, a New Jersey firm that advises hearing health companies. “The trick is where do you define moderate.”
Some hearing aid manufacturers aren’t waiting. Tokyo-based Olive Union bills its Olive Pro devices as a combination of Bluetooth headphones and hearing aids. Scheduled for release in July, the Pro is available for preorder from Olive Union, and the company says it is planning for U.S. sales through major stores such as Walgreens and CVS.
But not every OTC hearing aid is likely to cost so little. “My gut tells me that the sweet spot is going to be in the $300 to $500 range, and that is going to be per [ear],” Powers says.
And when they’ll finally reach the market is far from certain. Powers says that if the FDA issues rules in late spring or summer, OTC hearing aids could be on store shelves by the end of the year, but “that’s a wild guess.”
Edward C. Baig is a contributing writer who covers technology and other consumer topics. He previously worked for USA Today, BusinessWeek, U.S. News & World Report and Fortune, and is author of Macs for Dummies and coauthor of iPhone for Dummies and iPad for Dummies.