Do hearing aids damage ears? Is the helping hurting in the long run?

Posted by bobbyboomer @bobbyboomer, Mon, Jul 15 9:42am

I had this discussion on the HLAA forum and got no satisfactory answer. The HLAA forum is pretty dead and on it's way out so I didn't get but one or two responses and they weren't conclusive. Also it is my fault because I don't think I explained myself clearly.

Please understand, I'm not trolling, I really want to know. If my logic is sound, I will only wear my aids when I need to instead of all day. I can't get along without them.

Let me divulge my logic (or lack of it):

1) I know that the sound level of 85dba ("A" weighted, slow response) for 8 hours per day permanently damages hearing. The DB scale is logarithmic function, each 3db is double the power of the one before. So at 91dbdba 2 hours of exposure damages permanently, at 100dba it's only 15 minutes, at 110dba it's mere seconds and at 120dba it's instant permanent damage. Logarithms are comparative ratios, adding the a suffix (dba) is referencing it against a standard, and is what all hearing tests use — db is a ratio and dba is a definite value.

2) Hearing aids amplify the frequencies you cannot hear as a reverse curve to your hearing loss audiogram

3) Say you have a 70 db loss in hearing at 3Khz (3,000 cycles per second), that means at 71 dba in a quiet hearing booth you can barely hear the faintest whisper of a 3khz tone. And like many of us, say your lower frequency hearing is either zero or around 6 dba. (note: most consonants are in the 2-4 khz range so this is where we understand speech)

4) Now say you are in a room that conversation level is around 75 dba, you will need about 75 db of the consonants to understand what the person across the table is saying to you. (Note: I have several sound level meters and 75db in a restaurant is average for one without loud background music.)

5) Since your hearing loss is at -70db, there is already 75dba of conversation in the room how high does your hearing aid have to amplify the 3khz sounds?

6) Do you have to take the 70db loss, add it to the 75dba conversation level in the room and amplify to an ear damaging 145dba? Remember, adding 70dba is your tiniest, softest, perception at the frequency in a quiet soundproof booth. So it seems 70dba wouldn't be enough. Hearing a whisper of a consonant in a 75dba room seems to me to be worthless.

So it seems to me that amplifying the ambient noise of the room above 85dba could slowly erode your hearing so you will need stronger and stronger hearing aids, which amply more and damage more, which means you will need stronger and stronger hearing aids, damaging more and more. etc. (feedback loop)

Or am I missing something?

If my thinking is faulty, please explain in detail and tell me why my logic is not logical.

Thanks,
Bob

As a disclaimer, your question is beyond me and I think you need to talk to an audiologist or otorhinolaryngologist to obtain a reliable explanation. That said, my understanding is that the "right" hearing aids can be adjusted to filter (bringing up the particular frequencies one is deficient in, without over-amplifying the others). One caveat I would say is that it seems that some over-the-counter (OTC) "hearing aids," or "personal sound amplification products" (PSAPs) are as effective for some people as "prescribed" hearing aids, and others or perhaps incorrectly selected PSAPs potentially could be harmful. There is a good article about this, "Personal Sound Amplifiers for Adults with Hearing Loss" by Sara K Mamo (https://www.amjmed.com/article/S0002-9343(15)00935-3/fulltext). However, I am concerned about NOT wearing my hearing aids as much as possible due to the apparent association between "untreated" hearing loss (i.e., not wearing HAs) and cognitive decline, falls, dementia, etc. There is some interesting research by Sharma at University of Colorado and Lin at Johns Hopkins University about neuroplasticity (brain changes, in this case associated with treated/untreated hearing loss) and undesirable associated factors. Unfortunately, there are not many solid scientific conclusions regarding hearing loss and causality, but for myself – in the limited studies I've read – the risks associated with not wearing my hearing aids are too high. Hope this is helpful for you.

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I think they do damage your hearing in the long run. They have for me. I went from a moderate hearing loss before hearing aids to now a profound hearing loss in 2 short years. I asked my audiologist about it and she had no clue. I'm not surprised she had no answer, she's pretty much clueless about most things people with hearing loss experience.

