by Neil Bauman, Ph.D.
A lady asked,
Why must we wear our hearing aids all the time? I mean, lots of times they are not needed—when cleaning house, reading a book, at the gym, etc.
This is an excellent question. There are two schools of thought regarding the “right” answer. One school of thought—promoted by doctors, audiologists and people who have normal hearing—is that they have listen to everything all the time. That’s the way God made us. Therefore, why should hard of hearing people be any different?
Thus, they tell us (hard of hearing people) to wear our hearing aids all our waking moments. In addition, they drag out the argument—”use it or lose it”—meaning that if we don’t actively use the hearing we have, our auditory systems will atrophy and thus we will lose the little hearing we now have.
The second school of thought comes from those of us who have to live with our hearing losses every moment of every day. We know that hearing aids do not give us normal hearing. Furthermore, we know that neither our ears/brains nor our hearing aids can filter out background sounds so that we can hear in noise like people with normal hearing can.
Compounding this problem, is the fact that we also typically have to put up with conditions such as recruitment, hyperacusis, dead spots in our cochleae and “fuzzy” hearing that people with normal hearing don’t have. All this can cause auditory overload resulting in extreme fatigue, headaches and other problems. Therefore, we feel we should be able to choose the times when we wear our hearing aids and the times when we choose “deafness” in those situations where the toll on our bodies is greater than the benefit we derive from the additional limited hearing we gain.
Let’s look at both of these arguments, because both have some merit.
First, let’s look at the argument that you should wear your hearing aids all the time you are awake. Yes, God did make our ears to hear, so when we lose hearing, it seems right that we should wear hearing aids to restore hearing to as near as normal as possible.
This argument would be valid if hearing aids gave us normal or near normal hearing. If you have a mild hearing loss, this may be close to possible. However, for those of us with severe hearing losses, what we hear via our hearing aids is a far cry from what people with normal hearing hear.
Because of the various factors mentioned above, we need relief from the barrage of sounds that so often assaults our ears. Simply put, we need “down time” in order to recharge. If that means taking off our hearing aids and living in a world of silence for a time, so be it.
For those of us that choose to be proactive, we may choose in advance not to wear our hearing aids when we know we will be in an environment that will cause undue wear and tear—not only on our bodies—but also on our emotional health. That way we can work longer and not require so much “down time”.
One of my “rules of thumb” is that if wearing hearing aids significantly helps you in a given situation, then wear them. If wearing them doesn’t significantly help you hear better/understand more, then don’t wear them. And if you understand worse with them on, then definitely take them off. There is no point in wearing hearing aids in situations where noise assaults your ears and you get no benefit from wearing them. This makes the decision-making process pretty easy.
I wish more hearing people could experience what we hear (and the way we hear it), so they would understand why wearing hearing aids all the time is not necessarily good for us.
The argument that we must “use it or lose it” is basically a scare tactic in my opinion. Yes, to some (small) degree it is true, but in reality, it is largely a bogus argument. You see, we all hear some sounds (after all, we are hard of hearing, not deaf)—and those sounds, as small as they are, are enough to keep our auditory circuits running quite well. Besides, we do wear our hearing aids (or assistive listening devices) some or much of the time and again this keeps our auditory circuits in good working condition. We do not have to be exposed to amplified sounds from dawn to dusk in order to keep our auditory systems in good shape.
When I was a boy, I was fitted with a body-style hearing aid. I was given two ear molds and told that I had to switch ears or I’d lose the hearing in the unamplified ear.
What was the reality? For some reason, maybe because I was left-handed and thus could more easily put the ear mold in my left ear, I chose to only wear a hearing aid in my left ear for the next 20 or more years. (Now I wear hearing aids in both ears.)
If the “use it or lose it” rule was correct, then you would expect that now I hear better in my left ear than in my right ear, right? Guess what? Instead of losing more hearing, my right ear is now my better ear! In my case, I lost more hearing in my left ear from wearing a hearing aid and using amplified devices in that ear!
Nevertheless, there is a valid reason for wearing hearing aids as much as possible. You see, it takes our brains several weeks, and up to three months, to learn how to process the new sounds we now hear when wearing our hearing aids. Our brains actually grow new neuronal connections in order to process the sounds coming through our hearing aids. Therefore, the more we wear our hearing aids, the better our brains adapt to the sounds we hear.
