Understanding Hearing Loss Levels and Hearing Aids
Figuring out whether you have hearing loss can be challenging. Most people go for years before they realize they have a problem. One of the trickiest things about hearing loss is that the symptoms vary from person to person, and it doesn’t occur all at once, making it challenging to know when it begins and when it’s time to seek help.
Have you noticed a need to turn up the volume louder than you used to on the television? Does it seem like the people around you aren’t enunciating or are mumbling more than they should? This common condition affects at least 15% of American adults, and it can strike at any age, though your risk increases as your age advances.
Unfortunately, the longer you wait to get help, the more difficult it is to slow down the progression of the condition. People with hearing loss can experience secondary conditions, such as tinnitus and depression, if they don’t get help quickly. Therefore, it’s a good idea to go to your audiologist for regular checkups. Adults aged 18-60 should go for hearing checkups every three to five years while those over the age of 60 or who work in loud environments, may want to go every year, just as a precaution.
Your level of hearing can be determined during a hearing test that graphs the sounds you can hear on an audiogram. An audiologist provides these exams. The intensity of sounds as well as varying frequencies are tested to determine your hearing sensitivities. These numbers are noted as decibels. There are different levels of hearing loss.
We also know that understanding the five stages of hearing loss can be the first step in knowing when to seek help.
It is based on how loud sounds need to be for you to hear them. Decibels, or dB, describe loudness. Source: Clark, J. G. (1981). Uses and abuses of hearing loss classification. If you can only hear sounds when they are at 30 dB, you have a mild hearing loss. You have a moderate hearing loss if sounds are closer to 50 dB before you hear them.
Hearing Loss Levels and Hearing Aids
Patients can wear hearing aids for all levels of hearing loss defined by the Hearing Health Foundation (HHF). However, as you’ll discover below, assistive hearing devices are better for some types of hearing loss than others.
Mild Hearing Loss (26-40 dB)
The HHF defines mild hearing loss as trouble hearing sounds quieter than 26-40 decibels (dB). Noises in this range might include general background noise, whispering or the ambient noise of water flowing along a stream. Stage 1, or mild hearing loss, is diagnosed when the quietest sounds you can hear are between 25 and 34 decibels (dB). If you’re in this stage of hearing loss, you probably have trouble following conversations from time to time, especially when there’s a lot of background noise or in crowded situations.
While the classification mild seems quite innocuous, it is important that patients discuss how much the condition is affecting them with your audiologist. The toll it is taking on daily life is the most important consideration.
Adults with mild hearing loss should begin using hearing aids immediately, even if they can still pick up on most conversations. The reason for this is that it helps to improve brain function by stimulating auditory processing. The more sounds you can hear, the more active the brain becomes and the slower the progression of the condition.
Moderate Hearing Loss (41-55 dB)
The HHF defines moderate hearing loss as difficulty hearing any sounds below 41 to 55 decibels. Stage 2, or moderate hearing loss, is diagnosed when the quietest sounds you can hear are between 35 and 49 dB.
Patients in this category can often benefit tremendously from wearing hearing aids. These allow them to detect normal conversation, street traffic and birdsong.
Even if your moderate hearing loss is not preventing you from having an active social life, hearing aids are still worth considering. That’s because they help improve brain function, just as they do for patients with mild hearing loss.
Moderately Severe Hearing Loss (56-70 dB)
Patients with moderately severe hearing loss struggle to hear sounds between 56 and 70 decibels. When the quietest sounds you can hear are between 50 and 64 dB, the diagnosis is stage 3, or moderately severe hearing loss.
Individuals in this category find it difficult to hear regular speech at all without an hearing device. Their ears may also fail to pick up the sound of the dishwasher or washing machine while it operates.
If your hearing falls into the 26-70 dB range (mild to moderate), a hearing aid can be very effective in restoring sounds for your daily life.
Severe Hearing Loss (65-79 dB)
Severe, or stage 4, hearing loss is the diagnosis when the quietest sounds you can detect fall between 65 and 79 dB. With stage 4 hearing loss, you cannot hear conversational speech at all, and you’ll likely struggle to hear loud speech.