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Oh one more thing about PSAPs – if you read the article above, it gives some background on the 2017 regulation that will provide guidelines for the new law allowing for over the counter "hearing aids." Also, you can read about the law at (https://www.congress.gov/bill/115th-congress/senate-bill/670) and the ASHA position paper at (https://www.asha.org/News/2018/Hearing-Associations-Release-Consensus-Recommendations-for-New-Over-the-Counter-Hearing-Aid-Classification/). It is probably not a simple decision – personally if it involved me or a loved one, and the option was PSAP or NO hearing aid, I would opt for PSAP. However I would try to find an audiologist who would (willingly) provide me with a test and help me choose a PSAP appropriate for my needs… I think it is pretty complicated to just choose one off the internet, as a lay person. Maybe when issues, the FDA guidance will provide some User Guidelines.

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tmcclain – I'm sorry you haven't had a good experience with your audiologist, and that your hearing loss has worsened. It could be possible there are other reasons your hearing loss has worsened. I would urge you to find a new audiologist that is more helpful to you. Good luck.

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@tmclain

I think they do damage your hearing in the long run. They have for me. I went from a moderate hearing loss before hearing aids to now a profound hearing loss in 2 short years. I asked my audiologist about it and she had no clue. I'm not surprised she had no answer, she's pretty much clueless about most things people with hearing loss experience.

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They do- my best friend years had powerful aids in the early days- now Deaf- no other explanation . She was one of 5 kids and others had no issues

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I'm larking about audiologist supplied, prescription hearing aids, not a PSAP.

I had ReSound AIrs and now Oticon OPNs

Perhaps if we knew how many dba's maximum output these devices have, it would be helpful. A-googling-I will go.

I do know that anything over 85dba is potentially damaging.

Bob

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Such a good question, Bobbly. I'd like to invite @judysmayo @julieo4 @imallears @jkmcelveen @mikepa and @judymartin into this discussion about hearing aids hearing decline – true or false?

While we wait to others to weigh in, you might also be interested in reading this discussion
– One or two hearing aids https://connect.mayoclinic.org/discussion/one-or-two-hearing-aids/

PS: The Hearing Loss Group on Mayo Clinic Connect will be replacing the HLAA Forums so make sure to join. The HLAA Forums will be phased out in the coming months and will eventually be discontinued. See more info here: https://www.hearingloss.org/forums-mayo-clinic-connect/

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@colleenyoung

Such a good question, Bobbly. I'd like to invite @judysmayo @julieo4 @imallears @jkmcelveen @mikepa and @judymartin into this discussion about hearing aids hearing decline – true or false?

While we wait to others to weigh in, you might also be interested in reading this discussion
– One or two hearing aids https://connect.mayoclinic.org/discussion/one-or-two-hearing-aids/

PS: The Hearing Loss Group on Mayo Clinic Connect will be replacing the HLAA Forums so make sure to join. The HLAA Forums will be phased out in the coming months and will eventually be discontinued. See more info here: https://www.hearingloss.org/forums-mayo-clinic-connect/

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Thank you, Colleen. I've replied to the discussion on One or two hearings aids just now. Fascinating stuff to consider and not easy to come up with a definitive answer for! Regarding Bobby's question, it fits that same pattern. Given my background of hearing-in-noise and spatial hearing R&D, I think some things that might be generally under-appreciated are how finely tuned our auditory system is to small time delays and frequency changes, how dependent we are upon hearing well in the 6-10 KHz range, and how the outer ear helps enable our ability to localize and extract target sound sources. Hearing aids in one or both ears slightly (and confusingly) change the timing and frequency information that our hearing has used over a life time of learning (presuming onset of hearing issues in older age) to sort out voices and other sounds. In addition, our ears are not exactly the same – the right one deals with speech better and the left one with noise. (Recall how an average person might lean forward with their hand cupped behind their right ear to hear better in a noisy situation). Finally, I'll toss into this mix the idea that while vision and hearing correction are only very superficially alike, one way that they might be is in how the brain learns to always expect a correction. In the early days of someone new to glasses, the change is a hard one. But, over a few weeks, the brain learns to adapt. The same seems to be generally true with hearing aids. Likewise, with glasses, one might be tempted to use them all of the time (even when not needed, like when viewing things far away when you are far-sighted) or even use higher magnifications even when not needed. This trains the brain in a way that is perhaps not optimal and there are those who argue that it even causes atrophy of muscles and neural pathways that would otherwise be beneficial. I'm not an audiologist nor an optometrist and will very willing accept correction by those who understand these matters more deeply. Very best, Keith

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@bobbyboomer

Hi,
Do Hearing Aids damage ears in the long run?
My take on this is ultimately a properly programmed aid will not damage hearing in the long run. I will say that any loud noises will damage the ear and I am including otc PSAPS and the old analog hearing aids which I wore in the beginning of my journey.