In the process, we learn how to tolerate louder sounds so that they do not bother us the same as they’d did when we first began wearing hearing aids. This is a strong argument in favor of wearing hearing aids more rather than less.
I notice this phenomenon each time I put my hearing aids on. For the first few minutes, everything sounds too loud, but soon my brain adapts and things become more normal. Therefore, unless you’re in the noisy environment that’s causing undue wear and tear on your system, side with your audiologist and wear your hearing aids as much as possible.
At the same time, remember that you are in control. When wearing your hearing aids begins to wear you out, there is nothing wrong with taking your hearing aids off and giving your ears a break, thus giving you a chance to unwind and recover. By the same token, if you want to relax and read a book, there’s nothing wrong with taking your hearing aids out and letting your ears relax at the same time. This way you can have the best of both worlds.
Thank you for your post. You expressed exactly how I feel as I was unable to express it to those around me. I’ve just started wearing hearing aids after a sudden loss of hearing 15 years ago at the age of 36. I shouldn’t have waited so long but hindsight is 20/20. Sometimes all these sounds are just too much for me to deal with. It’s exhausting. I can take a “hearing aid sabbath” and not feel guilty.
This response answered my question100% Thanks very much, Lynn Bank
My “hearing aid specialist” was very upset to learn that I was wearing personal amplification devices to bed. I live in an environment where one cannot predict WHEN a sound I need to hear will occur. Coyotes, mountain lions and even bears have ambled by.
Delivery trucks honk their horns when they arrive. These are not scheduled.
As to taking time off, the hearing aids I have can be controlled by an app on a smart phone. I can shut them off in environments where the sound is overwhelming,.
Hi Jon:
It is a personal preference if you want to wear your hearing aids all the time–day and night, but personally, I still think it is better to take them off at night and let your ear canals “air out” and give your ears a rest.
Cordially,
Neil
Great advice, thanks. At a recent wedding reception the music was so loud that even youngsters were texting guests across the 12-guest round tables. I just had to remove my hearing aids because reducing the volume achieved nothing.
In your article, you stated that we may choose in advance not to wear our hearing aids when we know we will be in an environment that will cause undue wear and tear—not only on our bodies—but also on our emotional health. My mom just celebrated her 78th birthday and at her party, she started complaining that she couldn’t hear what we were saying. I wonder if the hearing aids they use for the elderly are the same hearing aids that they use for children.
Hi Derek:
I’m not aware that they use particular hearing aids for children or elderly people. You choose the hearing aid that will work the best for you–no matter what you age.
The question is why did your mom not hear at the party? Was the background noise level too loud? Was the hearing aid set to automatically turn down the racket and thus turned down the level of the people talking? Or what?
Cordially,
Neil
I have hearing aides and have found in many circumstances the noise is just to loud. Thank you for giving me this awesome information. I would like to know how my hearing aide specialist knows that I not wearing my hearing aides. He has me on his computer and can tell exactly how much time I spend wearing them every day. Thank you in advance
Hi Betty:
Some hearing aids (such as yours) have a built in “logger” that records a lot about your hearing aid use–such as how long you wear them each day, what programs you use and the settings you use. When you come in, he hooks your hearing aids to his computer and downloads the logger file with all this information in it.
Cordially,
Neil
Neil, can i fool the
logger by leaving them on and out of my ear?
Hi Len:
I’m not sure, but I think it’s possible. But why do you want to fool the logger? if you don’t want to wear your hearing needs all the time, as far as I’m concerned that’s fine. I don’t see anything wrong with your audiologist knowing that you only where your hearing aids for certain number of hours a day. That’s your choice. Your audiologist may give you flack for it because they believe you need to wear your hearing needs all the time. I wear my hearing aids when I want to and the rest of the time I leave them in my pocket. That’s my choice.
Cordially,
Neil
hello Neil
Very informative thank u.
My father was using a hearing aid in which due to amplification of sounds he was not able to hear properly. We visited another audiologist who suggested him to wear the hearing aid only in his right ear. Audiometry suggests he has severe hearing loss in his left ear. So is it ok to use only in one ear??
Hi Raghunath:
Just because your father has severe hearing loss in his left ear doesn’t mean that a hearing aid won’t work for him in that ear. For example, I have severe hearing loss in both ears and I wear hearing aids and they help me.
