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Comment by car | Hacker News Reader

With the AirPods now officially becoming hearing aids, it will hopefully reduce the stigma and attitude towards hearing aids and allow many more people to realize how bad their hearing actually is.

I have been wearing hearing aids for a few years now (Phonak). I've also used the AirPods Pro with the accessibility audiogram feature (basically making them hearing aids), which is really good and has also been around for a few years. I'm very glad, that Apple has made this official and even gotten FDA approval.

When I started to loose my hearing a decade ago, for a long time I refused to wear hearing aids, probably due to the perceived stigma. Even though it made life harder and harder -- imagine work meetings with a mumbling boss or me accusing my family to intentionally whisper -- it took years to change my mind. In hindsight I should have gotten hearing aids years sooner.

My 'real' hearing aids are nothing short of a technological marvel. They are tiny and run for a few days on zinc-air batteries (312/Costco but made by Varta), while providing all-day BT streaming. Btw, funny how most hearing aid brands come from Denmark. In contrast, the AirPods run out after a few hours and are also destined to become landfill due to their built in battery.

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You're certainly not alone in resisting hearing aids. My dad just got some from Costco (most affordable) and really likes them. He probably waited 5-10 years too long.

My father-in-law however doesn't like hearing aids because he feels they amplify things he doesn't want to hear. Granted he's never been fitted to actual hearing aids. I understand his concern, but he's told me multiple times his hearing loss leaves him isolated during conversation. He told me one night that he has a lot to say, but can't hear so he spends a lot of time just smiling. It makes me sad that his pride (and stubbornness?) is causing him this stress.

> he feels they amplify things he doesn't want to hear.

I mean that's kind of the whole point of having them adjusted with an audiologist. They're tuned to your specific needs.

It's too bad so many people think they're just mics and amplifiers. Modern hearing aids do a lot of signal processing.

> It's too bad so many people think they're just mics and amplifiers. Modern hearing aids do a lot of signal processing.

This is what I'm still trying to convince my dad of, after he found the pair he was fitted with ~20 years ago absolutely useless. He found that they simply made everything louder which did nothing to help him pick out what he wanted to hear.

But he's always been picky about his soundscapes, wanting the TV muted during ad breaks etc etc.

> But he's always been picky about his soundscapes, wanting the TV muted during ad breaks etc etc.

I'm with him on this one. Commercials always end up being louder than the rest of the content, and are just.. annoying.

I thought I had hearing loss. I don't. I have Audio Processing Disorder. When I found out about APD and read its symptom list, I cried. It's me, all over. Between that and ADHD I now understand how my brain processes (or doesn't process) sound properly and why even a well intentioned (but clueless) audiologist told me I had "selective hearing".

> he found the pair he was fitted with ~20 years ago absolutely useless

IKUK but that's like having bad vision so you put on a pair of your glasses from 20 years ago, still having bad vision, and deciding glasses just don't work well. Hearing and vision change over time. And that's assuming those were good hearing aids 20 years ago compared to what is available today.

I hope your dad ends up taking a chance.

My grandmother did that, as well. She was brilliant, but she was reduced to nodding a long, often inappropriately, because she couldn't hear.

It's rough now that I know it bothers him. Late at night, when the house is quiet and it's just you and him, he'll talk your ear off and hear every word you say.

> because he feels they amplify things he doesn't want to hear.

Could that be your mother-in-law telling him things to do?

Is he afraid of losing plausible deniability - "Sorry, honey, I didn't hear that, you know how bad my hearing is."

>> he feels they amplify things he doesn't want to hear.

Modern hearing aids can be adjusted to amplify only the things you want to hear, and even reduce the things you don't want to hear.

How do they accomplish this when the other/background noise is speech, like in a crowded area; where you only want the person near you amplified?

One method is using directional information. My low-end aids have two microphones each, and can share audio information from one aid to the other. I believe there are also some other methods, but I don't know how those work

Costco is great for this I found out. Free audiogram, and all name brand hearing aids.