Profound Hearing Loss (91+ dB)
Profound hearing loss occurs when patients can’t hear sounds below 91 decibels. Stage 5, or profound hearing loss, occurs when the quietest sound you can hear is 80 dB or higher.
At this level, amplification of ambient noises via a hearing aid is unlikely to make much difference. Often, the issue for patients in this category is not a lack of volume, but damage to the machinery of the inner ear itself, preventing sound signals from traveling to the brain, no matter how loud things get. In these cases, hearing aids may not be effective, however, it depends on the individual patient.
The Importance of Early Intervention
Individuals with sensorineural hearing loss should get a hearing aid as soon as possible. Assistive hearing devices can help prevent conditions, such as tinnitus, and they stimulate the brain’s auditory cortex. They can also help to prevent social isolation and depression - both common side effects of being hard of hearing.
Please note, though, that you might not be able to tell whether you have hearing loss easily. That’s because, at first, the signs tend to be subtle. Asking people to repeat themselves might seem normal and doesn’t confirm that you have a problem.
The only way to find out if you have hearing loss is to go for a hearing test. Here an audiologist will give you a pair of headphones to wear and then pipe pure tones to you at various volumes, asking you to indicate when you can hear them. Everyone has trouble hearing sometimes. Maybe it’s due to a noisy environment or you’re communicating with a soft-spoken person.
An audiological evaluation by Dr. Michael Riesberg will include tests of the outer, middle and inner ear to identify how these structures are working. Dr. Riesberg will also chart your level of hearing to determine the appropriate treatment.
Choosing the Right Hearing Aid
There are many different types of advanced technology hearing aids that can improve your quality of life without drawing attention to the fact that you are wearing one. Choosing a hearing aid can sometimes feel overwhelming because there are so many options available.
The hearing aid buying process looks a little different depending on the type you need. You can buy over-the-counter (OTC) hearing aids online, but prescription devices require a series of in-person appointments. An ear, nose, and throat doctor, audiologist (hearing specialist), or hearing aid dispenser must examine your ears and administer a hearing test before you can purchase a prescription hearing aid.
After the exam, your health care provider will discuss different types of hearing aids and let you try on a few models. You don’t have to make an immediate decision. Ask for brochures and other take-home materials that can help you weigh your options. You’re also not locked in to purchasing a hearing aid from the doctor who diagnosed your hearing loss. Once you make a decision, the hearing care professional will order the device for you and schedule a fitting appointment. At this appointment, they’ll program the hearing aid according to the results of your audiogram-a graph that visually represents the results of your hearing test, showing the softest sounds a person can hear-and demonstrate how to use it.
Anyone can buy OTC hearing aids-you don’t need to see a professional at any point in the buying process. But experts recommend you get an in-person hearing exam first to rule out any causes of your hearing loss that can’t be treated with hearing aids. OTC hearing aids are available to adults at least 18 years old with mild to moderate hearing loss. You can buy them online directly from the brand or from popular retailers like Amazon and Walmart. Some models can also be purchased in brick-and-mortar stores like Best Buy.
You’ll want to think about many factors when choosing the best one for you. Your degree of hearing loss, style preferences, and budget help to narrow your choices. Hearing aids can address different degrees of hearing loss. OTC hearing aids are approved for mild to moderate hearing loss only.
Types of Hearing Aids
Hearing aids come in several different styles.
- Behind-the-ear (BTE): As their name implies, behind-the-ear (BTE) hearing aids include a housing unit that sits behind the ear. The housing unit is like the brains of the hearing aid. Sound travels from the receiver to the ear canal via a thin plastic tube.
- Receiver-in-canal (RIC): At first glance, receiver-in-canal (RIC) hearing aids look like BTE hearing aids, but there’s a key difference: The receiver is nestled in the ear canal instead of in the housing unit behind the ear.
