Photo credit: Artem Podrez
by Daniel Fink, MD, Chair, The Quiet Coalition
CNN reports that Apple’s new Airpods Pro 2 will double as a hearing aid. The Food and Drug Administration has approved software that will allow the new generation of Airpods to be used as over-the-counter hearing aids, although that feature is not yet enabled.
For decades, hearing aids could only be obtained from doctors, audiologists or licensed hearing aid dispensers in the U.S. Hearing aids were also very costly. Only about 15% of younger people and a third of those over age 70 with moderate to severe hearing loss had ever used hearing aids. A few years ago, bipartisan legislation was passed that allowed the FDA to authorize the sale of cheaper OTC hearing aids, sold directly to consumers without the need to see a hearing health professional. It took a while for the FDA to issue regulations, but it did so in 2022.
Some thought there would be an immediate boom in sales of the OTC hearing aids, while others were skeptical. I was a skeptic, and remain one, although maybe Apple’s technical and sales prowess will prove me wrong. So why am I a skeptic? First, because there is a stigma surrounding hearing loss. No one wants to admit to having hearing loss, and fewer still want to wear hearing aids. Second, even people who have hearing aids don’t wear them. In the audiology community, this is known as the “hearing aid in the drawer problem.” (Both these reports are old, from the days of analog hearing aids. It’s possible that newer digital hearing aids are used more often, but if this were true, I would expect to see relevant articles in peer-reviewed medical and audiology literature. I have yet to see them.)
More importantly, hearing aids don’t usually work well in noisy environments at helping people understand conversation, which is what those with hearing loss need. Hearing aids amplify all sounds, not just what the person at the other side of the table is saying. The newer digital hearing aids, with directionality and frequency band adjustment features, are advertised to function better in noisy environments, but I haven’t seen any articles documenting this.
Finally, the few audiologists I have spoken with told me there it is as much an art as it is a science to fit the right hearing aid to the right patient. Then, it takes weeks to months for most users to learn how best to use their hearing aids. There are articles in medical literature documenting equal success from self-fitted or audiologist-fitted hearing aids, but I’m skeptical. In real-world clinical situations rather than research studies, success rates of many treatments don’t reach reported levels.
Maybe Apple will be successful with its Airpods Pro 2 hearing aids. Certainly there’s no stigma in walking around wearing an earbud, so that problem is eliminated. Maybe Apple’s software will enable the Airpods to work better than other OTC hearing aids. As I often write, only time will tell.