It’s not the degree of hearing loss you have, but the degree of discrimination you have. If he wears a hearing aid in his left ear and all he hears is louder garbled sound, then there’s no real point in wearing a hearing aid in that ear. I suspect this is your dad’s situation.
To answer your question, yes, it’s okay to only wear one hearing aid. The way I look at it is if wearing a hearing aid in his left ear helps him understand speech better when he is also wearing a hearing aid in his better ear, then go for it. However, if wearing a hearing aid in his left ear makes it harder for him to understand speech in his right ear then no it’s not a good idea to wear hearing aid in his left ear. in other words, do what works the best for him.
Cordially,
Neil
thank you that was really interesting. I have had aids for 7 years now, last year I had some new hi-tech ones fitted. Have been several times for adjustments, but find it all so frustrating at times. My question is, if I tried to get on without my hearing aids for a while, what can I expect, am 63 and have mild/moderate hearing loss. thanks
Hi Marion:
When you don’t wear your aids, you won’t hear as much, but you won’t be bothered by all the racket you can’t decipher either.
My opinion is wear your hearing aids when they will help you, and take them off when they don’t, or when all the racket gives you headaches, etc.
My hearing aids are in my pocket right now. I’m alone in the office so there is nothing I want to hear. I don’t want to hear my computer fans, and printers and keyboard, etc. so I leave them in my pocket and enjoy the silence. There is nothing wrong with that. It’s up to you.
It is true that wearing your hearing aids as much as possible is better for your hearing health so you brain knows how to deal with various levels of sound. But you are the boss and can choose whether the benefits to wearing your hearing aids in certain situations outweigh the resulting problems (tension, headaches, irritability, etc.) that occur when you can’t make sense out of all the racket you are hearing with them.
Cordially,
Neil
I just want to know is there any harm in wearing my hearing aid whole day from morning to bed time . Presently i wear only three to four hours in morning time , being a retired person of age 82,plus.
Hi Dr. Seth:
If your hearing aid is adjusted properly, and you are used to wearing it, then wearing it from the time you get up to the time you go to bed is perfectly fine.
However, if you find certain hearing situations leave you fatigued, frustrated, on edge, etc., then you might want to take your hearing aids off in those situations. In other words, if the benefits of wearing your hearing aids in a given situation are outweighed by the negatives of wearing them, then it makes sense to take them off during those times.
This is what I’ve done all my life.
Why do you only wear yours 3 or 4 hours in the mornings and not at all in the afternoons? If your hearing aids work well for you in the mornings, why not in the afternoons?
Cordially,
Neil
Thanks so much – my audiologist really gave me a ‘talking-to’ when I told her I take my aids out when I get home from work. She says I need to wear them from the time I get up until I retire at night. But I need to be able to unwind and I can’t when all 5 dogs are barking at the same time!
I wear my aids whenever I’m at work or out socially, but as soon as I get home I take them out. And after reading your article, I no longer feel guilty. It’s my decision!
Hi Gina:
Your audiologist is totally ignorant of what it is like to be hard of hearing and wear hearing aids that are NOT like normal hearing. She’s the one that needs the talking to!
Take them off when you need to unwind. You have to think of your mental health as well as your hearing.
I’m glad you no longer feel guilty taking them out. You do what works best for you. Don’t worry about what the “ivory tower” people theoretically say you should do. We live down here where the rubber meets the road and have to be practical in how me meet our hearing needs.
Cordially,
Neil
So glad I found your article. I got my hearing aids by the end of last year and was told to wear them all the time. My left ear has the most hearing loss while the right ear has a mild hearing loss. By wearing the Hearing aids all the time I got the feeling now that my right ear has lost most of its capacity to hear as well which frightens me. I will try to wear just the left hearing aid and see what will happen. It’s very hard to argue with the professionals since they tell you they know best. Feeling much better to make my own decision so thank you for your words which make so much more sense. 😄
Hi Monika:
Why do you say you feel your right ear has lost most of its capacity to hear? Is it because when you take that hearing aid out, everything sounds so quiet? If so, that is normal. It just shows you how much that ear really misses without help from your hearing aid.
Cordially,
Neil
my husband has hearing aids for both ears but he only wears one at a time. I tell him they gave him one for each ear and that is why he needs to wear them in both ears. Is this right?
Hi Cindy:
Basically, you are correct. I want to know WHY he will wear one hearing aid or the other but not both at the same time. What is his reason for this? He may have a valid reason–so what does he say?