- In-the-ear (ITE): An in-the-ear (ITE) hearing aid tucks the receiver into the ear canal while a housing unit rests in the bowl of the ear.
- In-the-canal (ITC): In-the-canal (ITC) hearing aids are smaller than in-the-ear devices but visibly stick out of the ear canal.
- Completely-in-canal (CIC): Completely-in-canal (CIC) hearing aids fit snugly inside the ear canal but may be visible from certain angles.
- Invisible-in-canal (IIC): Invisible-in-canal (IIC) hearing aids sit even deeper inside the ear than CIC devices. When properly inserted, the housing unit can’t be seen from any angle. Only the removal wire sticks out from the ear canal. These types of hearing aids must be administered by a hearing professional.
Hearing aids can have many different features to suit your needs and budget. Clarify speech in noisy environments. Customizable frequency bands are perhaps the most important because they let you choose the exact level of amplification for each sound frequency.
Cost and Care of Hearing Aids
Hearing aid costs vary considerably, from about $100 to more than $7,000. Hearing care providers set their own prices for prescription devices and often bundle fitting services and follow-up care into the total price. Ask what’s included in the cost of the hearing aid to avoid surprise service bills. For people new to hearing aids or with higher degrees of hearing loss, fitting services and follow-up care may be helpful to ensuring you’re happy with your hearing aids. Prescription hearing aids also come in different performance levels, which affects the final price. It’s like buying a car-if you want all the bells and whistles, expect to pay top dollar. Affordable hearing aids are more likely to be OTC models.
To get a free or low-cost prescription hearing aid, start by asking your hearing care provider about financial assistance or free demo models. Original Medicare (Part A and Part B) typically doesn’t cover hearing care, but there are exceptions. Many Medicare Advantage (Part C) plans offer benefits for hearing exams and hearing aids.
When you first get new hearing aids, expect a bit of discomfort. It can take several weeks or months to adjust to a louder world. “When starting hearing aids, you have to be prepared to deal with some minor inconveniences. Loud sounds like a blender running or an ambulance passing by might be more forceful than you've remembered,” said Anish V. People with hearing loss often say their own voice sounds odd once they start wearing hearing aids. Some also report tinnitus after wearing hearing aids for the first time, but it’s usually temporary. Sounds may tinny or robot-like, and it may be difficult to understand some words or accents at first. “These issues tend to naturally resolve as the brain gets accustomed to the hearing aids,” said Thakkar.
To care for your hearing aids, wipe them down with a soft cloth every day. Once per week, gently remove the ear dome and use a soft bristle brush to wipe wax off the filter that covers the receiver. Most hearing aids come with a care kit, but you may need to purchase extra components like wax filters. If your hearing aids often get wet, consider a dehumidifier to thoroughly dry them out. For people with low vision, the small size of hearing aid parts can make caring for hearing aids more difficult. A hearing clinic can help you understand how to clean your hearing aids and align the batteries correctly.
To choose the right hearing aid for you, be sure to consider three main things: your degree of hearing loss, the style of hearing aid that can address your level of hearing loss, and your budget. You can learn your level of hearing loss by taking a hearing test. But not all hearing aids can address all levels of hearing loss. In general, it’s better to get a hearing aid from an audiologist or hearing clinic since you’ll get more in-person support and post-purchase care. But buying hearing aids from a hearing clinic is also more expensive than OTC hearing aids.
You should always have a hearing test before buying a hearing aid. You can take hearing tests online or in person. Not all hearing loss is the same. Treatment will depend on how serious your hearing loss is. You go to the audiologist for a hearing test. You may be told that you have a mild hearing loss. Or, you may find out that your hearing loss is more severe.
Riesberg Institute has developed a hearing quiz: a quick assessment to let you know if it might be time to have your hearing tested.
If you’re struggling with hearing loss, contact the compassionate team at Jacksonville ENT Surgery for a hearing loss evaluation and personalize treatments. Audiology goes far beyond hearing aids. It’s about enhancing communication, connection, and quality of life by playing a vital role in managing hearing loss.