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  • Writer's pictureDavid Engelman

My Hearing Aids Don’t Sound Right! Hearing Aid Sound Quality Issues

Updated: Jun 10


A VU meter, demonstrating sound in a hearing aid.

Probably one of the most common reasons for repeat visits to the audiologist are for issues regarding the sound quality of a patient’s hearing aids.  This is when the hearing aids are essentially “working” as such, but the patient is finding how the hearing aid sounds to be unsatisfactory or unacceptable.  This typically manifests in a few different ways, and we’ll look at each of these issues and what may be done to help. 

 

a)      Hearing Aids Sound Hollow or "Echoey"

 

When first wearing hearing aids, it is very common to find them to sound quite echoey, hollow, or boomy.  This can especially be the case when hearing your own voice while talking with the hearing aids on.  This is because we hear our own voice through sound conducted via the bones behind our ears (bone conducted sound) rather than via the air outside of our ears (air conducted sound- which is how we hear most sounds).  When we block our ears with something like a hearing aid, this causes what is referred to as the “occlusion effect”, where there is an increase in sound that arrives to the inner ear via bone conduction.  This can then make your own voice sound more boomy to you than you are used to.  In most instances, this will usually settle within a few weeks or so of consistent use of your hearing aids. 

 

However, if you find this “occluded” sensation to be particularly uncomfortable, then sometimes an alteration may need to be made to the physical fitting of the hearing aid.  This will usually involve making your hearing aid fitting be more “open”.  For example, on a receiver-in-canal (RIC) hearing aid, if you are using a dome on the end of your hearing aid, your audiologist may switch you to an “open” dome, rather than a “closed” dome.  This is where the dome will allow more air to pass in and out of your ears, leading to a less occluded feeling in the ear, and less echoey sound to your hearing aids.  Similarly, if you are using either an in-the-ear hearing aid or have a custom fitted ear mould for your RIC hearing aid, then this will usually have a vent that allows air to pass through the hearing aid into your ear.  Having this vent enlarged can usually also help alleviate some of the above concerns.

 

Apart from changing the physical fit of the hearing aids, some simple adjustments can often be made by your audiologist to the programming of your hearing aids, which can help reduce the echoey sensation.  This will usually involve decreasing the amount of amplification in your hearing aids, particularly in the lower frequency range.  This will, of course, sacrifice a bit of the overall “volume” of the hearing aids, but often just a small adjustment will provide relief without compromising the sound level too much. 

 

b)      Hearing Aids Sound Tinny or Harsh

 

When you’re new to wearing hearing aids, it is also very common to notice them as sounding tinny or harsh.  Often people’s voices might sound squeaky or sibilant and may sound a bit manufactured or almost “robotic”.  This usually comes from amplification of the higher range of sound frequencies, which are critical to contributing to the clarity of speech.  Many consonant sounds, such as the “s” sound or the “f” sound are high frequency sounds that are important for the understanding of speech and conversation.  For example, did someone say “fix” or “six”?  Like the problem of echoey sound quality described above, it can take a little bit of time for this to settle down as you get used to hearing through hearing aids.  However, if you find these sounds to be overly uncomfortable or are not noticing improvement after consistently using the hearing aids for a little while, your audiologist can decrease the level of amplification on these frequencies a bit.  This will hopefully allow the hearing aids to sound a little more natural to you, without sacrificing too much of the clarity.

 

Some hearing aid manufacturers may also have a more “harsh” sound quality to their hearing aids in comparison to others.  This again, is to help increase the clarity of speech sounds, but some patients may prefer a more subtle sound.  Therefore, if you have not been able to adapt to how your hearing aids sound despite wearing them consistently and having them fine-tuned, then it might be worth trying a different brand to see if this works better for you.

 

c)      Background Noise is Overpowering

 

Struggling to hear in noisy places is one of the most common concerns of people who notice difficulty with their hearing, and often a prime reason people choose to get hearing aids.  It can be very disappointing and frustrating then, if you find that you continue to mishear or misunderstand conversations when there is a lot of background noise around you.  This is a complicated issue that I discuss in more detail in another article that can be found here

 

Suffice to say though, it is normal to still hear and be aware of background noises while wearing hearing aids.  When you are first getting used to hearing with hearing aids, your brain suddenly becomes overwhelmed with lots of sounds it hasn’t been hearing properly for a long time.  Thus, a lot of attention is initially focused on sounds like the refrigerator running, floors creaking, and papers rustling.  In a restaurant or coffee shop setting, you may have trouble with tuning out surrounding conversations from other tables, rather than focusing on the conversation that you want to listen to. 

 

Like the other sound quality issues discussed in this article, this is often a matter of adapting to how hearing aids work and sound, and this usually improves with consistent, full-time use of your hearing aids.  However, adjustments can also be made by your audiologist to reduce the amplification of certain frequencies that tend to contribute to the perception of background noise.  It can also be useful to have a special program that you can activate in your hearing aids to help improve sound quality when in background noise.  Sometimes the use of an accessory in conjunction with your hearing aids can provide additional benefit to help overcome distracting background noises and focus more on the person or people you are trying to listen to.


d) Hearing Aid Sound Is Not Clear


The final most common hearing aid sound quality issue that hearing aid users tend to encounter, is a general lack of "clarity". This is usually when the hearing aid wearer feels that they can hear sounds and speech as such, but the speech still lacks definition and is not as clear as they would have hoped. Similar to the background noise issue described above, this can be a complicated problem, and one that has a lot of overlap with that same issue as well.


The issue of poor hearing aid clarity will probably warrant a bit more detail in a future article, but suffice to say, there can be a few possible contributors to this problem. There can be the more obvious causes, such as a genuine problem with the hearing aid itself. This can range anywhere from a clogged wax filter to malfunctioning internal components of the hearing aid. It is also possible that the hearing aid needs to be fine tuned and adjusted more adequately for your hearing needs. Perhaps a real-ear measurement needs to be taken (usually performed as part of the initial hearing aid fitting) to measure how the hearing aids are operating while inside your ears, and then can be adjusted accordingly.


The most common culprit, however, for poor hearing aid clarity, is the nature of hearing loss itself. Hearing loss, particularly when it affects the inner ear (most commonly associated with age-related hearing loss), will degrade the overall clarity of speech sounds, even when those sounds are technically "loud enough" for you to "hear". This means that even when hearing aids are worn, you may still struggle with the clarity of the conversations that you listen to. The degree that you would struggle with clarity can vary widely depending on the individual and many specific factors, such as overall hearing loss level, age, and cognitive abilities and memory. The hearing aids will still, however, make things easier for you, but it is important to recognise that clarity may continue to be an issue (to an extent) for some people. Your audiologist will be able to give you more guidance that is specific and unique to your hearing loss and overall situation.

 

Conclusion

 

Sound quality issues with hearing aids can be a common problem. Hearing aid users may encounter issues such as their hearing aids sounding echoey or tinny. Or perhaps that background noises are overpowering, or that there is a general lack of clarity.  It is also not uncommon to experience several or all these issues at the same time!  It can be, however, notice these things when first getting used to hearing aids, and in most instances, improvement is seen over a few weeks or so of consistent, full-time use of the hearing aids.  However, if the problems continue to persist, then your audiologist may be able to make some adjustments to the hearing aids that can help.


If you'd like to learn more about the kind of hearing care we provide for our patients at Finchley Hearing, please explore our website and feel free to get in touch with any questions.


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