I used to be like your father-in-law, pride, vanity, stubborn, not wanting to be told what to do, whatever it was. And my dad was like this too (the hearing loss is heritable), I used to mock him about not wanting hearing aids before my own hearing declined. When I finally got fitted, it was shocking to me how much my hearing had suffered. Suddenly I could hear birds and crickets again, and most importantly speech!

Maybe you can get your father-in-law to first play around with AirPods as hearing aids to win him over to get proper ones. The latest generation hearing aids, like the AP's, have amazing AI signal processing that will suppress noise and enhance speech. It's always cool when my Phonak's detect noise and shut it down.

The important thing about hearing loss in elderly, especially if someone has an elevated risk of cognitive decline, is the resulting social isolation, and the increasing risk of dementia [1]. It should be addressed sooner than later.

To sum it up, the AP's have the potential to provide an affordable on-ramp for more hearing impaired people to experience hearing restoration and warm up to better ones (hopefully covered by insurance). I don't think AP's would a permanent hearing solution, other than for people who are uninsured and can't afford real hearing aids (sadly).

Edit: I could not imagine wearing AP's all day, great as they are, while I don't even notice my receiver-in-ear hearing aids anymore.

Edit: While AP's are not perfect, having any kind of hearing aid is a 100% improvement over having none, which is probably also why the FDA allowed OTC hearing aids.

Edit: [1] https://www.nih.gov/news-events/nih-research-matters/hearing...

My hearing is on the border; the doctor told me hearing aids would help, but I don't "need" them. I've been resisting getting them because

- I've always (decades) had issues with distinguishing speech when there's background noise. Even when my hearing was "perfect", my brain just had problems separating the two. This is _especially_ true in a crowded area (mall, restaurant, etc) where the background noise _is_ speech. My father had the same issue, tried many different aids, and _never_ managed to get a pair that worked.

- Cost. I'm not interested in experimenting at thousands of $ per try. With the expectation that I'll wind up at the doctor's office a dozen+ times while they try something new to help me (with the first issue), and a likelihood that they'll never succeed; I'm very hesitant to shell out the money involved.

Did LACE not work for you?

I'd never even heard of it before you asked.

I have the same issue with noise spaces... If I can't see the person talking, it's impossible for me to distinguish anything but the loudest thing. I may as well be def in a noisy room.

> He probably waited 5-10 years too long.

What's the downside of waiting?

Diminished quality of life during the waiting period

> My father-in-law however doesn't like hearing aids because he feels they amplify things he doesn't want to hear.

I have this issue with AirPods too, in the "adaptive" mode. It feels natural outdoors, but sometimes indoors and especially in rooms with echo it feels like it makes distant chatter unnaturally loud and closer-sounding.

I have got to say it was fantastic seeing my grandmas eyes glow when, for no reason, I thought "wait my xm4's could help her" and put them on her.

She was then able to hear our conversations even though the xm4 are not as good the real thing.

She didnt want hearing aids before that, but afterwards she wanted ones.

The Sony WH-1000XM4? I'm still on the Bose QC 35, but you got me curious. Could you explain how using it as a hearing aid works? I searched the web but couldn't find good references.

There is a noise canceling mode that let's you hear what is received by the microphone array and an option to "filter in voices while suppressing noise" (they call that voice passthrough). That section of the app is called "Ambient Sound Control" if that helps your research.

I haven't tried XM4, but the noise cancelling on XM3 had a very uncomfortable "sucking" feeling even though it is very strong, especially on a plane. The AirPods aren't as bad about this and NC is about as good.

Note also phonaks are traditionally a couple thousand euros a piece while even the most expensive airpods are still around 300 the pair. Certainly the phonaks are impressively small, lasting, good quality, and imperceptible, but is the almost 10x price markup justified?

The biggest problem with hearing aids (and doctors/calibrators/whatever) is that they are ridiculously expensive... the attitude/stigma much less so. (And in any case airpods are about the opposite of "imperceptible" so I fail to see any appeal other than the price)

I don't think I've ever seen someone with a hearing aid and though anything negative of it, I get it people can be self-conscious, but for something like a hearing aid I think it's unjustified.

