Your Hearing Matters

What is meant by ‘hearing loss’?

Hearing loss is any reduction in your ability to hear sounds at a normal volume. It can affect one or both ears, can come on suddenly or gradually, can be temporary or permanent and can have a range of causes.

The most common form of hearing loss, however, is age-related and is a result of changes in your ears as you grow older. These changes result in a permanent reduction in your ability to hear, but can come on so gradually that many people don’t realise that their hearing is diminishing. It is reckoned that on average people live with hearing loss for 10 years before asking for help.

If you’ve noticed changes in how well you hear, you aren’t alone. Hearing loss is extremely common, affecting around 11 million people in the UK – about 1 in 6, or almost 17%, of the population. Because older age is a key factor in most hearing loss, around 40% of people aged over 50 will have some hearing difficulty. By age 70 more than 70% of people will be affected.

If you suddenly lose hearing in one or both ears you should seek immediate medical advice. Hearing loss that occurs suddenly or rapidly, over, say, a couple of days, can indicate several serious conditions that need urgent treatment.

How your hearing works

Your ears change soundwaves in the air into electrical signals that are sent to your brain – you understand these signals as sounds. Hair cells in your inner ear vibrate to create the sound signals.

Watch the video below, from MED-EL, for a full description of how the ear works

What goes wrong?

Hearing loss occurs when the sound signals fail to reach the brain because parts of the ear are not working properly or are blocked. There are many causes of hearing loss, typically the types of hearing loss can be categorised as either:

• Sensorineural hearing loss, which is caused by deterioration of the hair cells or by damage to the nerve that transmits the sound signals.

• Conductive hearing loss where sounds reaching your outer ear can’t get through to your inner ear.

• Some people have both conductive and sensorineural loss; this is called mixed hearing loss.

The most common causes are highlighted in this video by Hearing Link:

Read more about the types and causes of hearing loss at Action on Hearing Loss.

Tinnitus

It is common to experience tinnitus along with hearing loss. Tinnitus is described as the perception of sounds in the head or ears which have no external source. It is rarely an indication of a serious disorder but if you have tinnitus which is bothersome you should discuss this with your GP, who may refer you to an ENT specialist for further investigation. There are many strategies that can be helpful in managing tinnitus including relaxation, counselling, sound therapy and hearing aids to correct hearing loss.

• More information can be found on the British Tinnitus Association website: https://www.tinnitus.org.uk/

How hearing declines – volume and frequency

The volume of sound we hear is measured in decibels (dB) and the quietest sound anyone can hear is just above zero dB, though most will need more volume to hear anything. Typical volume levels for common sounds are shown here:

However, it’s not just how loud a sound is that governs whether you can hear it – the frequency, or pitch, is critical. The most common types of hearing loss typically have the biggest effect on higher-frequency or high-pitched sounds – you may for example struggle to hear birdsong or children’s voices but have normal or near-normal hearing at lower frequencies or pitches.

Effects of hearing loss

The loss of hearing at the higher pitches makes it difficult to follow conversation because sounds in speech are in the frequency range where the hearing has declined, this is known as the speech banana. For most people with early hearing loss, one of the first noticeable symptoms is difficulty understanding speech against background noise. Trouble clearly hearing voices on the telephone is another very common symptom.

The core problem caused by hearing loss is difficulty communicating with others. It can often be difficult for you to follow and join in with conversations and there are risks that you might misunderstand verbal instructions or public announcements. However, hearing loss can impact your daily experiences in numerous ways such as listening to the television or music or hearing your doorbell.

As the ability to hear declines, many people get symptoms that are not obviously related to hearing loss. The unconscious increased effort you have to make to understand what you are hearing, can lead to irritability and stress. It’s not uncommon for people to suffer fatigue before they realise the cause is hearing loss. Many studies show that loss of hearing can lead to a reduction in overall mental, emotional and physical wellbeing.

There are many reasons that people delay getting help with hearing loss. Some ignore it or think it’s just ‘their problem’ and try to cope alone, others see it as a ‘failing’ or a sign of ageing and decline – it’s not uncommon to mourn for the loss of hearing in much the same way as with losing a loved one.

Your stories

“I didn’t realise how bad my hearing had got. For a long time I just assumed that that people were mumbling and speaking quietly” - Amanda

“I found it much easier to hear men’s voices as opposed to women’s. As my hearing loss progressed, I couldn’t hear the birds singing yet I could still hear low pitched sounds pretty well, such as the sound of a door closing and the bass when listening to music” - Jo

“People started saying that the TV volume was too high and I kept missing the doorbell” - Jim

“As a trainer, I first began to really notice my hearing loss when I couldn’t hear the questions that students were asking me. I found it embarrassing to keep asking them to repeat themselves” - Frances

“As my hearing deteriorated, I felt increasingly left out of the lunchtime chat in the staffroom. Colleagues were often not aware of my disability or forgot and I felt awkward having to keep reminding them. Although I tried to make light of it, inside I was feeling frustrated and demoralised. They were generally too busy to make time to have a one to one chat with me; if only they knew how much it meant to me when they did! Group conversations became almost impossible and I started to avoid social events as it was just too challenging and tiring” - Paul

First step to managing hearing loss

“It took me quite some time to come to terms with the fact that the only way forward was to accept my hearing loss and basically ‘announce to the world’ that yes, I am struggling to hear and yes, I need your help and support if you want me to hear what you are saying, for us to communicate effectively and have a satisfying conversation.” - Sarah

There are many things you can do to manage your hearing loss and minimise the impacts. Following this information programme is a first step on the road to living well with hearing loss – so well done for signing up!

There’s a great deal of evidence that acting early to address hearing loss can help you achieve the best outcome and continue to enjoy life to the full. You may have already seen your GP and been referred to an audiologist for a hearing assessment.

If, however, that’s not the case and you aren’t sure what your next step should be, you could initially try one of the numerous easy ways to have a simple hearing check. Checks are available free online, by telephone, as smartphone apps and some ‘high street’ stores will also offer free initial testing. These sorts of checks can give a useful clue to whether you might have hearing loss, but they won’t give a precise indication of the nature of any loss.

You can find many smartphone apps, such as Hearing Test (Android) or uHear (iPhone), by searching for ‘hearing check’ in your device’s app store. You can find online checks and phone checks through an internet search. Remember these apps may not give you an accurate result, so if they tell you your hearing is fine, but you still have concerns you should go to your GP.

You could try the Action on Hearing Loss free online check, which is also available as a telephone check on 0844 800 3838 – phone charges apply.

If you do one of these tests and the results suggest you might have hearing loss, you should see a GP or audiologist. Even if a check suggests your hearing is normal, you should still see your GP if you are concerned – automated checks are only a guide and are not a substitute for a professional assessment. When you see your GP you can choose whether you want to be seen on the NHS or whether you would rather be seen privately.

Life with hearing loss

Permanent hearing loss of whatever degree can be challenging. However, there are plenty of ways to improve the listening experience and minimise the impact of hearing loss on your everyday life. The following modules explore ways in which you can manage the effects of hearing loss and offer advice and information to help you find any support you may need.