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

[pugworthy]

One of my Phonak Audeo 90’s (RIC) died the other day after 5 years and I’m shopping for new. What’s your go to hearing aid currently if you’ve upgraded recently or have been thinking of doing so?

Moderate loss, have worn them for many years, enjoy listening to music and nature, but also need help in meetings and noisy environments.

Not worried about cost and wanting to get one more good deal out of work insurance before I retire.

[retrac]

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.

[icoder]

My mom has hearing aids, I only get all the technical info through her, so it's a bit blurry, but she complained about very unpleasant scratchy noises, for instance when my dad was watching videos on his iPad (for himself) elsewhere in the room. Settings were changed but now she has a harder time understanding us. We don't have to scream but if we don't speak 'clearly', she misses a lot, especially when we are with a larger group (say 10 people at a dinner). She says she has some friends that she understands very clearly, in contrast to others (admittedly, me and one of my sisters are not the best examples of how to speak crystal clear).

Perhaps this is just the limit of her hearing capacity. Or do you think she should not settle for this and push for something better?

[julianlam]

Thank you so much for commenting.

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.

[stevenjgarner]

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-...

[thfuran]

They only get a couple hours better life even with a belt pack to fit more battery?

[EionRobb]

Does that setup work ok outside in windy environments? A lot of the 'active' audio systems I've found really focus on the wind noise while hearing aids will try to filter that out

[madeofpalk]

This sounds essentially like a higher end/specialised version of what Apple Airpods do.

[tlar]

I'm not going to give a direct recommendation on the hearing aids themselves as my personal options have been pretty limited due to profound hearing loss. I can say, however, that hearing aids are not the only thing that helps - especially with meetings/noisy environments.

I [recently wrote an article][0] going over my journey, but the recent technology that significantly improved my life has been live captions in glasses. Specifically, the ones from [Captify][1]. Not a paid sponsor at all, just a very happy customer.

Between the glasses for IRL settings and bluetooth/live captions on meet/etc, I've felt much more empowered in my working life.

  [0]: https://upsun.com/blog/tech-accessibility-hard-of-hearing/
  [1]: https://captify.glass/

[mustntmumble]

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...

[dmcc7897]

You can change the mic during calls now on iOS.

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.

[KingMob]

I have the same problem, but I always assumed it was Apple's fault. I don't know why the HAs/Airpods have the final say.

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"

[Balinares]

I trialed hearing aids a little while ago and ended up not committing, because the sound quality was bad, wheezy and tinny, and gave me headaches. Particularly bad in noisy environments, which is where I'd most need the help. Also the app sucked, Bluetooth pairing broke all the time and the controls were just confusing.

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.

[seltzered_]

An elaboration on how complicated call handling can be with hearing aids (and how I wanted AirPods-like behavior): I assisted someone with purchasing hearing aids a year ago, and we first had a pair of Philips and returned them within a few months because they only worked with iPhone for supporting phone calls with the microphone on the hearing aids themselves, for Android it didnt work. Even the next generation Philips 9050 that supported Auracast didnt support this.

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.

[Barbing]

iOS 26 finally enabled custom mic selection!

Settings > Sound & Haptics > Input > change from "Automatic: ..." to "iPhone Microphone"

[pugworthy]

Yea, my Phonak + iPhone experience was not great. I stopped using any integration with them after a while and now just use AirPods for all my calls, music, etc. I have open domes and can pull off wearing both, but do take the HAs out now and then when I just want to focus and let the noise cancellation do its thing.

[ezfe]

This is the case for any Bluetooth microphone headset, it has nothing to do with the hearing aid “trying to mimic AirPods “it is because Apple refuses to give us fine-grained controls on our Bluetooth devices

[Semaphor]

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.

[dts-five]

I posted this standalone, but replying to you since you specifically asked about HAs in noisy environments.

The newest HAs have AI that helps in noisy environments. The ones I have are the Phonak Audéo Sphere Infinio I90s. I've worn HAs for 40 years. It's truly unbelievable in noisy environments. I know it's easy to think it's all marketing garbage, but some great demos on YT of the technology. I keep them in AI mode all the time when I have them on, and charging them for an hour at lunch is enough to get me the necessary runtime.

[adinisom]

Hearing in noise is both what most people want from hearing aids and what they are least equipped to provide.

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.

[retrac]

I'm completely lost in noise. The benefits for this kind of thing is part of why my audiologist pushed for hearing aids with directional microphones. And they do help. But it's not a fix. I'm still mostly lost in noise.

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.

[exceptione]

Have a look at librepods [1], which was lately on HN.

___

1. https://github.com/kavishdevar/librepods

[Sammi]

Bose used to make these noise cancelling earphones called the Hearphones that could focus on the speech of person in front of you and they were amazing:

https://support.bose.com/s/product/hearphones-conversationen...

I absolute loved them, but unfortunately lost them, and they are irreplaceable.

[zsoltkacsandi]

I have the same problem (took 35 years to find out), and hearing aids with directional microphones might work. I don’t say they will, but it is worth to try it.

[lfowles]

Thanks for bringing this up, I'm often lost in a setting with competing voices. I don't strictly need hearing aids but the few times I've had my earbuds in with ambient voice enhancements it's really improved my QoL. Gonna have to look into this more!