On the other hand, I can't bring myself to keep earbuds (airpods or w/e) in my ears while talking to someone, regardless of if I can hear them properly, I just seems incredibly rude.

My uneducated opinion, is that someone using airpods as hearing aids is more likely to face stigma for that reason, than someone wearing what are clearly hearing aids, unless people actually know they have hearing issues.

It almost certainly depends how social norms develop.

When Borg bluetooth earpieces first came out, they definitely carried a tech bro/fin bro/VC/etc. vibe that, at any moment, someone more important than you might want to get in touch with me.

I do think Airpods today carry a certain I'm not necessarily giving you my full attention vibe whereas an obvious hearing aid is a medical prosthetic. To the degree that Airpods replace hearing aids for some number of people or just assist people who aren't quite at the prescribed medical device level, that probably changes.

The one thing that I do believe Apple managed with the iPhone is the removal of this "tech bro" vibe from carrying a smartphone overall. So I guess it's not entirely out of the question that Apple will remove the stigma from wearing huge headsets 24h long...

I'm skeptical about big headsets but small earpieces seem headed towards becoming pretty normalized.

One of the other things that was happening at the time--though not disconnected--is that data charges were getting to the point where normies (or at least reasonably well-paid ones) could at least reasonably consider owning a phone with a data plan even if their company wasn't footing the bill. I bought a Treo a while before the iPhone came out and paid for it on my own after a foot injury that made it difficult to travel with a laptop.

A buddy had a girlfriend who had reduced hearing. I noticed that people would raise their voice and really dumb down when speaking to her, like they were talking to a senile elderly. It'd happen before she'd said a word, so they clearly saw the hearing aid and assumed.

She admitted she disliked wearing the hearing aids, due to such things. But the alternative was not following conversations, which meant she'd get excluded because she missed important information.

Gave me a whole new perspective on hearing loss.

Maybe it's because I have been wearing aids through all my life, but I see things this way. I don't care much what stigma wearing one carries, considering the alternative is being "that guy" who needs everything repeated twice, and that is a stigma I hate.

It does seem to depend on the hearing aids as to whether people can see them. I have NHS hearing aids - made by GN Resound, I think. I really like them, but as they use sound tubes rather than wires to a speaker in the ear canal (the oddly named "receiver in canal"), they are fairly low end. Ok, so that means I have small tubes snaking in to my ears. I still had to tell a cousin four times that yes, I was wearing hearing aids, and no, I hadn't forgotten them. In fact that was how I got my mother to get hearing aids - I told her I'd been wearing them for three years and she had not noticed.

As to being excluded: one of my jobs is funeral officiant. Several times I've found the spouse of the deceased being left out of the funeral conversation because of hearing and I've even been told not to bother talking to them because they won't hear. Every time I've found that we can talk perfectly well - it just needed a bit of effort on my part.

I don’t think the stigma is around hearing loss it’s about age.

And stigma is probably not the right word, it’s an internal acceptance issue.

You are right, I thought about it a bit more, and I think it was more vanity for me, since I was fairly young when the hearing loss started. But hearing aids nowadays are so inconspicuous that most people don't even notice them.

> I don't think I've ever seen someone with a hearing aid and though anything negative of it, I get it people can be self-conscious, but for something like a hearing aid I think it's unjustified.

Neither have I. On the other hand, I have seen people wearing air pods and thought they looked ridiculous, as if they had qtips sticking out of their ears. Especially if they're sticking out at different angles.

> In contrast, the AirPods run out after a few hours and are also destined to become landfill due to their built in battery.

Just looked up AirPod battery run time. Wow - that's short. I have Anker A40 earpods.[1] 10 hours, and the case has enough charge for 50 hours. 10 minutes of charging gives you 4 hours. They're a lot cheaper than Airpods, so you could easily buy a pair (for much cheaper) and be good!

Not sure how accurate they'll be as hearing aids.

