Can AirPods Work as Hearing Aids? An Audiologist Explains

Unless you've been living under a rock, you've heard of AI. Maybe you've used it. Maybe you've done a few prompts. But have you thought about how AI is going to interact with hearing and your hearing health? So I'm excited today. We're going to talk all things AirPods and AI today with Dr. Mandy Rounseville-Norgaard. She is the owner of Sioux Falls Audiology Associates. And we're going to be talking all things AI and AirPods.

Health and wellness is confusing. There's a new trend every week. Everyone's got an opinion. And half the time, you can't tell what's legit and what's just good marketing. And we get it. We're in it too. Welcome to Dialed In Health. I'm Melissa Goodwin. Every episode, we bring in the people who actually do this work, providers, practitioners, the experts who see clients and patients every day. We ask the questions you'd ask if you were sitting across from them so you can find the right people, make better decisions, and feel confident about what's out there, whether it's peptides, gut health, water quality, ADHD, biohacking, or something you've never heard of, we're covering it. So let's get into it. Let's get Dialed In.

Thank you again for being on the show. It's always exciting to learn all the things that are in your brain and all of your experience. So thanks again for being on Dialed In Health. Yeah, it's fun to be here.

So we are today going to be focusing a lot on AirPods. I've never thought, we walk through the airport, you see people with the AirPods in. I just think of it as blocking things out. So this is exciting to hear about how they might be used differently. So tell us a little bit about AirPods. Can they actually be used as hearing aids?

I would say if you're going to utilize them as hearing aids, you're probably going to be in the beginning stages of hearing loss. Because they only will put out about 25, at most, 25 decibels of sound, which is not that much sound. It might be like me raising my voice a little bit type of volume. But you can only really convert it unless you have AirPods 2s or 3 generations. You have to have iOS 18. So you've got to be a little technically savvy if you're going to try to turn those things into little hearing aids.

OK, so are they more like, I know in the first episode, we talked a little bit about how if you were to buy a hearing aid maybe over the counter somewhere, it's more of an amplifier versus actually a hearing aid that you can dial in. Is this the same kind of concept?

Well, I'm not sure because I've never done it to myself. Because 25 decibels of volume to me would be nothing. I would need a lot more. But from what I've been understanding is you can actually get a hearing test somewhere, import it into an app, and then go do your back end stuff on your settings on your iPhone, because it's only iPhone. And it will, to a degree, configure that 25 decibels volume for the hearing loss. But again, it's going to be with those hearing losses where you just have that mild beginning stages. I don't know how well it would perform in background noise. I just think it's going to give you just a little bit of volume to notice a difference. Maybe temporarily hold you through until you bite the bullet.

So who would be a good candidate for something? You mentioned 25 decibels might not be enough for what you would need. Who is somebody that maybe 25 decibels would make a difference?

Maybe somebody that has a 30 to 35 decibel hearing loss. But no more than that, probably.

So early stage, maybe in your 50s, 60s?

No, it just depends. I would get a hearing test because a 50-year-old male may not have the same loss as a 50-year-old female. Maybe that 50-year-old male has a loud occupation. You know what I mean? So it's hard to gauge.

So I'm curious. I always thought of those things as maybe even being detrimental to your hearing. You walk around with an AirPod in all the time. And how would that, especially if the ringer goes off or something, how will that adjust the volume for those kinds of things?

It won't. So what I'm guessing is these people are wearing AirPods as Bluetooth devices to talk on their phones and listen to their music. And kind of the rule of thumb with any sort of hearing headphone type thing is if other people can hear it around you, it's too loud.

Right. So my kids definitely have theirs on too loud. I could hear them in the car. All right. So are they actually FDA cleared as a hearing aid?

Not yet. Not that I know of, yeah.

So currently, it's more of a hack. Do you see this actually moving to a clinical device?

No. I don't think Apple is in the market to compete with the major brands of hearing aids.

So what is the real difference between an AirPod and maybe an early stage hearing aid that you would get from an audiologist?

It's probably going to amplify more of what you don't need to hear than what a prescriptive hearing aid would, where we can hone in on what you don't need and what you need and how much. That's going to be the difference. I don't know if there's a guarantee that if your hearing is normal to a degree, that that AirPod isn't going to give you amplification where you don't need it. So then you might hear more background noise than what you want to hear.

Got it. So it's almost like the other over-the-counter hearing aids where it's just amplifying everything.

Probably. Yeah.

Do you see, from your experience, people who are in the early stages of hearing loss, that there is a lot of nuance in what they need and don't need, or is it pretty common to just need an amplifier type device early stage?

I would say it's more of a prescriptive hearing aid, because beginning stages of hearing loss is still so variable when you look at different degrees, and where is it in that frequency range?

And when you see people come in with early stage, somebody who might be using their AirPod as an early stage device, what do they typically say? Like, I just need it a little bit louder?

