Ask HN: Hearing aid wearers, what's hot?

I’m sorry I can’t answer your question but on a related note I wonder if anyone has used AirPods Pro 3 as hearing aids either as their first pair or replaced their traditional ones with AirPods? I’m considering getting a pair for a family member who has been reluctant to wear traditional ones but I think would be willing to do AirPods.

Following... My audiologist had the big talk with me last week and I guess I'm due to take care of my hearing...

I have worn hearing aids since childhood in the '90s. Moderate sloping to profound loss. Been through all the tech since the equalized analog era.

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.

I have moderate-to-profound hearing loss and have worn hearing aids since I was 4. I currently have Oticon Opn1’s and have had Oticons since 2017 (and got new ones in 2022) and they are fabulous. I find the sound quality in noisy environments much better than any other aid I’ve had - much better perception of voices in restaurants, for example. I rarely have to fiddle with the volume control and in fact do not even use any other settings than the main program - I find that whatever the core program is doing tends to be basically what I want.

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.

Not sure why this is directed at deaf people only,

adjective 1. having a high degree of heat or a high temperature.

Hope that helps!

I'm not a hearing aid wearer, but I came across https://www.envoymedical.com/ during investment research activities. They seem to have the leading candidate for a fully implantable device. FDA Breakthrough Device designation. I'm interested in the reaction of any hearing aid wearers to what they are developing.

Would like something like the Apple ones, without Apple or an app at all. Anyone make such a thing that works with Linux?

Using Advance72 (made by Sonova) has BlueTooth which makes using a phone a breeze. The Hearing Remote app allows me to override the audiologist configured settings for volume, listening modes and equalizer.

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.

I wear the new(ish) Starkey AI Genesis. Jump ahead in terms of battery life and water resistance. Great overall. Use a CROS in one ear.

I just replaced my Jabras (from Costco) whose microphones stopped working. I tried Phonaks and found that the use of Bluetooth to connect to my iPhone was painfully flakey (there were certain locations in my neighborhood that every time I walked in front of a particular house, I would lose audio). I ended up returning them and the only MfI hearing aids the audiologist I went to (I was limited by what was in-network by my insurance and while the old insurance covered equally in-network and out, my new insurance covered 0% out of network so I was going to be looking at double the price to go to Costco). I ended up with Resound which are essentially the same as the Jabras.

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’ll chime in with a sidebar: Anyone got any experience using hearing aids for the "hearing in noise" issue (aka. King-Kopetzky syndrome or lack of cocktail party effect [0], part of a whole bunch of things also called adhd for ears). Essentially I have filtering issues, as soon as multiple people talk, I can’t really understand anyone anymore, unless they very directly speak into my ears so they are significantly louder than other noises.

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.

I'll tell you what is NOT hot!

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...

Here's a crazy idea. I personally prefer the fidelity of an active ambient in-ear monitor (IEM), as used by musicians on stage over the best hearing aids. Once a year, I do a monthly trial with the latest hearing aid models and IMO the fidelity (especially low-end) and the comfort just is not there compared with the best active ambient IEMs. The difference between hearing aids and IEMs is blurring, but they are not yet fully interchangeable.

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-...

I'll tell you what's not hot: cochlear implants. I wore hearing aids since the late '80s. I wear CIs as of about 5 years ago, and while my hearing is much better and stable than it used to be, I've found that UX for CIs is pretty bad.

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.

There's something I think must be possible and wonder if it would be useful: using noise cancelling earphones to mimic someone else's hearing loss. The idea is if you live with someone with hearing loss, you could enter the frequencies they can't hear, and cancel only those. Then you could spend a day with these in to try to get a more direct understanding of which noises they can hear and which they can't.

What about bone conduction headphones (like Shokz) typically used for swimming and running?

A long time ago, I interviewed at a company called Earlens. They had a really interesting solution that used mineral oil to stick some kind of tiny speaker directly to your eardrum. The processor then beams the sound to the speaker. I think the first generation used a laser, but they've since switched to inductive coupling: https://earlens.com/wp-content/uploads/2022/09/LBL00153vJ.ar...

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.

This is very unrelated but I worry about posts like these.

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.

I have the Widex SmartRIC 220, and would buy them again. They are comfortable, have musical audio quality (Widex works with musicians), very low latency (reducing comb filter effect), and in general look and feel very professional.

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.

Widex Moment 440. They’re expensive but really good.

Bit a side question since OP mentioned company's name: anyone from Europe with Phonak devices with recently replaced earmold? I wonder if you got a soft silicone or something that appears to be some firm 3D printed material.

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.

One of my friends has the latest Apple Airpods. He has had various (expensive) hearing aids over the years but these are much better for him (and cheaper). For the first time he can actually hear everything going on

Has anyone tried AirPods Pro as hearing aides? I remember Apple talking big game about getting them certified or something