What is ‘Hidden’ Hearing Loss?

Colorado is a loud state in the best possible way. Red Rocks concerts that shake the ground, packed Avalanche games at Ball Arena, ski runs where the wind drowns out everything else.

Westminster sits right in the middle of all of it, close enough to Denver to catch most of it and close enough to the mountains to add a whole other category of noise. Most locals have been around plenty of loud noise and never thought much about it.

That’s often where hidden hearing loss starts to show up. Nothing seems obviously wrong at first. You can still hear plenty of sounds around you, but conversations become harder to keep up with when there’s background noise.

A lot of people describe it as hearing but not understanding. The words are there, but they’re harder to sort out from everything else going on around them. That’s why so many people know something feels different long before a hearing test shows a problem.

Why Standard Hearing Tests May Miss Hidden Hearing Loss

A standard hearing test is usually performed in a quiet room where you’re asked to listen for soft tones. These tests are excellent at measuring how well you detect sound, but they don’t always reflect the listening challenges people face in everyday life.

Real life is rarely quiet. Conversations often happen in busy restaurants, crowded sporting events, family gatherings and other environments filled with competing sounds.

Someone with hidden hearing loss may have no trouble hearing a tone through headphones during a test, yet still struggle to follow a conversation when several voices are talking at once.

About one in ten people who report difficulty hearing in noisy settings receive normal results on a standard hearing test. That’s because hidden hearing loss isn’t always about detecting sound.

What Hidden Hearing Loss Feels Like Day to Day

Hidden hearing loss often shows up in situations where there’s a lot happening at once. You might be out to dinner with friends and find yourself missing parts of the conversation whenever the restaurant gets busy.

At a family gathering, you hear people talking but have trouble keeping track of who’s saying what. In meetings, group discussions can feel harder to follow than one-on-one conversations.

A lot of people describe the experience the same way: they can hear voices, but the words don’t always come through clearly. It can feel like everyone around you is mumbling or speaking from across the room.

By the end of a noisy evening, you may find yourself relieved to be somewhere quiet again.

These challenges can be confusing because they don’t always match the results of a hearing test. You know conversations aren’t as easy as they used to be, but it’s hard to explain exactly why.

Why Background Noise Makes Everything Harder

Many people with hidden hearing loss don’t notice a problem in quiet settings. The challenge usually shows up when there’s a lot going on around them.

A one-on-one conversation may feel perfectly normal, but add a crowded restaurant, a busy office or a room full of people talking at once and things become much harder to follow. Some common signs of hidden hearing loss include:

• Feeling like people mumble in noisy places
• Asking others to repeat themselves more often
• Struggling to follow group conversations
• Missing parts of conversations when several people are talking
• Avoiding noisy restaurants or social gatherings
• Finding one-on-one conversations much easier than group settings

How Your Brain Helps You Follow Speech

Hearing isn’t just about your ears. Your brain also helps make sense of what you’re hearing. It recognizes familiar voices, fills in missing words and helps you keep up with conversations.

Most of the time, this happens automatically. But in noisy places, your brain has more to sort through. Multiple conversations, background music and other sounds can make it harder to stay with the person who’s speaking.

That’s one reason hidden hearing loss can be so frustrating. You may still hear plenty of sounds, but following a conversation becomes more difficult when there’s a lot happening around you.

Comparing Standard Hearing Loss With Hidden Hearing Loss

Traditional hearing loss and hidden hearing loss can feel very different in everyday life. With traditional hearing loss, the challenge is often hearing sounds in the first place.

You might have trouble hearing a phone ring from another room, miss a quiet comment from across the table or find yourself turning up the television more often than everyone else.

Hidden hearing loss works differently. Sound isn’t the problem. You can hear that people are talking. The issue is making sense of what they’re saying when there’s anything else going on around you.

A crowded restaurant, a family gathering, a room with more than one conversation happening at once, those are the situations where it shows up. You hear plenty. You just can’t follow it the way you used to, and that is hard to explain to someone who hasn’t experienced it.

What Can Cause Hidden Hearing Loss?

Hidden hearing loss is often linked to repeated exposure to loud noise, though aging and certain health conditions may also play a role. In Colorado, that exposure can come from more places than people realize.

Between concerts, sporting events, skiing and other outdoor activities, many people spend time around sounds that put extra strain on their hearing.

Some groups may have a higher risk of hidden hearing loss, including:

• • People who work around loud machinery or equipment
  • Musicians and frequent concert-goers
  • People who regularly attend sporting events
  • Adults with a long history of noise exposure

Older adults

• Anyone who spends a lot of time in loud recreational environments

Tests That Look Beyond the Standard Hearing Exam

When hidden hearing loss is suspected, the conversation doesn’t end with a standard hearing test. Audiologists often look at both your test results and the situations where you’re having the most trouble hearing.

Speech-in-noise testing is one example. Instead of listening for tones in a quiet room, you listen to words and sentences with background noise playing. It catches things a standard audiogram misses.

Your audiologist may also ask detailed questions about your day-to-day experiences. Struggling in restaurants, missing parts of conversations at family gatherings or finding group discussions difficult can all provide important clues.

Looking at both your hearing test and your real-world listening challenges often provides a better understanding of what’s causing the problem.

What to Tell Your Audiologist at the Visit

If conversations have become harder to follow, don’t wait until the problem gets worse to bring it up. Hidden hearing loss often shows up in everyday situations long before it appears on a standard hearing test.

When you come in, it helps to be specific about what you’re experiencing. Try to think about:

• Where you notice the most difficulty
• Whether background noise makes conversations harder
• How often you ask people to repeat themselves
• When you first started noticing a change
• Whether certain situations are more challenging than others

How Hidden Hearing Loss Is Treated

Treatment depends on the situations where you’re having the most difficulty. For some people, hearing aids can help make conversations easier to follow, particularly in places where background noise tends to get in the way.

While hidden hearing loss doesn’t always show up as a significant loss on a traditional hearing test, hearing aids may still provide benefit by helping emphasize speech and reduce some of the competing noise around you.

Many current hearing aids include directional microphones that focus on sounds coming from in front of you rather than every sound in the room.

Some also use noise management features that help reduce the impact of background sounds, making it easier to stay engaged in conversations at restaurants, family gatherings and other busy environments.

Some people also benefit from remote microphones. These systems allow a speaker’s voice to be picked up by a small microphone and sent directly to your hearing aids, which can be especially helpful in restaurants, meetings and other noisy settings.

When the Test Says Normal but Something Still Feels Off

Hidden hearing loss doesn’t fit neatly into the way hearing problems are typically described, and that can make it frustrating to explain. If your hearing seems fine on paper but you’re struggling in noisy places, there may be more going on.

The Hearing and Tinnitus Center in Westminster, CO specializes in exactly these kinds of concerns. Give us a call at (720) 420-7780 to set up an evaluation and get a clearer answer about what’s actually going on.