What Are The 7 Major Signs of Hearing Loss?
Hearing loss is typically a slow process, with deterioration occurring over years or even decades. This means that, unlike our eyesight, we simply get used to hearing less of the world around us. Given the continued stigma surrounding hearing loss and hearing aids, it’s not surprising that many people feel that they are coping when in fact they are often struggling. Having an awareness of the major signs of hearing loss can then be critical in determining when you, or your loved one, need to act.
The World Health Organisation reports that approximately one-third of people over 65 years are affected by disabling hearing loss. Unfortunately, people typically wait between six to ten years before seeing an audiologist, which puts their health at great risk. The detrimental impact untreated hearing loss has on your emotional wellbeing and quality of life, are often underestimated.
Hearing loss is sometimes referred to as an “invisible disability”, but the signs are there if you look for them. An audiologist can support you and your family through your hearing journey. It all starts with a simple hearing test!
Types of Hearing Loss
Audiologists describe two main types of hearing loss; conductive and sensorineural hearing loss. As a specialist in hearing healthcare, your audiologist has the equipment to test hearing and middle ear function to determine the type of loss that causes your symptoms.
Conductive Hearing Loss
In conductive hearing loss, there’s a problem with the sound conduction as it enters the ear to reach the cochlear. The problem could be in the ear canal, such as wax build-up or an ear infection or it could be in the middle ear.
Middle ear problems can occur when the Eustachian tube at the back of the throat gets blocked and therefore affects the pressure in the middle ear. This happens to everyone when we have a cold and our hearing should recover in a few weeks. This problem can continue causing a build-up of infected fluid in the middle ear. Conductive hearing losses can usually be treated with medication or surgery.
Sensorineural Hearing Loss
This type of hearing loss is caused by a defect in the cochlear, hearing nerve or brain. Age and noise-induced hearing loss are examples of sensorineural loss affecting the cochlear. A sensorineural hearing loss can also be due to a benign growth or stroke affecting the hearing nerve or brain pathways.
This is why it is important to have a comprehensive hearing assessment with an accredited clinical audiologist. Sensorineural hearing losses usually deteriorate over time so audiologists monitor hearing thresholds for changes.
Hearing Loss Risk Factors
There are many links between common health conditions and hearing loss. Those at a high risk of developing a hearing loss should have their hearing checked regularly.
Medical conditions that affect the hearing include:
- Diabetes Mellitus
- Heart Disease
- High Blood Pressure (Hypertension)
- Stroke and Dementia
Noise exposure, smoking, being overweight and some essential medications also increase the risk of hearing loss. Discuss this with your GP or trusted audiologist if you think you may be in a high-risk group.
The Warning Signs of Progressing Hearing Loss
As we age our hearing slowly deteriorates. We lose the ability to hear the high notes first, this includes sounds like “ss” and “t”. This high-tone loss means that speech, although loud enough, is no longer clear. Over time the mid and low-pitched tones are also affected. Age-related hearing loss is called Presbycusis. This type of hearing loss can start as early as age 40.
- Over half of people at age 75 years have Presbycusis
Noise exposure also causes a high-tone hearing loss and tinnitus, noises in the ears. As these changes happen gradually the hearing loss can go unnoticed for many years. Some hearing disorders do happen suddenly, and people tend to seek help sooner from their doctor or audiologist.
The 7 Signs Of Hearing Loss You Should Watch Out For
As you develop hearing loss you may start to notice the following.
1. Having to ask people to repeat themselves
It happens to all of us. In the middle of a conversation, you find your mind has wandered and you’ve missed a critical piece of information. You’ve caught some of what has been said and scramble to fill in the gaps. For many, this is simply a concentration issue, but for some individuals, it can be the one of the first signs of hearing loss.
Provided that the speaker or communication partner is facing you and has your attention, requesting a repeat can signal hearing difficulty because it is a coping strategy that allows your brain more time to process what has been said. To reiterate, asking someone to repeat themselves is quite normal if the person has an accent or is not facing you, but to request multiple repeats from a familiar conversation partner in a quiet environment can be a warning sign of hearing loss.
2. Speech often sounds unclear
The shape of the cochlea, or “hearing organ”, is tonotopic. In the physiology of the ear, tonotopy (from the Greek ‘tono’ meaning frequency and topos meaning place) refers to the spatial arrangement of where different frequency sounds are processed in the brain. This means that the hair cells in the cochlea are responsible for translating a specific pitch or frequency.
As we age and are exposed to occupational and recreational noise, our high-frequency hearing deteriorates before our low-frequency hearing. High-frequency speech sounds, or phonemes, relay information about clarity. So, if an individual has a high-frequency hearing loss they may report that it sounds as if people are mumbling when this could just be highlighting their reduced hearing acuity.