Since a hearing aid is programmed to your particular loss then the decibel level is also programmed to your individual loss. At least it should be . It should never be at a damaging level. If you think your aids are too loud then they are. I can say that my hearing went downhill about 25 years ago when I was wearing one analog aid. Audiograms confirmed this. Then the aids became more sophisticated and my loss stagnated…it didn’t get any worse. It has been at a standstill for at least 15 years.
I attribute this to wearing 2 aids and the improved advances over the years. When I say my Phonak aids are powerful, I don’t mean they are loud. I mean that they are capable of doing so much more than ever before. I have gone through Audi’s bad and great and hearing aid techs both bad and great.
I have had aids that were way too loud…the decibel level wasn’t programmed properly. I’m sure that did damage.

It’s the DECIBLE level that is the CRUX of this very good question. And a very thought out detailed question. Properly programmed aids won’t damage your ears…improperly programmed ones probably will.

For people who are new to hearing aids….this can be a problem. They don’t know what to expect and perhaps think loud is good. Hearing people think loud is good. You can go through years and years of bad Audi’s or providers and have your hearing get worse and worse and blame the aids….it’s the person doing the programming. Then you opt for new aids and maybe that wasn’t necessary at that time.

So my answer is no…..aids do not damage ears unless they are improperly programmed. Hearing aid dispensers need to be held accountable and we need to be more demanding. I’ve had 45+ years of wearing aids and I still go back and back and back until they get it right. At this point I can spot a bad Audi right away….they SHOULD have the answers to my questions and they SHOULD know all this stuff and they SHOULD NOT let you out of their office until they are sure you understand.

Two vs one aid is another topic entirely

My 2 cents from FL Mary

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@jkmcelveen

Thank you, Colleen. I've replied to the discussion on One or two hearings aids just now. Fascinating stuff to consider and not easy to come up with a definitive answer for! Regarding Bobby's question, it fits that same pattern. Given my background of hearing-in-noise and spatial hearing R&D, I think some things that might be generally under-appreciated are how finely tuned our auditory system is to small time delays and frequency changes, how dependent we are upon hearing well in the 6-10 KHz range, and how the outer ear helps enable our ability to localize and extract target sound sources. Hearing aids in one or both ears slightly (and confusingly) change the timing and frequency information that our hearing has used over a life time of learning (presuming onset of hearing issues in older age) to sort out voices and other sounds. In addition, our ears are not exactly the same – the right one deals with speech better and the left one with noise. (Recall how an average person might lean forward with their hand cupped behind their right ear to hear better in a noisy situation). Finally, I'll toss into this mix the idea that while vision and hearing correction are only very superficially alike, one way that they might be is in how the brain learns to always expect a correction. In the early days of someone new to glasses, the change is a hard one. But, over a few weeks, the brain learns to adapt. The same seems to be generally true with hearing aids. Likewise, with glasses, one might be tempted to use them all of the time (even when not needed, like when viewing things far away when you are far-sighted) or even use higher magnifications even when not needed. This trains the brain in a way that is perhaps not optimal and there are those who argue that it even causes atrophy of muscles and neural pathways that would otherwise be beneficial. I'm not an audiologist nor an optometrist and will very willing accept correction by those who understand these matters more deeply. Very best, Keith

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@ jkmcleeven
Hi,

What jumped out at me was when you stated how finely tuned our auditory system is and how different we hear with one or two aids or under other external circumstances, frequency, timing, health .even the weather. Hearing people accuse us of selective hearing and it is hard to explain to them everything that affects our hearing and changes how well we hear or don’t hear at that particular time. Blank stares all around. An ongoing process with us. The brain is very adaptable and it is so true that it can accept what is normal but not necessarily optimum. But it can also change. Amazing brains we have😏
Thanks for a great post

