Ask HN: Hearing aid wearers, what's hot?

Here's a crazy idea. I personally prefer the fidelity of an active ambient in-ear monitor (IEM), as used by musicians on stage over the best hearing aids. Once a year, I do a monthly trial with the latest hearing aid models and IMO the fidelity (especially low-end) and the comfort just is not there compared with the best active ambient IEMs. The difference between hearing aids and IEMs is blurring, but they are not yet fully interchangeable.

Standard IEMs isolate you from the world, which is the opposite of what a hearing aid does. However, a specific category called "Active Ambient" IEMs bridges this gap. These are IEMs with embedded high-fidelity microphones on the outer shell. They pick up the sound of the room (bandmates, crowd, conductor), amplify it, and blend it with your monitor mix. The accompanying bodypack or app often includes a multi-band EQ and Limiter. You can boost specific frequencies where you have hearing loss (e.g., boosting highs to hear cymbals or speech clearly) and set a volume ceiling to protect your remaining hearing. I have no ownership/sponsorship in the product, but I personally LOVE the ASI Audio 3DME (powered by Sensaphonics), which is the industry standard for this. [1] It allows you to use an app to shape the ambient sound to your hearing needs.

The Pros: It provides hearing protection + monitoring + hearing enhancement in one device.

The Cons (Why they aren't daily hearing aids):

1) Form Factor: You are tethered to a belt pack. You likely won't wear a wired bodypack to a grocery store or dinner party.

2) Social Barrier: Wearing full-shell custom IEMs creates a "do not disturb" look that discourages conversation in social settings. This can be more socially alienating than a comparatively inconspicuous hearing aid.

3) Battery Life: IEM systems typically last 6–8 hours, whereas hearing aid batteries can last days or weeks.

[1] https://www.sensaphonics.com/products/3dme-custom-tour-gen2-...

I have the same problem (took 35 years to find out), and hearing aids with directional microphones might work. I don’t say they will, but it is worth to try it.

I'll tell you what's not hot: cochlear implants. I wore hearing aids since the late '80s. I wear CIs as of about 5 years ago, and while my hearing is much better and stable than it used to be, I've found that UX for CIs is pretty bad.

For one, unless you use Med-El's Rondo processeor, you're going to have a thin cable connecting your processor to the coil. Taking off your CIs and putting them back on (as one does every day) is going to put stress on the cable. Sometimes the cable frays and you find that out with sound cutting in and out. There's nothing you can do until the manufacturer sends you a replacement cable in exchange for your frayed one. If you want a backup, be ready to shell out $250 for each cable.

Another UX issue is that processors depend on gravity to stay on your ears. Since there's no earmold to anchor to, processors can easily be jostled off and left hanging precariously. Wearing hearing aids, I never had to worry that my hearing devices would fall off if I rode my bike on a bumpy road. Also with cochlear implants, high-intensity interval training requires some kind of hat or bandana to make sure that the processors don't fly out.

Battery life is another disappointment. Rechargeable batteries don't last a full day. If I put them in at 6:30a, they'll last until about 4:30p. With disposable zinc air batteries, I can squeeze out about a day and a half, but then I'm having to dispose batteries. And while I can track processor battery levels with the rechargeable batteries on my phone, disposable batteries are opaque to the app.

One new thing that would be useful in terms of UX would be an configurable indicator, e.g., a blinking LED, signaling that audio streaming is occurring. It's awkward to find oneself in a conversation that already started and having to excuse oneself to turn off the stream.

Don't get me wrong, I'm glad I have my cochlear implants, but they're way behind hearing aids in terms of UX.

I know one person at work with CIs and yea, I imagine it's a challenge.

UX for a lot of assistive technology is iffy at best. Repeating some of the comments others have made, I'd love it if Apple would make a full on hearing aid that "just worked". Or someone would do a good AI integration that could notify you of things you probably should focus on - like someone trying to get your attention, or emergency vehicle sirens, etc.

Marketing too. But it's nice to see some vendors starting to actually make their devices visible and fun. HAs are a bit like glasses ages ago, when it was kind of this shame thing to get teased about when you were 8 years old. Selling them as "discrete" and with colors designed to match your skin or your hair is just continuing that perception of them being something you should hide.

I have severe hearing loss in my right ear and no to mild hearing loss in the left. AirPods Pro 2 make it so that I feel like I can hear in stereo while streaming without resorting to setting the balance 90% right and jacking the volume. In that respect I love them. However, they are designed only for moderate loss so they will not amplify the right ear sufficiently to hear well in that ear unless the left ear is uncomfortably loud.

For me, I need a real hearing aid to hear a person that is at my right shoulder.

If both ears are about the same, I think the hearing aid volume (separate slider from general volume) could be adjusted to get past the “designed for moderate loss” limitation.