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-...
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 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...
During a call, swipe down for the control centre. You’ll see an option at the very top to adjust the audio options. Mic input is just there.
They were Phonaks.
I guess I'm glad to hear that it's not intrinsically a hearing aid thing, and I may find a better experience with other brands.
Mine were exactly like this to start with and over time the effect goes away such that you don't notice. I'd recommend if you do actually have hearing problems, sticking with it for quality of life improvements.
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 personally use iPhone and I do prefer to leave phone in pocket for my phone call. But it does seems like a massive oversight to not make this configurable.
Settings > Sound & Haptics > Input > change from "Automatic: ..." to "iPhone Microphone"
This does seem to let me enable voice isolation though, which seems to work very well.
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"
And AirPodsSanity (& SoundAnchor) offer polished options here. Maybe using that same script underneath!
I think the Macbook does some more advanced beamforming stuff to filter out sound coming from other directions.
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.
The traditional solution is an FM system where you give the person speaking a microphone linked to your hearing aids. There are dedicated ones like Phonak Roger. You could probably also use your phone as a microphone if it's bluetooth connected to your headphones or hearing aids.
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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.
As for technology, they use bluetooth low energy to connect to the smart phone, which works really well, with the caveat that the range is quite low and if it is in the pocket and you are moving around, media sound will often disrupt or desync intermittently. On the plus side, they last well over a day even with media use (WIdex says they last 37 hours without bluetooth use and that checks out). The case provides charge for about a week, and has wireless and usb-c charging.
They are quite pricey, but there are several options (110, 220, 330, 440), and the 220 were more than enough for me. The app has several modes, including directional focus mode, and you can define your own. I sometimes use a different mode for listening to concert music, that disables most filters such as volume protection.
I am wearing them for 9 months now, and there was no situation (concerts, traveling, work, sports, etc) were they gave me any issues whatsoever.
Oticon just announced/released their 'Zeal' product - a non-custom CIC, with seemingly all the bells and whistles, including bluetooth. Planning to try them soon.
I have tried a few aids before (Starkey and some older Phonak) and I do really like the Oticon 'sound'. They work for me, but of course YMMV. I think many aid manufacturers (many of them the same company - WDH!) do 60 day trials. Worth a shot.
My only dislike is the new fad, particularly of Oticon, of stopping disposable batteries and only going rechargeable. Disposable zinc-air cells have great life (I'd get a week on the Opns at least, with a few hours streaming per day). I travel for work a lot, so carrying a couple of tiny 312's in my wallet or keychain was perfect. The Zeal look to have what Oticon think is a 'compact' charger - but it ain't small. My kingdom for a charger the size of the AirPods Pro case...
I also travel a lot with work. So far, the estimate of 20 hours battery seems genuine - but you’re right, the charger is not small. What I didn’t know though, is that the charger holds three full charges worth of capacity. Meaning it doesn’t need to be plugged in for three nights in a row.
Due to my level of loss (80db), I need the custom mold option. This seems to be primarily to reduce feedback. I’m swapping between the custom mold and the standard tip to see which is best for my use case.
So far though, I’m impressed.
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.
In terms of hearing quality, for me, it's been solid, with the caveat that it took a while to get the fitting right. I think my audiologist was a bit old school, and was sticking to settings he'd known to be good in the past rather than fitting for what the aid is capable of. I've recently had its prescription type updated to the native Oticon one, and it's been a revelation in terms of clarity.
My hearing loss is relatively recent (About four years now) so I will caveat this that I've only used Oticons, so can't really compare to anything else.
https://stonecharioteer.com/writing/2019/the-sound-of-music/
I tried the Starkey ITC ones a couple of weeks ago, but found the performance in noisy environments to be sub-par.
The Oticon Zeals seem good so far, but it has only been a few days. One thing they seem very strong at is the Bluetooth connectivity.
Thanks to recent iOS changes, I can use the mic in the Oticons or the iPhone for calls - and I’m tempted to try a DJI mic on my lapel as the mic. Although, so far during testing it seems that the Oticon mic might actually be good for phone calls.
In terms of size - I don’t know what they were thinking. I’m considering doing a 3D scan of the charger shape and trying to make my own. I’m sure every customer will compare it to the AirPod case. It’s small enough to throw in my laptop bag, but I won’t be keeping it in my jeans pocket anytime soon.
HN is a great place to get genuine thoughtful discussions compared to a big portion of the rest of the internet. Reddit used to be the place for finding genuine experiences for products with subreddits like buyitforlife (or more specific) but now these and other subreddits are filled with bots and marketeers promoting what they sell and hammering their competition in the same thread.
Some bots are already here but I fear when the marketeers come.
Rather than noise cancelling headphones, I’d be happy with an audio recording that has my loss applied to it. Anything to demonstrate what it’s like would help awareness and understanding.
Mother uses hearing aids since end of 90s and most of the time it was in-the-ear but recently due to increased hearing loss she had to pick a new behind-the-ear device - still with button battery tho.
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.
My daughter has the Cochlear N8 and the rechargeable battery lasts 20 hours
> Sometimes the cable frays and you find that out with sound cutting in and out
Is there any way you can know about this, e.g. from the app? I'm asking because my daughter is 1 and if this was happening she'd currently have no way of communicating that to us
I know somebody who really dislikes the over-the-ear type devices and swears by the all-in-one kind.
She seems to get a full day of battery out of hers, but I don’t know what kind they are and I imagine usage patterns make a big difference.
For what it's worth in the UK the NHS no longer provides the off the ear models (at least for children) as they say they have too many problems with them
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.
One of the engineers I had lunch with actually used their own product and he seemed to like it. I get the impression it's a more premium tier kind of thing that may not be covered by insurance, though.
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.
Interestingly, they work well for the realtime audio adjustments for music - but sadly not well enough for external speech.
I will keep trying them with every new software and hardware release though!
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.
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.
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.
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.
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.
adjective 1. having a high degree of heat or a high temperature.
Hope that helps!