You would think hearing loss would be obvious.
It rarely is.
Most people do not wake up to silence. They start thinking everyone mumbles. The television gets louder. Conversations require more concentration. A spouse starts repeating everything twice.
October is National Audiology Awareness Month, recognized by the American Academy of Audiology to encourage better hearing health, prevent noise induced damage and recognize the role audiologists play in treating hearing and balance concerns.
Naturally, we turned to our partners at Hearing and Brain Centers of America and asked Dr. Keith Darrow what we should all be listening for.
Dr. Darrow is a Harvard Medical School and MIT trained neuroscientist, clinical audiologist, researcher, author and educator who has spent more than 20 years studying how hearing loss and tinnitus affect the brain.
Here are eight things everyone needs to hear.
1. You hear with your brain
Your ears collect sound. Your brain makes sense of it.
“The ears collect sound, but the brain must organize it, interpret it and attach meaning to it,” Dr. Darrow says.
When the signal becomes weak or incomplete, the brain works harder to fill in the blanks. That can increase cognitive strain and reduce the stimulation the brain receives.
Hearing loss has been associated with cognitive decline, memory concerns, falls and social isolation, although hearing loss alone does not cause dementia. An NIH funded clinical trial found that hearing intervention may slow cognitive decline among older adults already at greater risk.
That is why Dr. Darrow tells patients to “catch it early and treat it early.” A comprehensive evaluation establishes a baseline and makes it easier to monitor changes.
2. Hearing loss does not always sound like hearing loss
“I can hear. I just cannot understand.”
Dr. Darrow hears that sentence often.
Someone may hear a voice but miss the words, especially in restaurants, meetings or rooms with background noise. They may think people are mumbling, turn up the television or rely on someone else to repeat what was said.
Ringing, mental fatigue, headaches, sleep trouble and withdrawing from social situations can also be warning signs.
“A basic hearing screening may not reveal the entire problem,” he says.
A comprehensive evaluation should also measure speech understanding, performance in background noise and how efficiently the brain processes sound.
3. Your brain may be tired from trying to hear
That end of day exhaustion may not be only stress.
When the brain receives an incomplete sound signal, it works overtime. Instead of naturally following a conversation, you may find yourself studying faces, searching for context and concentrating on every word.
That extra effort can cause headaches, irritability, poor concentration and difficulty remembering what was said. The American Academy of Audiology calls it listening fatigue.
Dr. Darrow uses speech in noise testing, which he describes as a “stress test for the brain,” to uncover problems a traditional hearing test may miss.
Depending on the patient, treatment may include prescription hearing technology, communication strategies and continued monitoring.
4. Hearing loss can quietly shrink your world
It often starts small.
You stop joining the conversation. You smile and nod because asking “What?” again feels embarrassing.
“Hearing loss does not affect only the person experiencing it,” Dr. Darrow says. “It affects the entire family.”
Missed words become misunderstandings. Misunderstandings become frustration. Eventually, people may avoid invitations, gatherings and activities they once enjoyed.
Treating hearing loss is not only about making sounds louder. It is about helping people stay connected, confident and independent.
“Better hearing helps people reconnect with the conversations and experiences that make life fulfilling.”
5. Ringing should not simply be ignored
Tinnitus can sound like ringing, buzzing, humming, hissing or pulsing.
It is often connected to changes in the auditory system. One leading theory is that when the brain receives less sound input, it creates phantom sound within the auditory cortex.
“Tinnitus can affect sleep, focus, memory, mood and emotional health,” Dr. Darrow says.
Persistent, worsening, one sided or pulse like tinnitus should be evaluated, particularly when accompanied by sudden hearing changes, dizziness or neurological symptoms. Sudden hearing loss is considered a medical emergency and requires immediate care.
Treatment depends on the cause and whether hearing loss is present. It may include hearing technology, sound therapy, counseling, stress management and sleep support.
6. Hearing and balance are closely connected
The systems responsible for hearing and balance both live within the inner ear and communicate constantly with the brain.
When those signals become weak or distorted, a person may experience dizziness, vertigo, instability or reduced awareness of where the body is in space.
Warning signs include unexplained falls, veering while walking, feeling unsteady in the dark or experiencing dizziness with tinnitus, ear pressure or hearing changes.
Sudden or severe symptoms require prompt medical attention. Testing the complete hearing and balance system can help identify the problem and guide the next step.
7. Your ears keep score
One loud concert may leave your ears ringing for a night. Years of concerts, earbuds, sporting events, motorcycles, power tools and travel can add up.
“Hearing damage is cumulative,” Dr. Darrow says. “The louder the sound and the longer the exposure, the greater the risk.”
Noise induced hearing loss is often preventable. Keep earbuds at a comfortable volume. Move away from speakers. Take breaks from loud environments and wear properly fitted hearing protection when needed.
Noise canceling headphones can also reduce the urge to overpower background sound by raising the volume.
Ringing, muffled hearing or sound sensitivity after a loud event are warning signs, not normal souvenirs.
8. A device is not the same as hearing care
A hearing device can be part of treatment, but it does not replace a comprehensive evaluation, individualized programming and continued follow up.
“Traditional hearing care may consist of one basic test followed by an amplifier and little continued support,” Dr. Darrow says. “Our approach considers the whole patient.”
At Hearing and Brain Centers of America, that includes advanced diagnostics, prescription hearing technology and continued monitoring of hearing clarity, tinnitus, communication needs, cognitive health and quality of life.
The team includes doctors of audiology, nationally board certified hearing instrument specialists, Certified Dementia Practitioners and providers with advanced tinnitus training.
Because hearing can change, follow up matters. Continued testing and adjustments help keep treatment aligned with the patient’s needs.
The biggest takeaway this October is simple.
You do not need to wait until the world becomes quiet.
If conversations are becoming work, restaurants are becoming frustrating or your brain feels exhausted from trying to keep up, listen to what those signs are telling you.
hearingandbraincenters.com/arizona/paradise-valley