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Hidden hearing loss is a term used to describe hearing difficulties that don’t show up on a standard hearing test. You may hear just fine in a quiet room but struggle to understand speech in noisy environments—like at a restaurant or during a conversation in a crowded space. If this sounds familiar, you’re not alone! Read on to learn more about the causes, treatments, and signs of hidden hearing loss.

Possible Causes of Hidden Hearing Loss

Listed below are a few potential causes of hidden hearing loss

Damage to auditory nerve or synapses

Affects how sound signals are transmitted to the brain.

Prolonged noise exposure

Loud environments can lead to hearing loss without it being easily detectable. 

Aging

Natural decline in auditory processing abilities over time.

Ototoxic drugs

Ototoxicity refers to inner ear damage caused by certain medications, which can lead to hearing loss, balance issues, and tinnitus.

Medical conditions

Conditions like diabetes or autoimmune disorders may impact auditory nerve function.

Difficult to detect

Standard hearing tests may not identify hidden hearing loss, which means you may need to look towards scheduling specialized assessments.

Signs of Hidden Hearing Loss

Recognizing hidden hearing loss can be tricky since traditional tests might not reveal it. Here are a few common hidden hearing loss symptoms to watch for:

  • Difficulty Understanding Speech. Struggling to understand people, especially in noisy places like restaurants or cafes.
  • Following Conversations. Difficulty following or keeping up in conversations with multiple speakers.
  • Distraction in Noise. Feeling easily distracted or unable to focus in noisy settings.
  • Misinterpretation. Frequently misinterpreting or mishearing what people say.

Learn more about hearing loss signs and symptoms

Tinnitus, Hidden Hearing Loss: Is There a Connection?

Yes, there is a connection between tinnitus and hidden hearing loss. A study from Massachusetts Eye and Ear found that people with one condition showed signs of the other.

Why might that be? When the brain struggles to receive clear auditory signals due to hidden hearing loss, it may create tinnitus symptoms as a response.

How to Test for a Hidden Hearing Loss Diagnosis

Testing for a hidden hearing loss diagnosis can be tricky since this diagnosis is defined by hearing loss that doesn’t appear on a standard hearing test. There’s no officially titled ‘hidden hearing loss test’ per se, but your audiologist may use the following ways to test your hearing

Audiogram

Audiogram tests how well you can hear different frequencies (pitches) and intensities (loudness of sound). Hidden hearing loss is frequently high frequency hearing loss not measured on a standard audiogram. Your hearing health care provider may perform an extended high frequency audiogram to more accurately diagnose your hearing loss.

Auditory Brainstem Response Test (ABR)

Auditory Brainstem Response Test (ABR)'s primary function is to assess the VIII/acoustic cranial nerve as well as the auditory system in the brainstem and auditory cortex.

Speech in Noise Test

Measures an individual’s ability to understand spoken words or sentences when background noise is present. Speech in noise testing is a critical factor in assessing hidden hearing loss.  

Hidden Hearing Loss Treatment

Treatment varies greatly depending on the severity of the hearing loss and the unique needs of each individual. Options can include:

  • Low-gain hearing aids with a “speech in noise” setting if no hearing loss is found.
  • Assistive listening devices, like remote microphones, can improve signal to noise ratio and assist with hearing in noise.
  • Environmental changes that can potentially improve acoustics.

It’s also helpful to avoid or minimize exposure to loud environments to mitigate future issues. 

How Can I Prevent Hidden Hearing Loss?

The best prevention method is to protect your ears from loud sounds. Here are some simple steps you can take:

  • Wear ear protection (earplugs or earmuffs) at concerts, sporting events, fireworks displays, or car races.
  • Keep volume levels in check on your phone, music player, or other devices.
  • Move away from loud noise whenever possible—every few feet can make a difference!
  • Ask your doctor before taking ototoxic drugs.
  • Get your hearing checked regularly.

To help understand when sounds are “too loud” read about decibels and noise level charts. Take care of your hearing now can help you maintain better hearing for years to come. 

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Think You Have Hearing Loss? Don’t Wait

Knowing if you have hearing loss can be tricky, especially if it’s hidden hearing loss. But don’t wait on getting a professional diagnosis. Amplifon’s program is designed to support your hearing health needs, including a nationwide network of in-network NCQA-accredited audiologists.

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