3. Having difficulty hearing in noise
Unsurprisingly, background noise is regularly listed as the most frustrating listening environment in which people with hearing loss can find themselves. As the level of ambient noise around us increases, it masks low-frequency hearing thresholds. This means that a patient with presbycusis (or age-related hearing loss), where hearing is best in the low frequencies, will struggle more than those with “normal” hearing.
The lighting and acoustics in these environments can also contribute to difficulty hearing. But bear in mind that hearing easily in noise doesn’t just depend on an individual’s hearing thresholds as it also depends on their auditory processing ability.
Auditory processing is what the brain does with the auditory signal it receives from the ears. Auditory processing ability is not regularly assessed in adults but it can help to determine what benefit the individual may get from amplification, including what technology level they may require if their hearing loss is aidable.
4. Avoiding social interactions
Another major sign of hearing loss can be an individual’s withdrawal from social situations in which they were previously actively attended. One explanation for this withdrawal might be that those with hearing loss need to exert more energy to concentrate and follow a conversation, as compared with their normally hearing peers.
If hearing loss is not yet diagnosed, individuals might feel embarrassed or anxious about asking people to repeat themselves. Reduction in social interaction might begin with avoidance of large parties or gatherings and then, over time, cancelling on smaller group situations. Hearing aids, if appropriate, may help to reduce some of the anxiety around engaging in group situations.
If you or a loved one have recognised a recent aversion to attending social gatherings this might be a trigger to seek advice from your GP or a hearing assessment from an audiologist. Avoiding social situations may also lead to social isolation, which can have a serious impact on an individual’s well-being and potentially increase the risk of dementia. While research is ongoing in this area, researchers have discovered a link between hearing loss and dementia, with social isolation a key component.
5. Increasing the volume when watching television
Another tell-tale sign of hearing loss is a request for more volume when watching television with your spouse or family, or for others to complain that the volume is intolerably loud for them. As sound travels through the air from your TV speakers to your ears the signal degrades. This degradation of signal, coupled with hearing loss, indicates a need for more volume.
Additionally, many people report that even with the increased volume they still find it difficult to follow speech on TV, especially if the program they are watching has background music or if the speaker has an accent. This almost always indicates that the individual has a hearing loss in the higher frequencies as it is high-frequency information that is needed for speech to sound sharp and clear.
6. Increasingly feeling tired
Following conversations can be an exhausting task for many people but add hearing loss into the equation and it becomes significantly harder. Most hearing aid users will report that their hearing is best in the morning and that it reduces as the day wears on, reflecting cognitive fatigue.
Listening effort, or cognitive fatigue, is best described as the allocation of cognitive resources toward auditory tasks, such as detecting, decoding, processing, and responding to speech. This means that our brain plays an important role in our ability to hear, not just in our ears. When our hearing deteriorates our auditory system loses the ability to translate certain frequencies, causing the brain to work harder to process incoming information. The extra effort we must exert then causes us to feel tired.
7. Speaking louder than necessary
Loud speech can be a predictor of hearing loss. While this is much more common in children, it stems from an individual’s ability to monitor their own voice as their hearing changes. In children hearing changes are usually temporary, as a result of fluid or infection in the middle ear cavity, so the child talks louder in order to overcome the hearing loss and to hear themselves speaking.
The same can be said of adults, except that hearing changes in adults tend to be permanent. After an adult is fitted with hearing aids one of the first things that they usually comment on is the volume and quality of their own voice. This is because our hearing tends to deteriorate slowly, such that we barely perceive any change to the volume and sound quality of our own voice until this volume is returned artificially, and instantly, via hearing aids.
Do You Suspect A Hearing Loss?
If you are concerned about your hearing or the hearing of a loved one, arrange a comprehensive hearing assessment. An accredited audiologist will be able to determine the extent of any hearing loss and the underlying cause. The audiologist will also tell you if medical intervention is needed and be able to advise regarding suitable hearing aids.
Tell your audiologist if you have any noises in your ears or balance problems, they may be able to help with these too. You can also discuss your communication difficulties with your audiologist and they can help develop strategies to better cope in difficult situations.
When It’s Time To See Your Audiologist
Everyone’s hearing deteriorates as they age, although some conductive hearing losses can be alleviated with treatment. Sudden hearing loss or deafness on one side should always be investigated. It is always worth consulting an audiologist for individual advice regarding your situation. Reducing your exposure to noise and management of other health risks can prevent further damage.
Hearing aid technology has greatly improved in recent years and your audiologist can explain how they will help you based on your lifestyle and hearing loss. Attune audiologists can set up trial hearing aids for you to test at home and in social situations. Addressing hearing needs sooner rather than waiting until the hearing loss becomes severe, produces better results.
Hearing loss should be taken seriously and not accepted as “just part of getting old”. Discuss any hearing difficulties with friends and family and ask how it affects them. Seek advice from your GP or an accredited audiologist. Attune audiologists are independent hearing services providers who can advise on a range of hearing solutions that won’t break the bank. To learn more or book an appointment, give us a call at 1300 736 702 or book online!