Only last week, I had a delicious meal at a local restaurant but the frustration of trying to have a conversation with my friends overshadowed the meal. I will not return to that restaurant because of the loud music and poor acoustics.

The number one complaint people have is the challenge of hearing and understanding conversation in noisy situations. This challenge is intensified when you have a hearing loss, even if you wear hearing aids.

Why is it so frustrating for people to understand speech in the presence of noise? And why do people who wear hearing aids have more difficulty with understanding in background noise than people with normal hearing? In order to answer these questions, we need to go back and look at the anatomy of the human hearing system. Sound is collected by the ears and sent down the ear canal to the eardrum. When sound hits the eardrum, it begins to vibrate causing the bones in the middle ear to vibrate. The bones vibrate, stimulating the hair cells in the inner ear. The inner ear, also known as the cochlea, changes the sound into electricity.

Electricity is the language that the brain understands. Signals are sent from the inner ear to the brain and the brain is where we process sound and make sense of what we hear. The truth is that we actually hear with our brain, not with our ears! In people with nerve loss, some of the cochlear hair cells are damaged. It is these damaged hair cells and the brain’s processing ability that makes it more difficult to separate speech from background noise. At this point in time, modern medicine cannot repair these damaged hair cells. Only hearing aids can help keep you hearing the best you can by stimulating the hair cells that are still functioning.

And they do a good job in quieter listening situations. However, each person is unique and each hearing loss is different. That’s why it’s important to have a very thorough hearing test which includes puretone testing (listening for the beeps), Speech Testing to determine how much hearing aids will help, and Loudness Discomfort testing for both speech and puretones.

The information from the Loudness Discomfort tests help in programming your hearing aids not to be uncomfortably loud, especially in noises places. This is the first step in making hearing aids work as well as possible in background noise. Hearing aids have to remain comfortable to listen through in those noisy places. In my practice, we also take the time to do a special hearing test called the QuickSIN™ (Quick Speech-In-Noise test). It’s a test that predicts how well your brain can separate speech from background noise. And that’s a processing issue.

Every brain is different. For example, I have one patient who only has a mild hearing loss but has a severe Speech-In-Noise loss. Despite wearing top-of-the-line hearing aids, he still has an extremely difficult time understanding in restaurants and parties. That’s the limitation of his brain’s processing ability. On the other hand, another patient of mine who has a severe hearing loss does amazingly well in noise because he has a mild Speech-In-Noise loss. He hears almost as well as a person with normal hearing in noise! Only the QuickSIN test or the HINT™ (Hearing In Noise Test) can determine how well you’ll do in noisy environments.

Again, everybody is different. It pays to take the time to do these extra tests to determine how well you will be able to hear in both quiet and noise. Based on this vital information plus your lifestyle and communication needs, only then can a hearing healthcare provider truly recommend the right hearing aids for you. In another article,I’ll tell you how technology including Directional Microphones may help you hear better in noise.