Can’t Hear in Background Noise?

One of the most common complaints that hearing providers hear from clients is- “I can hear just fine in quiet, but I don’t do well when it’s noisy.”

In this article, we'll look at why it's more challenging to hear in noise, how our ears normally compensate for noise, and how this may break down.

Then, we’ll review options for improving your ability to hear in noise.

Why is it so hard to hear in noisy environments?

The most obvious answer, is explained by sound's ability to “mask” other sounds.

Essentially, some extraneous or unwanted noise covers up, or masks what you want to hear.

For example, suppose you are at a business meeting, deep in discussion about a proposal and then you hear the sound of an ambulance siren outside.

Chances are that you will momentarily pause the discussion until the siren fades.

You and your business associates recognize that the loud siren overpowers your voices, so you wait to continue to talk.

Another reason it's hard to hear in noise, is because noise reduces the natural redundancy present in speech.

Normal conversational interactions have a lot of redundant information, which allows us to easily fill in parts that we might miss because of poor acoustics, noise, or inattention.

Because of your knowledge of the language and the topic of conversation, you expect to hear certain words more than others.

So if someone starts a sentence with “I need to go to the store to buy …”, you probably expect to next hear words like “shoes” or “paper” and not “Russia.”

Many times, we don’t realize that our brains fill in missing parts of conversation.

One example is studies of the phonemic restoration effect. Researchers will edit out part of a word, like the “n” in “night” within the phrase “opening night”, but study participants will swear that they heard the entire phrase normally.

When you’re listening to a conversation in noise, the noise masks out some redundant information.

You might be able to cope if you have normal hearing that picks up well on the rest of the information.

However, if you have an auditory disorder- such as those we discuss below- you might not be able to cope with the missing information.

As a result, you experience a breakdown in communication.

What causes problems hearing in noise?

Normally, the brain uses information from our two ears working together to manage background noise.

With two ears, the brain figures out where sounds are coming from.

If you know where sounds are coming from, it’s easier to separate out the voices you listen to from other sounds.

If you have difficulty hearing in background noise, it may mean that you have a sensorineural hearing loss (damage to the inner ear or auditory nerve).

Sensorineural hearing loss has two components: audibility and distortion.

The audibility component refers to the fact that there are sounds that you cannot hear when you have sensorineural hearing loss.

The distortion component refers to the fact that even speech that is easily audible to you may not be clear.

When you have damage to the inner ear or auditory nerve, the ear cannot capture sounds and transmit them to the brain as precisely, resulting in a distorted signal.

In a quiet environment, your brain may still be able to make sense out of the distorted signal from your auditory nerve and inner ear.

However, in a noisy environment, you have a “double whammy”- distorted sound coming into your ear, and a distorted system processing that sound. Your brain can no longer compensate.

Other potential causes of difficulty hearing in noise

Hidden hearing loss: Increasingly, hearing care professionals have recognized that you can have damage to your auditory system even if you have a normal audiogram. The conventional hearing test may not pick up on the smaller deficits, called hidden hearing loss, that lead to complaints about hearing in noise.

Unilateral hearing loss: If you have hearing that is much worse in one ear than the other, you are no longer able to benefit as much from binaural hearing. One of those benefits, as noted above, is the ability to localize where sounds come from.

Young age: The neural connections in the brain that are responsible for the ability to hear in background noise do not fully mature until children reach their teens. Therefore, children do not hear as well in background noise as young adults.

Central auditory processing problems: Children and adults with problems listening in noise may be diagnosed with Central Auditory Processing Disorder (CAPD).

Aging: Older adults have more difficulties separating out noise as a result of brain changes that happen with age. There have been reports that reduced estrogen in women during menopause may also lead to difficulties hearing in noise.

Less familiarity with language: People who speak English as a second language may struggle in background noise.

How to treat problems hearing in noise

If you have a sensorineural hearing loss, the first step in treating problems with hearing in noise is to consider buying hearing aids.

Hearing aid technology can help you hear in background noise in three main ways:

• Restore audibility to soft and moderate sounds: If softer speech sounds are more audible to you, you’ll naturally have a better ability to hear in noise.
• Directional microphone technology: This technology uses special microphones to separate out sounds based on the direction that they come from. The most sophisticated versions utilize binaural synchronization, where information from both hearing aids’ microphones are combined and used by the computer chip in the devices to do calculations.
• Noise reduction technology: According to research studies, this technology doesn’t directly improve speech understanding in noise. However, noise reduction circuits can make your listening experience more comfortable.

If you choose to wear hearing aids, it’s important to realize that the effectiveness of the technology is limited by the quality of the sounds that arrive at the hearing aid microphones.

While the computer chips in hearing aids can do a lot to clean up distorted signals, sometimes the signal is so bad that not much can be done by the hearing aid by itself.

One of the most powerful ways to hear better in background noise is to combine your hearing aids with remote microphone technology.

Remote microphones consist of a microphone that the speaker wears. The speaker’s voice is transmitted wirelessly to your hearing aids. Sometimes this is a direct transmission; other times, you may have to wear a receiver that picks up the signal and then transfers it to your hearing aids.

The signal that your hearing aids get directly from remote microphones is much cleaner than if the speaker’s voice had to travel through the air, bouncing off of walls and furniture, and mixing in with environmental sounds along the way.

The video below highlights remote microphone functionality

If you use hearing aids, it's likely that your hearing aid manufacturer also builds remote microphones- ask your hearing provider about this.

Other options (aside from hearing aid technology)

People with sensorineural hearing loss as well as central auditory processing problems may try to improve their listening skills with auditory training programs.

Over time, with training, your brain learns how to listen better in background noise.

Programs that you may complete at home on your computer include LACE, Angel Sound, and clEAR.

In addition to technology and training, you can also address background noise by altering your environment and using good communication skills.

For example, you can turn down the television if you are in your living room and having a discussion with your spouse.

In a restaurant, avoid sitting near the kitchen. Choose booths with high walls that can block out some noise.

While you are listening to your conversation partner, make sure that you are looking at them.

Even for individuals with normal hearing, lipreading improves the ability to understand words spoken in noise.

During the conversation, speakers should talk at a comfortable pace that gives people time to process what’s being said.

Conclusion

If you are having problems hearing in noise, it may be time to get a hearing test to find out if you have sensorineural hearing loss or other problems.

Based on your hearing test results, your hearing care professional will make recommendations on how to best improve your ability to hear in noise.

There are a variety of options, from technology to training, to help you improve your ability to hear in noise.