Can earbuds work like over-the-counter hearing aids?

The Washington Post helpdesk every Friday answers readers’ questions about the technology in their lives. This week we heard from an 82-year-old reader in Atlanta who wondered if people who use hearing aids could also wear earplugs, and if the tiny in-ear headphones could ever completely replace hearing aids.

Now’s a good time for this question — the Food and Drug Administration (FDA) decided this month to go green on sales of over-the-counter hearing aids, the first time Americans with hearing loss can access the devices without a prescription. This also opens the door for technology companies to adapt their earplugs to FDA requirements and market them as hearing aids. Sony, for example, said it has plans to make over-the-counter hearing aids. Audio company Jabra already makes earplugs with what it calls ‘medical-grade’ hearing enhancement.

For people who already wear hearing aids, most modern devices are compatible with Bluetooth, says Lindsay Creed, associate director of audiology practices at the American Speech-Language-Hearing Association. That means you can connect them to your audio source without wires. Check with your audiologist or the manufacturer to find out if your hearing aids are Bluetooth compatible and how to “pair” them with an audio source such as a mobile phone, computer or MP3 player.

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If your hearing aid does not have Bluetooth, the manufacturer may sell an adapter that acts as an intermediary between your phone and hearing aid. If not, you can always use behind-the-ear, over-the-ear or in-the-ear headphones, audiologists told me — just make sure you keep the volume around 50 percent. to prevent further damage.

Whether a good pair of earplugs can completely replace a hearing aid depends on it, says Payal Anand, director of audiology at the University of California at San Francisco.

“Earbuds may provide some amplification, but they will be limited in terms of how much amplification they provide and how customizable they can be,” she said.

So-called hearables, or hearing-enhancing earplugs, can work great for people with mild hearing loss or problems in noisy environments, Anand said. Apple, Beats, Bose and Panasonic are the brands her patients have had the most luck with for gain or noise canceling wireless earbuds, she said.

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How to adjust your earbuds for better hearing

If you have later-generation Apple or Beats headphones, Apple devices allow you to adjust the sound level with an audiogram or hearing test. The best results come from a test performed by an audiologist, but in a pinch, an audiogram app can estimate your levels of hearing loss. I used the Mimi Hearing Test app to measure what high and low sounds I could hear at different volumes. Then I shared my results with the Apple Health app. Finally, I went to Settings -> Accessibility -> Audio/Visual -> Headphone Accommodations. I turned the green slider to the “on” position, then tapped “Custom Audio Setting” to tell the phone to use my unique audiogram to set the gain, transparency, tone, ambient noise cancellation, and call boost levels on my AirPods.

Your custom AirPod settings should remain the same even if you use the earbuds with an Android device.

To adjust the sound settings on an Android phone, go to Settings -> Sounds and vibrations -> Advanced sound settings -> Sound quality and effects -> Adjust sound. Select your age and “watch” the sound to see if the adjustment is helpful. Go to Settings -> Accessibility -> Hearing Enhancements to enable “hearing aid support” for better sound quality, adjust the balance between your left and right ears when using headphones, or switch to mono sound (one ear only).

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Remember, you can always see an audiologist for help dialing in your earplugs or over-the-counter hearing aids.

While earplugs with advanced features such as fall detection and AI-powered sound customization may soon be approved as over-the-counter hearing aids, they will likely still have limitations in terms of battery life and adjustability compared to standard hearing aids, according to Anand. In short, they are a cost-effective resource for those with mild to moderate hearing loss or who want a specialized, extra pair for exercise or other specific use.

For example, Creed once had a 90-year-old patient bring in an old pair of hearing aids for some fine-tuning. She had written a “bucket list” that included skydiving, and she didn’t want her latest hearing aid to fall out at 10,000 feet.

“She went skydiving three or four times with those old hearing aids,” Creed says.

Earplugs with beautiful hearing enhancement software are an exciting step towards improving the affordability and accessibility of hearing aids. (Only one in five people with hearing loss get the treatment they need, Creed noted, and some studies have linked hearing loss to dementia.) But if you have moderate to severe hearing loss, don’t throw out those traditional aids. just.

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