Regards from FL Mary

Liked by jkmcelveen

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Bob: Thanks for the good question! I have also wondered this myself. I have a 60dB drop at voice frequencies. Every morning I do a one hour cardio workout…biking,walking,etc. I do not wear my hearing aids during this time but put on wireless headphones. I am mindful not to play it too loud as to not damage my ears any further, but I have taken them off at what I consider a very low level and hand them to my wife…she winces with a painful look on her face…way too loud for her! So even if does not seem too loud to me am I still damaging what's left of my hearing? My mornings are typically quiet at home. Do I need to wear them when I am by myself? Is it important that I hear the ice machine on the refrigerator cycle? I know that most audis will tell you it is better to wear them all the time to get the most benefit. Just food for thought. Enjoy this blog!

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I found that my old ReSound Air aids had a maximum volume of 100dba. At 100dba you are allowed 15 minutes per day without causing permanent ear damage.

This is a cause of concern for me. I know that thy weren't blasting 100dba into my ears all the time, but in noisy environments it is quite possible they were.

I haven't been able to find specifications on Oticon OPN aids.That's what I'm wearing now. The technology is decades newer, but if they are putting out 100dba, it puts me in a dilemma. I need the aids to understand speech, but are they causing more of a dependence on the aids as the damage my hearing? Is there a limit to the damage?

Does anybody know where I can find the specs for the OPN aids? Oticon didn't answer my e-mail yet. Perhaps they will, perhaps they won't, if they do give me the information I'll post it here.

Bob

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@scottk

Bob: Thanks for the good question! I have also wondered this myself. I have a 60dB drop at voice frequencies. Every morning I do a one hour cardio workout…biking,walking,etc. I do not wear my hearing aids during this time but put on wireless headphones. I am mindful not to play it too loud as to not damage my ears any further, but I have taken them off at what I consider a very low level and hand them to my wife…she winces with a painful look on her face…way too loud for her! So even if does not seem too loud to me am I still damaging what's left of my hearing? My mornings are typically quiet at home. Do I need to wear them when I am by myself? Is it important that I hear the ice machine on the refrigerator cycle? I know that most audis will tell you it is better to wear them all the time to get the most benefit. Just food for thought. Enjoy this blog!

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I don't wear earbuds for that reason.

Do yourself a favor, get a Sound Pressure Level Meter, they are pretty inexpensive. I got a few at Radio Shack when they were still in business, I imagine Amazon and other outlets might have some for sale.

Set it on "A" weighting and slow response. A weighting approximates the range of frequencies a well functioning hear can hear, and slow response is more averaging as it eliminates short peaks and valleys.

Play music or TV with the meter on and get used to what 85db sounds like both with your aids in and out. Once you can judge that you can better guess whether you are listening too loud with your earbuds.

Of course I'm not a doctor nor am I giving medical advice, so take this as just friendly non-pro advice. It could be wrong.

Bob

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@bobbyboomer

I don't wear earbuds for that reason.

Do yourself a favor, get a Sound Pressure Level Meter, they are pretty inexpensive. I got a few at Radio Shack when they were still in business, I imagine Amazon and other outlets might have some for sale.

Set it on "A" weighting and slow response. A weighting approximates the range of frequencies a well functioning hear can hear, and slow response is more averaging as it eliminates short peaks and valleys.

Play music or TV with the meter on and get used to what 85db sounds like both with your aids in and out. Once you can judge that you can better guess whether you are listening too loud with your earbuds.

Of course I'm not a doctor nor am I giving medical advice, so take this as just friendly non-pro advice. It could be wrong.

Bob

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great question, i also have an opn aid and a cochlear implant in my right ear. fascinating to read that speech comp is more dominant in right ear. have always wondered about this subject and will try to get some answers from my audiologist and/or oticon. thx for bringing this up

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@wassy2019

great question, i also have an opn aid and a cochlear implant in my right ear. fascinating to read that speech comp is more dominant in right ear. have always wondered about this subject and will try to get some answers from my audiologist and/or oticon. thx for bringing this up

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Don't bother asking Oticon. They are THE most non-customer oriented company on the planet.

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