[1]: https://www.amazon.com/dp/B0B1LPNDGF/?tag=thewire06-20&linkC...

Depends on the form factor and what functions are active.

I'd say 4-6-8 is low-average-high duration for the standard form factor and ANC will reduce the duration by 25-30%

10 hours is exceptionally high, i don't think i even seen that claim

But year, they don't even have ANC, they are just a good pair of buds, the 10h claim is good.

Pro tip:

You know that a pair of buds is good if they offer Multipoint. It is such a hard feature to find in the mid and low end market

> But year, they don't even have ANC, they are just a good pair of buds, the 10h claim is good.

Are you talking about the ones I linked to? They clearly have ANC, and Wirecutter claims it's among the better ANCs they've tested.

> 10 hours is exceptionally high, i don't think i even seen that claim

The claim is right there in the product description. Wirecutter also confirmed it with a test:

https://www.nytimes.com/wirecutter/reviews/best-wireless-ear...

They do say it can be reduced depending on how you use it.

Finally, here's a snippet of an Amazon review:

> I just played 7 hours of continous music with the noise canceling activated at high volumes and there's still almost 30 percent battery avaliable.

And another:

> I used the earbuds for 8 hours between ANC & transparency mode, ... Considering how often I use the earbuds after 8-10 hrs per day and 4-5 days of use from a full charge, the battery life is still 2 lights remaining.

One review does state lower life with ANC:

> But, a full charge only lasts me 6 hrs with anc on auto and volume at 50% or less.

A few reviews talk about even lower battery life, but given Wirecutter's tests and the preponderance of those who get long battery lifes, I'll assume the exceptions are defective products.

In any case, is ANC even relevant for hearing aids? I would have thought ANC would be a hindrance.

(In general, several reviews refer to using it continuously for their work shift).

The one thing that may not be particularly good is the mic.

Edit: Here is someone who tested with ANC on. They got 7hr 55 min:

https://www.soundguys.com/anker-soundcore-space-a40-review-8...

Landfill isn't so bad though. Segregating identical waste into one place is a fine approach, because once it becomes possible to recover it, now you know where it is. Think of it as a mine. (It's a problem if it leaks into the groundwater of course.)

But lithium is not at all rare so it's not going to be hard to make more batteries.

Is there a way of setting an audiogram? That's basically a frequency response curve for your hearing, so it's the basic requirement for acting as a hearing aid. This is a setting which iPhones have for Airpods (as far as I know, you can't set it without an iPhone).

Yes. It's called HearID

https://www.soundcore.com/hearid

> In contrast, the AirPods run out after a few hours and are also destined to become landfill due to their built in battery.

Also will entrench the user in a walled garden ecosystem from a very specific giant tech company that isn't big on making their products compatible with other companies.

I have no issues using my AirPods on Android.

Automatic device switching doesn’t work but that doesn’t work on my Sony headphones either.

+1 on this. I use them with my android phone, steamdeck, windows computer, TV. They work great!

The new hearing aid features are gatekept behind an iOS app. You can't tweak the hearing aid settings without an Apple device.

The Samsung Galaxy Buds only have 360 audio and the better audio codec if you use a Samsung Galaxy smartphone. Doesn't even work on other Android devices let alone iOS. And as far as I know you can't tweak the hearing aid features of Galaxy Buds on any device.

If you can't actually tweak audiogram settings, they're not really hearing aids. In fact, Samsung doesn't sell them as hearing aids and from what I can tell never use the term "hearing aid" in any of the marketing, branding, or feature listing of the devices.

They're not FDA approved as hearing aids, so they're not hearing aids.

Either way, pointing to another company being shitty isn't really a good justification of the first company being shitty.

Just trying to understand your argument: Samsung does it so that makes Apple ok? I hear a lot of people argue (when defending Samsung, Google Play, etc) that Apple does it so it's ok, but not usually the other way around. I guess it makes sense that it would devolve into the spiderman meme, but the real losers in that are everyone else that isn't making money from it.

