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Researchers say Apple Airpods and other wireless earbuds may be able to help people with mild to moderate hearing loss. Sol Stock/Getty Images
  • Although millions of people could benefit from hearing aids, many choose not to wear them because of their cost or the social stigma associated with hearing loss.
  • As a result, smartphone-paired earphones have gained popularity as alternatives for enhancing ambient sound clarity.
  • However, they are not regulated by the Food and Drug Administration as medical devices, and it’s unclear if they are as effective as hearing aids for people with hearing impairments.
  • Recently, new research from Taiwan has found that smartphone-bundled earphones have the potential as a hearing assistive device for people with mild to moderate hearing loss.
  • This discovery may lead to less expensive and more feasible options for people with hearing challenges.

Statistics suggest that approximately 28 million people in the United States could benefit from hearing aids.

Yet, about 16% of adults aged 20 to 69 and fewer than 30% of adults aged 70 and older who could benefit from hearing aids have used them.

Although prescription hearing aids are effective, they can be expensive and require visits to an audiologist.

Recently, the FDA established a new category for over-the-counter (OTC) hearing aids, enabling people to purchase these products directly from retailers. According to a press release, this action is expected to help lower hearing aid costs.

Despite this, the social stigma associated with hearing loss may still prevent some people from wearing hearing aids.

Personal sound amplification products (PSAPs) can be less stigmatizing and available at a lower price than prescription or OTC hearing aids. As a result, they are becoming increasingly popular as an alternative for improving sound clarity.

But research is limited about whether PSAPs are as effective as hearing aids for people with hearing loss.

Now, a new study published in the journal iScience suggests that PSAPs, specifically smartphone-bundled Apple AirPods Pro, may work just as well as traditional hearing aids to improve speech intelligibility among people with mild to moderate hearing loss.

In their study, scientists recruited 21 people with mild to moderate sensorineural hearing loss (SNHL) based on pure tone audiometry results.

People with cognitive impairment or asymmetric, conductive, or mixed-type hearing loss were excluded from the study.

The research team conducted electroacoustic analysis on four devices. The results were compared with the American National Standards Institute (ANSI) standards of hearing aids and PSAPs.

The devices used include:

Then, the participants were asked to verbally repeat randomly selected sentences from a Mandarin version of the Hearing in Noise Test (MHINT). The scientists read the sentences while the participants were in a quiet environment as well as environments with background noise coming from the front and the left.

Each participant was tested in these five scenarios:

  • Not wearing any hearing aids
  • Wearing a premium hearing aid
  • Wearing a basic hearing aid
  • Using AirPods Pro bundled with a smartphone
  • Using AirPods 2 bundled with a smartphone

After examining the data, the scientists reported that AirPods Pro performed similarly to basic hearing aids in a quiet environment. However, its performance was slightly inferior to premium hearing aids.

The AirPods 2 did not perform as well as AirPods Pro or basic hearing aids. However, the participants still heard more clearly while wearing an AirPods 2 than without any hearing assistive devices.

Moreover, in an environment with background noise coming from the side, AirPods Pro performed comparably to premium hearing aids.

However, the AirPods Pro and AirPods 2 failed to improve hearing ability when background noise was introduced from the front of the participants.

Dr. Yen-Fu Cheng, a physician-scientist at Taipei Veterans General Hospital and associate professor at the National Yang Ming Chiao Tung University in Taiwan as well as a corresponding study author, told Healthline:

“We found that AirPods Pro (with the smartphone) meets most PSAP electroacoustic standards (four of five). The speech recognition of AirPods Pro is similar to conventional hearing aids in noise. We, therefore, concluded that AirPods Pro might have the potential to be a hearing assistive device for adults with mild to moderate hearing loss.”

“However, more research is needed to investigate the safety and feasibility of using such a concept in other wireless and smartphone product combinations,” he added.

Despite these promising results, some limitations to the study include:

  • It used a small number of participants.
  • It did not include people with severe SNHL or other hearing impairments.
  • The experiments were conducted in a laboratory environment, so the results might not carry over to real-world conditions.
  • Only Apple PSAPs were tested, so it is unknown whether other manufacturers’ devices would produce the same results.

According to the FDA, PSAPs are not regulated as medical devices for people with hearing impairments.

Instead, they are considered sound amplification devices for people without hearing loss.

In contrast, hearing aids are intended to correct impaired hearing.

Earbuds made by Apple and companies like Samsung — a brand not used in the study — are PSAPs you might be most familiar with as they are often bundled with smartphones. They allow you to listen to music or other audio wirelessly via Bluetooth technology.

Other available PSAPs include:

The price of PSAPs varies depending on the type you choose.

For example, price comparisons indicate AirPods are around $129 to $249.

The other PSAPs listed above run from $180 to $1,000.

In contrast, the average price of OTC hearing aids is $1,600, and prescription hearing aids average around $4,600. What’s more, insurance companies may not cover all the costs.

According to Cheng, the benefits of PSAPs include:

  • They may offer people with mild to moderate hearing loss a new experience for sound amplification for their daily life.
  • People can use PSAPs in noisy or quiet environments.
  • They may be more affordable than hearing aids.

Kathleen Wallace, Au.D., a licensed audiologist and head of provider education at Tuned, told Healthline:

“Devices like AirPods have the major advantage of being not only ubiquitous in our society but actually desired, which helps these devices address the big issue of stigma plaguing the hearing aid market.”

Wallace explained that some sound-enhancing features built into Airpods are effective and “can help you compensate for your hearing changes and also help you hear better in background noise, the number [one] complaint of people with hearing loss.”

According to Wallace, some limitations of PSAPs include:

  • They are not suitable for all levels of hearing loss.
  • They aren’t conducive for all-day use.
  • They have limited battery life.
  • PSAPs may produce the occlusion effect or the feeling that your ears are plugged. This may make internal sounds like your own voice bothersome.
  • Because they appear to be headphones and not hearing devices, they might not be appropriate for use in certain settings.

According to Cheng, the research team used Apple AirPods for this study because:

  • The percentage of smartphone ownership has been increasing over time and Apple iPhone has a substantial market share in Taiwan and globally.
  • A single manufacturer produces AirPods and their bundled iPhone and iOS system, so it may be more manageable to implement adequate quality control and calibration compared to other systems.
  • The “Live Listen” specification in AirPods bundled with Apple iPhone is unique and there is no need to download an extra application.

“However, other smartphone brands with Bluetooth earphones may also support the ‘Live Listen’ function after downloading a related application,” Cheng explained.

In addition to AirPods, studies suggest that other PSAPs may show promise as hearing assistive devices. For example:

  • A 2019 study comparing the Able Planet in-ear amplifier PSAP to hearing aids found that the PSAP improved speech intelligibility in a quiet environment more than the hearing aid. However, there was no improvement in a noisy environment.
  • A 2021 study supported by Samsung Electronics Company comparing hearing aids, PSAPs, and Samsung Galaxy Buds Pro found that both PSAPs and the Galaxy Buds Pro may benefit people with mild and moderate hearing loss.

Healthline asked Cheng if his team plans to investigate how PSAPs might help people with more severe hearing loss.

“Yes, that’s our plan,” he said.

Cheng explained:

“The latest version of the iOS system supports the input of a user’s audiogram. It can customize input sounds at different frequencies according to the personal audiogram, similar to what conventional hearing aids require. This new function may also help patients to compensate for their hearing loss by ‘conversation boost’ and ‘ambient noise reduction’ functions to increase speech perception.”

“We are curious if these advanced features would help patients with more severe or various types of hearing loss,” he added.