Moderate loss, have worn them for many years, enjoy listening to music and nature, but also need help in meetings and noisy environments.
Not worried about cost and wanting to get one more good deal out of work insurance before I retire.
Moderate loss, have worn them for many years, enjoy listening to music and nature, but also need help in meetings and noisy environments.
Not worried about cost and wanting to get one more good deal out of work insurance before I retire.
17 comments
Standard IEMs isolate you from the world, which is the opposite of what a hearing aid does. However, a specific category called "Active Ambient" IEMs bridges this gap. These are IEMs with embedded high-fidelity microphones on the outer shell. They pick up the sound of the room (bandmates, crowd, conductor), amplify it, and blend it with your monitor mix. The accompanying bodypack or app often includes a multi-band EQ and Limiter. You can boost specific frequencies where you have hearing loss (e.g., boosting highs to hear cymbals or speech clearly) and set a volume ceiling to protect your remaining hearing. I have no ownership/sponsorship in the product, but I personally LOVE the ASI Audio 3DME (powered by Sensaphonics), which is the industry standard for this. [1] It allows you to use an app to shape the ambient sound to your hearing needs.
The Pros: It provides hearing protection + monitoring + hearing enhancement in one device.
The Cons (Why they aren't daily hearing aids):
1) Form Factor: You are tethered to a belt pack. You likely won't wear a wired bodypack to a grocery store or dinner party.
2) Social Barrier: Wearing full-shell custom IEMs creates a "do not disturb" look that discourages conversation in social settings. This can be more socially alienating than a comparatively inconspicuous hearing aid.
3) Battery Life: IEM systems typically last 6–8 hours, whereas hearing aid batteries can last days or weeks.
[1] https://www.sensaphonics.com/products/3dme-custom-tour-gen2-...
I have Phonak Audeos paired over bluetooth with my iPhone. A few years prior, I used to have Oticon, also paired with my iPhone.
With the Oticon, if I made a cellphone call, the iPhone would use the default iPhone microphone while the audio would stream to my hearing aids. It was good that way because in a noisy environment I could hold the iphone right up to my mouth and the other party would be able to hear what I was saying.
With the newer Phonaks, I was very disappointed to find that the new hearing aids would only use the microphone input that is built into the hearing aids themselves, and not the iPhone mic input. I discovered this when I realised that talking directly into iPhone mic did not make it any easier for the other party to hear me.
I complained to my Audiologist who explained that yes, the new hearing aids were copying the behaviour of Apple AirPods, which also have the mic input on the earpod itself, and that there was no way at all to configure the Phonaks to use the iPhone mic input instead.
Why is this a problem you might ask? Because my hearing aids are Behind The Ear (BTE) and thus the mic input on the hearing aid is a good 4 inches away from my face and thus my voice cannot possibly sound as clear as when I could speak directly into an iPhone mic.
When I next replace my hearing aids, I shall look for aids that do not mimic this crappy AirPods behaviour...
We ended up with Phonaks rebranded as Sennheisers. The audio quality during calls may not be as clear as a separate mic (what i believe you refer to as oticon), but from a user experience its nice to not have to fish out your phone to answer a call or wonder why you can hear the other person but they cant hear you.
Note that my complaint here is specific to Android support.
I don't think there's a way around it on the iphone, but I was able to cobble a fix for my macbook at least. It uses Shortery to run a Shortcut whenever my HA connects. The Shortcut runs a shell script that uses https://github.com/deweller/switchaudio-osx/ to determine the built-in mic and switch back to it immediately:
BUILTIN_MIC_ID=$(switch-audio --list-input | jq 'map(select(.name == "MacBook Pro Microphone")) | .[0].id') switch-audio --set-input="$BUILTIN_MIC_ID"
It’s a brain thing, my hearing itself is above average for my age (40), so I’m not sure what exactly can be done, but there was an article many years ago about someone (Bose?) working on aids for that issue, no idea what came of it. I guess all modern hearing aids have some focus mode.
[0]: https://en.wikipedia.org/wiki/Auditory_processing_disorder
edit: In case there’s an airpod suggestion, I’ll also need to know if that feature works on Android, it’s not crippling enough to make me use an iPhone.
People rely on the (usually very large) dynamic range of hearing to be able to understand in those situations. In people with typical hearing the brain filters out the sounds too loud or too quiet to be what they are trying to listen to. But hearing aids act as compressors reducing the dynamic range.
For a while now, like the last 15 to 20 years, since hearing aids went DSP, I had not been much impressed by each new generation. At the risk of sounding like a bit of an advertisement, that changed this year.
I have the new Oticon Intent. RIC style aid. They have some of the best spatial awareness I've experienced. They're capable of quite a lot of directionality - accelerometer and three microphones in each. I had to have the intensity of the directionality turned down a bit. It was startling me when I turned my head and I wasn't hearing things behind me enough. But that's at the expense of less signal due to more environmental noise.
The machine-learning based noise reduction is an improvement over the previous generations, too.
They have a music mode. It drops all the speech remapping and noise reduction and just makes it feel loud. It's some sort of perceptual algorithm: in my case as I turn up the volume it gets more and more treble, because only at the loudest volumes would I hear those high frequencies. All while being power limited at 95 dB SPL so I know I'm not blowing my ears. I used to wear over-the-ear headphones for that but I now prefer the hearing aids. It's nice to not worry about if it's too loud.
As a parent with a child with mild-to-moderate hearing loss it is heartening to know that the hearing aid technology is progressing, and progressing well!