Personally I thinks it's shitty when anybody does it.

> will entrench the user in a walled garden ecosystem from a very specific giant tech company that isn't big on making their products compatible with other companies

Are you suggesting AirPods aren't Bluetooth 5.3 and aren't compatible with Bluetooth audio sources? Or that it doesn't play AAC, MP3, and FLAC?

The proprietary capabilities (such as instant smart switching between active devices) are all incremental, taking nothing away from normal Bluetooth usage.

Seems like a rage bait post but: how do you update the firmware without an apple device?

You need to do more than update the firmware. You need to upload your personal audiogram into the device.

At an Apple Store[1].

[1]: https://support.apple.com/en-gb/106340

As mentioned elsewhere you can't tweak its setting outside Apple's walled garden.

Better wait for more open competition to catch up unless you are already deep in their ecosystem and not intending to move.

Do you need your own iphone, or can you use a friend's iphone to fix the settings once?

It probably should be your own device; the audiogram ends up in the iPhone's health app. It can probably be done by someone else if they don't care and don't need to apply a different audiogram for themselves.

That is some nice integration. Having one’s own up to date audiogram stored in a health record and available to doctors and devices.

I was able to use my partner's iPhone to configure some settings.

It's frustrating that the settings can't be changed on Android, and macOS seems to have a subset of settings compared to iOS.

Can you use them as hearing aids without an iPhone?

Is the hearing aid market big on modularity and compatibility?

isn’t it good to have multiple options so consumers can pick what they value?

That's an argument against buying an iPhone and AirPods Pro together as a combination instead of buying a hearing aid, but

- it's not an argument against using AirPods as an aid with mild hearing loss if you're already an iPhone user

- it's not necessarily a great argument against buying an iPhone and iPods Pro anyway, given that hearing aids can easily run hundreds or even thousands of dollars more than that combination

- the vast majority of smart phone customers, both on and off HN, have either factored "walled garden" into their buying considerations at this point or never will

- let's not pretend Samsung is not already trying to figure out how to cram this into their next Galaxy Buds for Android users anyway, which will somehow work best with Samsung phones, not so well with other Android phones, and not at all with iPhones, but nobody will really complain about it because whatevs, it's not Apple

I'm looking forward to this going live. I've worn the "we have an app!" BLE enabled hearing aids and am currently wearing a pair of amplifiers I got on Amazon for $200 and they've lasted almost two years. AirPods Pro + this software should make it a lot easier for me to follow conversations and filter out high frequency noise (like you get when there's nothing but bare walls and ceilings and floor space). I mostly ignore the Apple-haters.

And will put some people off from talking to them. I don't talk to people with AirPods stuck in their ears until they take them out. Too many times I have tried to start a conversation or just say "Hello" but they are oblivious because they are on a call or have music or something else playing.

that sounds more like a you problem. i use mine pretty frequently as hearing aids, especially in noisy environments.

> Too many times I have tried to start a conversation or just say "Hello" but they are oblivious because they are on a call or have music or something else playing.

This is GP's problem? What should GP do to solve this problem? (Seriously asking, even though this probably sounds sarcastic). Should GP tap them on the shoulder or try to wave them down or something to get their attention? What if they don't want to be bothered? What about the sibling comment ( https://news.ycombinator.com/item?id=41533796 ) about it being a feature not a bug? If GP were to tap that person or get their attention someway, it seems that it would be unwanted.

Sounds like a feature and not a bug.

If ever there was an opportunity for apple to earn some easy goodwill, it would be opening accessibility features like this to other platforms. Keeping accessibility features locked to iphones only isn't good optics IMO.

For posterity wanted to add this interesting post [1] by TSMC about their work with Oticon (one of the established hearing aid manufacturers). It's a few years old (2021), so instead of 28nm, more recent models probably use even 5nm.

