Early Stages of Hearing Loss Are Very Subtle

When you think of hearing loss, what image comes to mind? A common image of hearing loss is someone cupping their hand around their ear and leaning in to hear better.

But by the time someone needs to do that, their hearing loss has been growing for quite a while. Hearing loss, it turns out, is pretty sneaky. In fact, hearing loss doesn’t sound like, well, hearing loss.

To understand why, let’s review how hearing works.

Hearing Basics

A lot must happen behind the scenes for you to hear something. Your ears, nerves, and brain work together in a complex process. Take a look:

Sound waves enter your outer ear, travel down your ear canal, and cause your eardrum to vibrate.
Your eardrum vibrations are picked up by the three smallest bones in your body, amplified, and transferred to your inner ear.
The vibrations become waves in a fluid-filled cavity and jostle tiny ribbon-like hearing cells, called hair cells.
The hair cells convert the wave information into nerve impulses, which your auditory nerve carries to the sound-processing part of your brain.
Your brain does a lot behind the scenes: It pinpoints where the sound came from, focuses on it, separates out background noise, tries to recognize the sound, and identifies whether it’s speech, music, etc.

A lot happens during the hearing process! It happens all day, every day, effortlessly — unless something keeps one of the above steps from happening.

Hearing Loss Basics

Many things can cause hearing loss, such as earwax buildup, illness, or damage to your auditory nerve. But to set the stage for what’s to come, let’s consider one specific cause.

The hair cells mentioned above number in the thousands. Aging and loud sounds can damage or destroy them. That damage can’t be repaired.

When you lose hair cells, less sound information gets sent to your brain. When enough hair cells die, you start to notice hearing loss.

Two of the most common types — age-related hearing loss and noise-induced hearing loss — are examples of high-frequency hearing loss

In this type, the hair cells that get damaged or destroyed first are responsible for sounds with a high frequency, like the notes on the right side of a piano. Another way to describe them is high-pitched sounds.

Subtle Signs of Hearing Loss

Not hearing high-pitched voices as well

Women and children have higher-pitched voices than men, so someone with high-frequency hearing loss will have issues hearing those voices first.

Because the hearing problems start with specific women and children — the ones with the highest voices — it’s easy to dismiss: “She’s mumbling” or “Why won’t my grandson speak up?”

Even later, when the communication challenges involve more and more women and children, it’s easy to dismiss because you hear men just fine: “I hear my boss loud and clear” or “I never have trouble hearing my dad on video calls.”

Misunderstanding others more often

When you speak, sounds like “oh” and ah” — the vowels — give your speech volume. These are low-pitched.

The sounds created by letters such as S, K, and P — the consonants — help you tell words apart. These are high pitched.

Let’s look a little closer at that idea:

When you hear the words “bay” and “boy,” you know right away you’ve heard two different words. The “ay” of “bay” rings out clearly. Same with the “oy” of “boy.” That’s because the words are different in the low pitches, where the volume is.

Now, assume you are developing high-frequency hearing loss, and your spouse asks from another room, “Where’s my cup?” But you mishear the hard C — a high-pitched sound — as P, also a high-pitched sound. You hear, “Where’s my pup?” and respond, “We don’t have any pets.”

You heard them just fine. The volume was good enough for you to hear each word. But you didn’t understand what was said, because one consonant — the sound at the beginning of the word — wasn’t clear.

High-frequency hearing loss, especially in the early stages, is characterized by a lack of clarity. It’s easy to think the problem lies with whoever is speaking to you.

Hearing fewer high-pitched sounds

This sign is exceptionally subtle. It’s about what you’re not hearing.

High-pitched sounds are all around you, and it’s easy to get used to noises you hear often. You might not notice that you don’t notice them anymore.

But if you like walking outside, perk your ears up. In spring and summer, do the birds seem quieter than you remember? Does the hum of your fan seem less noticeable? In autumn, do the leaves seem less crunchy?

These are all high-frequency sounds that might disappear or fade into the background early on in hearing loss. The same is true of doors creaking and kittens meowing.

Having a hard time pinpointing sound sources

Remember: Your ears and brain work together. When sound information reaches your brain, it must process it.

Hearing loss, however, gives your brain less sound information to work with, so it has a harder time doing its job. One thing that slips — identifying where a sound came from.

That might not seem like a huge deal, but what if someone in your household was injured and calling out? What if there was a knock at the door, but you thought it was the dog bumping into a cabinet because of where it seemed to be coming from?

Holding a conversation amid background noise

Your brain can take in all that sound data and separate out the noises you don’t need to focus on.

But, as with pinpointing sound sources, hearing loss gives your brain less to work with. It has a much harder time determining what you want to focus on when the sound input is not clear or seems incomplete.

It’s subtle because it’s location-specific. You can hear your friend very well when you’re standing outside a restaurant, but seated at the table, straining to hear them, it’s easy to blame it on the other patrons — not high-frequency hearing loss.

Tinnitus, or ringing in the ears

This might be surprising. If anything, shouldn’t tinnitus show that you can hear too well? And how could anyone even tell if they have hearing loss with all that ringing, buzzing, or whooshing going on?

Unfortunately, though we know a lot about tinnitus, there’s also a lot we don’t know. But the data supports it — of those with tinnitus, around 90% also have hearing loss.

With a statistic like that, it just makes sense for anyone with tinnitus to get a hearing checkup.

High-Frequency Hearing Loss Is Treatable

Luckily, high-frequency hearing loss can be treated. Today’s advanced processors can amplify only the frequencies you need at the volumes you require.

If any of the above describes what you or a loved one has been experiencing lately, contact us today to book an appointment with our board certified doctors of audiology!

Hearing Loss Doesn’t Sound Like Hearing Loss