He's been using a pair of Phonak Skys since infancy, and while they can be tuned by the audiologist I sometimes wonder what it'll be like if and when he gets his next pair.
I also very much appreciate that they can natively connect to iPhones (this is also essentially the main reason I have an iPhone). This makes phone calls and music and podcasts very easy. (Whereas up until 2017, I used to dread phone calls.)
I actually tried Phonaks briefly in 2022 and hated them. Lots of controls to fiddle with (some with oddly unintuitive names), but that meant I was constantly trying to adjust it and was rarely able to just exist in the moment. I found them markedly worse in noisy environments - I basically couldn’t have a conversation in a restaurant.
The one thing that I find absolutely essential is using ear molds instead of domes. My cousin hated ear molds and gave up on them, but I definitely prefer them.
Incidentally, I would recommend the HA/hearing loss subreddits (r/HearingAids and r/hardofhearing) over HN for this discussion. The HA group can get a little rigid, but I really like the community at HoH.
I do participate in the Reddit subs but am interested in the technologists view of HAs I might get here. They are fascinating, necessary devices for myself.
For one, unless you use Med-El's Rondo processeor, you're going to have a thin cable connecting your processor to the coil. Taking off your CIs and putting them back on (as one does every day) is going to put stress on the cable. Sometimes the cable frays and you find that out with sound cutting in and out. There's nothing you can do until the manufacturer sends you a replacement cable in exchange for your frayed one. If you want a backup, be ready to shell out $250 for each cable.
Another UX issue is that processors depend on gravity to stay on your ears. Since there's no earmold to anchor to, processors can easily be jostled off and left hanging precariously. Wearing hearing aids, I never had to worry that my hearing devices would fall off if I rode my bike on a bumpy road. Also with cochlear implants, high-intensity interval training requires some kind of hat or bandana to make sure that the processors don't fly out.
Battery life is another disappointment. Rechargeable batteries don't last a full day. If I put them in at 6:30a, they'll last until about 4:30p. With disposable zinc air batteries, I can squeeze out about a day and a half, but then I'm having to dispose batteries. And while I can track processor battery levels with the rechargeable batteries on my phone, disposable batteries are opaque to the app.
One new thing that would be useful in terms of UX would be an configurable indicator, e.g., a blinking LED, signaling that audio streaming is occurring. It's awkward to find oneself in a conversation that already started and having to excuse oneself to turn off the stream.
Don't get me wrong, I'm glad I have my cochlear implants, but they're way behind hearing aids in terms of UX.
UX for a lot of assistive technology is iffy at best. Repeating some of the comments others have made, I'd love it if Apple would make a full on hearing aid that "just worked". Or someone would do a good AI integration that could notify you of things you probably should focus on - like someone trying to get your attention, or emergency vehicle sirens, etc.
Marketing too. But it's nice to see some vendors starting to actually make their devices visible and fun. HAs are a bit like glasses ages ago, when it was kind of this shame thing to get teased about when you were 8 years old. Selling them as "discrete" and with colors designed to match your skin or your hair is just continuing that perception of them being something you should hide.
The live listening mode is very good. I can hear my kid trying to quietly walk past 10pm :) There are a lot of features however you cannot selectively choose to lower / raise certain frequencies. I wish it had an equalizer I could use.
The ANC is fantastic, sometimes I even forget fans around me are on. Only issue is that when I use live listen mode and everything is super clear, people still treat me like I’m using full noise cancellation.
From the other side, it’s night and day. We can have conversations. He can hear my kids. The TV volume is set to reasonable levels.
Sample size of one, but it’s been a tremendous improvement. A lot of places are closing out the second gens right now for $140. I’d give it a go. It’s a pretty low price of entry for something that could literally be life changing.
I don’t ever hide my hearing aids but the discrete nature of them is great.
For me, I need a real hearing aid to hear a person that is at my right shoulder.
If both ears are about the same, I think the hearing aid volume (separate slider from general volume) could be adjusted to get past the “designed for moderate loss” limitation.
https://youtu.be/uykq5aJCwBw
In your situation they could be a low stakes way to get someone to try a hearing aid and sell them on the idea, while still being a useful thing to have around even if they do upgrade to something more purpose built.
But irrespective of any capability to act as hearing aids from the acoustic perspective, I don’t think they are the same.
For me hearing aids are glasses for my ears. Like glasses they need to be “put them on/in and forget about it”. If AirPods would not fall out of my ears when I walk or put on a hat or pull on/off a sweater, I might consider them.
I wake up in the morning, grab them from the nightstand and put them in. And they stay there all day until I go to bed. Only come out if I’m taking a shower or in a loud environment.
My understanding is they are pretty good hearing aids, but they don't have the battery life that purpose-built aids do (4-5 hours vs 18-24) so they're not optimal for full-time use. This is fine for her use case, since she only uses them when she wants to talk to someone, but could be an issue for someone who wants to wear them all day, every day.
IMHO rechargeable models are not worth the extra cost. With a typical 5 year replacement cycle the batteries will no longer hold the early levels of charge. 312 batteries are cheap and easy to carry spares.
Especially since the hardware is not upgradeable without another surgery, assuming it's upgradeable at all.
If you have HAs and wait, 1) the implant tech may get better, or 2) medical science may be able to regenerate inner ear hair cells. For #2 in particular, cochlear implants may prevent that from even being an option, since iiuc, they damage the cochlea.
adjective 1. having a high degree of heat or a high temperature.
Hope that helps!