"Compared to the previous generation of Oticon Opn S™ which is powered by TSMC’s 65nm low-power technology and contains 64 million transistors, the newest model features one of the most advanced chips with AI sound processing and analysis capabilities. The migration to TSMC’s 28nm opened the door for Oticon to utilize DNN, which is trained with 12 million real-life sound scenes. This new feature allows hearing aids to mimic how the brain would hear sounds and aims to respond the same way as the brain. As more functions are added, more compute performance and improved power efficiency will be required to support future generations of hearing solutions."

[1] https://esg.tsmc.com/en-US/articles/106

Sonova (Phonak) is Swiss by the way, not Danish.

They also own the consumer of Sennheiser since a couple of years.

Thanks, I stand corrected.

Most people don’t wear hearing aids because they don’t like how it looks and think their hearing isn’t bad enough to warrant social stigma from it. I don’t see how Airpods solve that problem as they are very unsightly, no matter how much pundits say they love them.

In fact you mentioning how they are like hearing aids has made me justify never wanting a pair.

The advantage of AirPods for social stigma is they aren't solely hearing aids, so you have a type of (casual) plausible deniability about why you're wearing them. They won't draw people's attention in the way that hearing aids (because they're different/unique) do.

But a lot of people don’t wear Airpods because they look dorky and look like something is growing out of your ears. This is what I’m saying, coolness doesn’t trump looks even if pundits say “I love my Airpods”. A lot of people do not like wearing headphones for a similar reason.

If i see someone wearing AirPods or headphones my initial reaction is they don’t want to be talked to or interacted with. Even if that’s not true and they have passive throughput.

Having earpods in while talking is an entirely new and worse social stigma than wearing hearing aids.

> you have a type of (casual) plausible deniability about why you're wearing them

"He doesnt even give enough of a shit about talking to me to remove his earbuds" isn't a good thing.

> They won't draw people's attention in the way that hearing aids (because they're different/unique) do.

They won't draw peoples attention in the same way because normal humans only begrudgingly interact with people wearing earbuds in conversations and only for a bare minimum.

I really can't stand this website sometimes. But at least you all got the AirPods™ branding right instead of just calling them earbuds.

I think that's more of a negative though. I always remove Airpods/earbuds if I'm in a situation when I may be interacting with others because otherwise I come across as rude, uninterested or unsocial, like having a "do not disturb" sign on.

Whereas I can see myself wearing a hearing aid (and probably need one) because people will recognize that I'm not trying to shut them out but I may have difficulty hearing.

If anything, if someone's wearing Airpods, I'm going to assume they can't hear anything I'm saying. "oh no he's wearing airpods" is a meme for a reason.

> In fact you mentioning how they are like hearing aids has made me justify never wanting a pair.

Why? Because hearing aids are unsightly? Are wheelchairs unsightly? Canes? Prosthetic legs? It looks to me like this idea of what’s “unsightly” is being fed by a cultural bias against the disabled. Interestingly, glasses were “unsightly” a few decades ago, and now they’re in fashion. It would be nice to see the same thing happen for other assistive tech.

One reason I already use them as hearing aids is because I use Airpods for phone calls, and it's a lot easier to leave them in than change to my hearing aids. So the question of what they look like doesn't arise.

How have the Phonak's been? I only learned of them recently - I've been wearing Oticons for a few years and have never been super impressed.

I may be ready to drop $$ for my next pair..... do you work with an audiologist or did you do everything at Costco?

I got them through an in network hospital audiology department, so paid by health insurance. For out of pocket Costco looks good to me. They have special models that are a little less fancy than the top of the line stuff, from name brand manufacturers.

I also checked out earlens.com, a pretty cool concept that’s supposed to be superior in audio quality. But they are pricey, and need to be fitted by a doctor/audiologist with a transducer that sits directly on the eardrums (and stays in your ear canal) and is driven by induction. Ultimately turned off by cost ($12k/pair).

I think the technology in hearing aids has profited from the advances in chip manufacturing [1]. So the latest models may also be on 5nm and thus have more transistors for fancy AI and longer battery life. You may have a better experience nowadays.

[1] https://esg.tsmc.com/en-US/articles/106

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