[BobaFloutist]

I know nothing about this, but if you have slightly above average hearing, maybe that's part of the problem? Have you tried weak earplugs (like loops or etymotic or flare or whatever)?

They sure seem to be marketing in your direction. No idea how well they work though.

[micromacrofoot]

Airpod Pros work well for me in adaptive mode for this, I've never compared to devices more dedicated for this thing, but it's enough for me. They seemingly reduce most of the surrounding noise while I can still hear the person talking closest to me.

[jlev1]

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.

[lambdafu]

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.

[double0jimb0]

I'm using Widex Allure. I only need to use one ear for now, and the low latency from the Widex was what won it, tried a couple Oticons that had a disorienting amount of lag. Also the Widex has really great high frequency transient filtering, much better than the Oticons in my experience. With a house full of screaming kids, this was also critical.

[pugworthy]

I've been seeing good things about Widex and it's got me curious to try.

[rolfus]

Audiologist and hearing aid user here. It's a great time to be looking for new hearing aids! Speech in noise capabilities have improved massively this generation, and I can personally attest to this. For me, the most important performance metric is speech perception in noisy / challenging listening situations. For you there might be other considerations, so keep that in mind.

With that said, my recommendation are the new Phonak Infinio Sphere devices with with their "Spheric speech in noise" feature. It's a complete game changer in terms of speech perception in loud noise. Activating this program in a noisy situation feels like turning off the background noise, leaving only (nearby) voices.

The caveat is that to achieve this they use a separate, power-hungry processor and compensate by increasing the battery size (making the whole hearing aid bigger than other, similar hearing aids). The upside to this is that if you're _not_ using the spherical program, you'll have really good battery life. I use mine for exactly 16 hours a day and if I'm careful I can make them last almost three full days. The charger is much better than the previous ones; they use magnets to keep the devices in place instead of relying on plastic friction.

The Oticon Intent and new Starkey AI aids are also great. You should always try more than one model before you make a decision.

Happy to answer any questions!

[dhosek]

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.

[pugworthy]

Yea I gave up on the phone integration with mine. Whenever I’d get a call or some audio thing was going to happen, my HA mics would go silent and second or so later the audio would come in. So answering a call i would often miss the callers initial words. Or driving instructions would be “…in 1000 feet” with the “turn left” or “turn right” part missing.

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.

[cheschire]

Losing audio in front of a certain house may be related to devices I’ve noticed my own neighbors beginning to use, which are those high pitched audio emitters that ward off voles etc. We don’t have that issue in our neighborhood and especially in front yards so I suspect it’s to keep dogs from pausing in their yard.

In any case it’s a periodic high pitched burst. I wonder if that was what caused your issue with the phonaks. Seems like it would be a rather common issue in suburbs that should be considered in hearing aid design.

[nickf]

Weird - in an incredibly similar situation and my RICs are overdue an upgrade (Oticon Opn 3). I've been keeping an eye on developments for some time, and I've been looking for something ideally CIC, though I do like the RIC Opns. However, nothing has had the feature set I wanted - bluetooth, auracast, Apple MFI and being CIC.

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...

[dmcc7897]

I’m trialling the Oticon Zeal right now.

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.

[KingMob]

> My only dislike is the new fad, particularly of Oticon, of stopping disposable batteries and only going rechargeable.

My Phonaks are like that, and I will say, rechargeable-only has been a boon for reliability, at least. They're more water-resistant, and the battery well never gets dirty, which required some repairs on previous models.

Though now that it's been 5 years, they no longer hold a charge all day, which is annoying.

[anurag]

Nuance has a unique offering: prescription hearing glasses built for noisy environments: https://www.nuanceaudio.com/en-us/c/hearing-glasses

[wojtczyk]

A relative got these and really likes them.

[kayson]

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.

[bensmoif]

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

[jonathanlb]

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.

[dts-five]

The newest HAs have AI that helps in noisy environments. The ones I have are the Phonak Audéo Sphere Infinio I90s. I've worn HAs for 40 years. It's truly unbelievable in noisy environments. I know it's easy to think it's all marketing garbage, but some great demos on YT of the technology. I keep them in AI mode all the time when I have them on, and charging them for an hour at lunch is enough to get me the necessary runtime.

[furyofantares]

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.

[Lerc]

I have a related question.

What is the best thing for people with no hearing loss but need help in noisy environments?

My partner and I both have difficulty listening to conversations in crowds.

Logic tells me that there must be some noise cancelling devices with directional mics that let you hear just what is in front of you, but querying staff in stores gets me the same bemused look as when I asked about Arm laptops before Apple did one.

[GianFabien]

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.

[mixmastamyk]

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

[Froedlich]

> Just speak clearly. ---

I finally got (very expensive) hearing aids, and made several trips back to the audiologist to have them tuned. Then I wound up not wearing them, because most people think they're speaking English, but it's some kind of mumbly slobbergobble with incorrect, missing, or mispronounced words. The aids just turned "mufuh dogga baytaaa" into "MUFUH DOGGA BAYTAAA."

Yeah, I heard that just fine without electronic assistance.

Paying attention to how often people with "normal" hearing said "what?" to each other was a revelation. Yes, I have a problem. But it's a small problem; the big problem is that a large number of people may as well be trying to communicate by interpretive farting and tap-dancing, because "the words what are coming out of their mouth" are mostly gibberish.