You May Have Signs of Hearing Loss and Not Know It. Here’s How OTC Hearing Aids Can Help.
The world is getting noisier, which means your hearing—no matter how young or old you are—is probably getting worse.
Noise pollution levels in the US double (or may even triple) every 30 years, according to research from the National Park Service. No wonder, then, that a 2017 study in JAMA Otolaryngology estimated that hearing loss among all Americans aged 20 and up would increase from 44.1 million in 2020 to 73.5 million by 2060. And just last month, the World Health Organization predicted that by 2050, more than 700 million people worldwide will experience disabling levels of hearing loss.
One of many reasons why hearing loss is such a widespread epidemic: It’s often hard to tell when you have it.
In a 2016 National Academies of Sciences study, nearly one in four adults who self-reported having good or excellent hearing actually exhibited measurable hearing loss—a sign of how adaptive the brain is to the gradual hearing loss that almost everyone experiences as they age, and one of the reasons younger adults may incorrectly assume that they have no symptoms.
The good news is that after years of delays, over-the-counter hearing aids finally hit the US market in 2022, offering wider access and easier ways to address one of the most undertreated health problems among American adults at a somewhat lower cost. (The three OTC hearing aids we recommend cost under $2,000 a pair, while prescription hearing aids can run more than double that.)
Here’s how you can assess if you may be experiencing the kind of “mild to moderate” hearing loss that over-the-counter hearing aids are intended to address.
![A close-up of someone wearing a hearing aid.](https://cdn.thewirecutter.com/wp-content/media/2022/10/hearingaids-2048px-000831.jpg?auto=webp&quality=75&width=1024)
Signs of hearing loss
You recognize when someone is speaking but can’t make out specific words they’re saying
“One of the biggest things that we hear with adult patients is, ‘Oh, I can hear, I just can’t understand’—and almost always, that’s the kind of mild to moderate, high-frequency hearing loss that these new hearing aids are intended to address,” Lisa Vaughan, AuD, a past president of the American Academy of Audiology and now the audiology program manager at Cook Children’s Medical Center, said in a phone interview.
The problem derives from a physiological aspect of aging that, depending on factors like genetic predisposition or environmental noise exposure, can begin as early as young adulthood: The small hairs in the cochlea (inner ear) that interpret high-frequency sounds—in speech, those are usually consonants that help a person distinguish similar-sounding words from one another, like “boat” versus “tote”—tend to die off first as the person gets older. “Those hairs are out there toward the edge of the cochlea,” Vaughan explained. “They experience the most damage and the greatest reduction of oxygen over time, decreasing their ability to capture certain sounds and present them at a loud-enough level for the brain to process.”
Angela Shoup, PhD, past president of the American Academy of Audiology, added in a phone interview that OTC hearing aids “are expected to be best at boosting loudness for specific pitches as needed by the user, so that your overall hearing experience is made clearer and sharper, rather than just across-the-board louder.”
You have trouble following a one-on-one conversation amid a social or group setting
In Vaughan’s experience, “I don’t hear well when there’s background noise” is the second most common complaint among those experiencing mild to moderate hearing loss. In addition to being higher in frequency, consonants are usually softer in volume and shorter in duration than vowel sounds, which means they tend to “get masked easily and quickly by all of that background noise,” she said. (Background noise, such as voices in a crowd or the hum of air conditioning, often includes prominent mid and lower frequencies.) A good pair of OTC hearing aids will offer what are called “situational sound modes” for places like restaurants or the outdoors, which can reduce background noise and allow you to hear conversations more clearly.
It seems like people, especially children, mumble a lot
If you feel like you’re constantly asking the kids in your life to repeat themselves—and you’ve presumed it’s because their mouths are usually several feet below your ears—high-frequency hearing loss could be the real culprit. “When people have hearing loss, it’s usually easiest to understand someone who has a low-pitched voice,” says senior staff writer Lauren Dragan, who spent two-plus years collaborating with the Hearing Loss Association of America while reporting our guide to the best OTC hearing aids. “You can pick up more of the context of what they’re saying even if you normally miss out on higher-frequency parts of speech.”
You’ve maxed out the volume on your TV, earbuds, or other devices but still want to turn them up more
When it comes to hearing loss, your devices often tell on you: You’re turning on subtitles even though you understand the language being spoken. People are remarking that your TV is turned up way too high. You’re ignoring your smartphone’s warning that you’ve been listening to music or a podcast at a concerningly loud level for too long. You feel like your headphones just don’t get loud enough.
Such early indicators can help a person self-diagnose any potential hearing problems. “A lot of smartphones have health apps that track your average audio exposure,” Lauren says. “Find out if the average level on your headphones last year was quieter than it is this year. That’s a pretty good indication that you might need to further investigate.”
You’ve worked in noisier industries, from the military to a farm to an orchestra
Repeated exposure to noise at rock-concert levels can damage hearing, obviously, but as one 1990s study pointed out, even the dulcet tones of a single string instrument can lead to hearing loss. Violinists and violists who performed with the Chicago Symphony Orchestra were found to have poorer hearing in the left ear—since they played their instruments tucked under the left side of the chin—than the right ear. Cellists, piano players, and other instrumentalists from the same orchestra whose instruments were not played directly under the ears did not exhibit the same hearing loss.