Cordially,
Neil
I am a new binaural hearing aid user. I was told I should wear them except when I go to bed – Which I do.
The reason I purchased the aids (after being tested) is because I attend many social functions each month and find that I can only make out what the people sitting on either side and across from me are saying (due to background noise). One on one I do not have a problem hearing. I haven’t found much improvement as yet in a noisy situation – Is it possible that my brain/ears will soon adjust?
Hi Faith:
It takes your brain around 90 days to adjust to your wearing new hearing aids. So if you’ve worn them faithfully for 3 months and you still have trouble hearing in noise, that may be what you have to put up with.
One of the most common complaints of people wearing hearing aids is that they can’t hear/understand speech if there i much background noise. I have had this problem all my life. That is why often you need to supplement your hearing aids with assistive listening devices that are designed to work well in noisy situations.
Hearing aids are designed to work well in quiet situations when you are only up to 6 feet away from the speaker. As the distance increases, or the noise level increases, hearing aids become less and less useful.
On the other hand, assistive devices are designed to overcome the limitations of hearing aids due to distance and background noise. Used together with hearing aids, they can make an awesome combination.
Cordially,
Neil
My audiologist recently told me by not wearing my hearing aids during my waking hours, I increase my risk of dementia. She directed me to a John Hopkins Univ. study. what say you? Cindy
Hi Cindy:
If that were completely true, then I should be a stark, raving idiot–since I don’t wear my hearing aids much and have lived this way all my life. For example, my hearing aids are in my pocket as I write this.
Thus, this study by Dr. Lin hasn’t covered all the variables it needs to cover to really be accurate. I don’t doubt there is some truth to it, but as the study stands, it is not complete. I think you’ll find that it is more true of hard of hearing people who withdraw from society, rather than true of hard of hearing people that stay actively engaged in spite of their hearing losses. So those that speechread all the time (as I do), use all sorts of assistive listening devices (which I do from time to time–certainly not all the time, any more than I wear my hearing aids all the time), and have other ways of communicating–such as email, texting, signing, etc., and who use closed captions on the TV and phone, probably don’t have a higher risk of dementia. Furthermore, if this were really true, then all deaf people who do not wear amplification, but sign would all have dementia too.
I think the take-away from this study is to remain actively engaged in social communication–however you do it. It’s when you don’t effectively communicate regularly with others that you get problems–whether you are hearing or hard of hearing or deaf.
Cordially,
Neil
If I had hearing aids, I would agree with you that I don’t think you need to wear them at all times. Given that everyone’s situation is different, it is always a good idea to talk to a professional when it comes to hearing aids. That way, you can be sure that they will work properly for you.
Good summary response to my question – I can give my ears a break from all the unwanted nose that comes with the hearing aids. I also think the Costco settings – when moved up to “100%” is much to loud and could be reduced somewhat (it was at 90% before and that seemed better for my ears). A new problem though – haven’t seen discussed much – is the earwax buildup issue that I now seem to have and didn’t have before. I don’t like the notion of creating a new problem for my mild-to-moderate hearing loss,
Hi Bob:
You’re the boss–and thus you need to tell the hearing aid fitter that you want the volume turned down to a more comfortable (to you) level–even though your audiogram target says it should be louder. You’ll hear less than optimally, but that is better than perceiving everything as too loud and thus taking your hearing aids off.
Ear wax build-up has two aspects. First, wearing hearing aids prevents the normal ear wax from coming out of your ear canals–so it is stuck in there and can tend to build up. Thus, you may need to clean your ears out much more often. (I do it daily to keep my ears clean.)
Second, ear molds/hearing aids may tend to irritate your ear canals and thus your ears produce more ear wax, so you indeed have more than you used to have.
The two together can really block your ears fast. So you need a regular program of getting the wax out so your hearing aids don’t clog up and not work well, and so you can hear properly.
Cordially,
Neil
Hi Neil
I have mild hearing loss and have not yet used hearing aids. I hear fine at work and home (i.e. 98% of the time).I do not hear well at loud events (less than 2% of the time). Is there a device I can use for that 2% of the time only?
Thanks
Hi John:
There are devices you can use–but first I need to know what kinds of noisy places you are talking about, and typically how far away you are from the person you want to hear. I have various devices I use, depending on the situation. And in some loud places, I don’t want to hear better–I need to wear ear protectors!
Cordially,
Neil