People in a remarkably wide variety of industries tend to experience higher-than-normal rates of hearing loss. Despite the rural environs, farming has become a hazardous occupation for hearing health, due in large part to tractors and other machinery. The same is true for forestry and commercial fishing. Hearing loss and tinnitus (ringing in the ears) are the two most common reasons for VA disability compensation claims among veterans.
Lauren added that people in any sort of guest-services job—including bartenders, bouncers, servers, and fitness instructors—are likely to be in a too-loud environment for long stretches of time.
Hearing loss (or other conditions that can cause it) runs in your family
“One thing we know about hearing loss is that it’s similar to sunburns,” Lauren says. “Some people are more predisposed to it than others.”
Substantial evidence indicates that you can be genetically predisposed to developing hearing loss later in life. But similarly, Shoup said, you could be genetically predisposed to other health conditions that tend to mess with inner-ear functionality, such as cardiovascular disease or diabetes. “The ear is a small sensory organ that has a blood supply,” she explained. “Anything that could potentially impact your blood flow or general organ health can negatively impact your inner ear’s sensory cells.”
Hearing loss can be a side effect of certain medications and medical treatments
“If you were to look at the possible risks and side effects of common medications, many have hearing loss as a potential risk factor,” Shoup said. And again, you could also be genetically predisposed to that side effect having a stronger-than-normal effect on you. “They’ve found genetic markers that make you more likely to develop hearing loss if treated with certain drug classes,” she added, “such as sensitivity to pharmaceutical agents that are used to treat infections.” Chemotherapy is also commonly known to affect hearing.
If you suspect that you have mild to moderate hearing loss
The next step is to get a hearing test to confirm. With the new class of OTC hearing aids comes an expanded array of options for assessing your hearing. The makers of our top-pick OTC hearing aids—the Jabra Enhance Select 100, Jabra Enhance Select 300, and Eargo 6—offer online diagnostic tests. (Here is Jabra Enhance’s test and Eargo’s screener.) Best Buy, which carries Eargo devices, also offers an online hearing-assessment tool. However, as Lauren notes in our OTC hearing aids guide, you can also get checked out by a hearing professional, even if you don’t purchase prescription devices. “A hearing test at an audiology office is the gold standard,” she notes, “but you can also ask your doctor for a hearing test during your annual physical.”
Whichever path you choose to get your hearing tested, the most important part is to take action if necessary. “There can be a lot of shame and stigma wrapped up in hearing loss and hearing aids, which people still associate with harmful negative stereotypes surrounding aging. But people with hearing loss are not defined by age group, nor does hearing loss mean that a person is any less vibrant,” Lauren says. “Ideally, OTC hearing aids will push hearing loss into the realm of how people deal with any other medical condition or specialized need. My hope is that, as this OTC technology grows, hearing aids just become another accessory.”
![Different hearing aids.](https://cdn.thewirecutter.com/wp-content/media/2022/10/hearingaids-2048px-1462-3x2-1.jpg?auto=webp&quality=75&width=1024)
How to shop for and adjust to a hearing aid
If you believe that you’re a candidate for an OTC hearing aid, Lauren stresses that the try-and-buy process may involve some trial and error. That doesn’t mean hearing aids aren’t for you—just that it may take a while to find the best pair and acclimate to wearing it. Here’s what she suggests:
- Think about your lifestyle and what hearing aid features might be the best fit for you. Do you need something that you can use with a headset for calls? Do you wear glasses and hate the feeling of something running over your ear? Would you benefit from included tech support?
- Find a device that has a long trial period and take note of when you have to return it, if necessary. The Jabra Enhance devices we recommend in our guide come with a 100-day return policy, plus a three-year warranty and three years of follow-up care included in the price. Our recommended Eargo aids carry a 45-day return policy, which should still be long enough for you to determine whether they’re right for you, as well as a one-year warranty with one-time loss protection.
- Even if the hearing aids feel weird in the beginning, resist the urge to give up on them. Lauren says one tester for our guide took a break from her new hearing aids, complaining that “everything sounded like too much,” only to quickly realize that, without them, she was missing a lot. After a period of adjustment, the tester later said of her assisted hearing, “Things sound pretty normal to me.”
- If you have access to customer support, use it. Some of the bumps that hearing aid wearers may experience with their new devices can be resolved via phone call or text chat. You can ask about tweaking the sound quality, how best to use the device, and more.
This article was edited by Adrienne Maxwell and Annemarie Conte.
Further reading
Over-the-Counter Hearing Aids Could Finally Give People an Affordable, Convenient Hearing Solution
by Lauren Dragan
Traditional hearing aids can be expensive and inconvenient. But lower-priced, over-the-counter hearing aids are coming soon.
Trouble Hearing TV Dialogue? The Right Soundbar Can Help.
by Brent Butterworth
Many soundbars offer voice-enhancement modes to improve dialogue clarity, but do they really work? We asked six hard of hearing people to give them a try.
How to Hang Heavy Stuff
by Harry Sawyers
Everything we recommend for mounting heavy stuff on a wall or ceiling.
The Best Record Player Setup for Beginners
by Adrienne Maxwell
Start your vinyl music journey here with our picks for turntable, receiver, speakers, and more.