Yeah, I just need it a little bit louder, or just a little bit clearer.

Looking for a little boost. Got it. And I feel that. I'm going to be reminded to get my ears checked. It's almost like readers. You just need a little something when you're in the beginning stages of getting reading glasses.

Yeah, that's the danger zone.

All right. If somebody out there is curious, how do I turn on that feature on my AirPods? Would you tell them?

Oh, there's a lot of steps. Honestly, it's in your accessibility, in your settings. I don't even have it memorized. You can Google it, and it'll tell you exactly what to do. But you might need to have some patience, and maybe a cocktail or something nearby. You need to be somewhat technically savvy, because you also need to get a hearing test. You need to upload it somehow into the app that they recommend in order for it to communicate with the settings of the iPhone. It's pretty sophisticated.

So if you're getting a hearing test anyway, why wouldn't you get an actual hearing aid?

You would think. Yeah, that would make sense. I would say the number one reason people who have a stigma of hearing aids, they're expensive. That's probably why they're going that AirPod route.

And well, the AirPods aren't cheap either, especially when you lose them and buy them over and over again.

True, yeah.

So you think it's the stigma of like, oh, I can wear an AirPod instead of a hearing aid, and I look cooler.

They go down to cost right away. And then your stigma after that.

Can they actually make it worse over time if you decide to hack into it, and you're wearing your AirPods around, and it's amplifying everything. Can it actually make it worse?

I don't think so. Maybe when you're streaming. If you're blaring your music streaming Bluetooth, I feel like that could make it worse more than that, because that 25 decibels isn't hot. When you're turning it into hearing aid mode. Unless, I suppose, you expose yourself to really loud noises and you have that 25 decibels going in, you could cause more hearing loss.

Sure. Or if it's not nuanced enough for the frequencies that you need potentially.

Right. You may not even notice a difference. If you turn it into a hearing aid and you're not noticing a difference, your hearing must be worse than what you thought.

So if you're out there and you have all of the technology steps outlined, and you've turned it on, and you're like, this doesn't really work, you might need to make a visit.

Yeah.

So what are some of the first signs, since we're talking early stage? And I know last time we talked, you mentioned it makes all the difference in getting a proper hearing aid early stage, because now your brain can adjust. What are those key signs that we should be aware of?

Probably the TV goes up. I hear spouses say the TV goes up. Hearing in background noise, going to a restaurant, you're saying what, what. At night, you might start noticing ringing, tinnitus, in your ears. Those are probably the top three signs of hearing loss.

And there's hearing loss, and then I actually need a hearing aid. What does that continuum look like?

Well, you can acknowledge that you might have some hearing loss, but mentally, are you ready for hearing aids? Are you ready to fix it? Kind of like readers. You know you're struggling to read. You're kind of doing this, but are you going to give in and go buy a pair of over-the-counter readers or go to the eye doctor? So it's one of those things that you might be aware of it, but you've got to be ready to do something about it to be successful.

So if voices are sounding muffled in restaurants or things like that, and I feel fine when I'm at home, is that another sign that we might need some help?

Yeah, you don't struggle as much when there's no background noise, but you struggle when there is background noise. So then I help people at that point. How much noise are you in? How often are you in it? Is it bothering you? It typically bothers family members before it bothers the person. Because you keep asking what?

And so if restaurants, I would assume airports, anywhere where there's a large hum of background noise is where you would notice it.

Or multiple conversations. People kind of talking over each other.

Now we're going to talk about AI. So tell me about what is happening in the world of audiology and AI? What are some of the key things that we should all be aware of?

So I think with AI, it could be fairly broad in the hearing aid world. I can say that all the manufacturers are in agreement with AI when it comes to DNN technology, which is Deep Neural Network. So what they're doing is they're taking AI, and they're trying to mimic how the brain receives and interprets sounds. And it's all in the processing of the computer chip to mimic the brain's activity. So that's kind of the new thing with AI. What you're going to hear is that DNN, Deep Neural Network. That computer chip has that Deep Neural Network technology to really process speech and noise, which is what everybody complains about with hearing loss, no matter what kind of hearing loss you have, to be able to understand speech.

So break that down for those of us that maybe heard DNN for the first time. What is it actually doing, and how is it making the hearing aid or your hearing better?

It is processing the speech signal and the noise signal a trillion times per second. And then releasing that so your brain can interpret it.

So it's just actually boiled down to the speed of the processor. OK, so faster, more data points.

And more precise.

So those manufacturers, are these out right now, or is it coming?

No, it's out.

So if you were to buy a brand new hearing aid tomorrow, it will likely have AI built into it?

If you get a top of the line hearing aid, it's going to have AI in it.

And I think people assume AI means people are following you or people are tracking you, and it's not that AI.

The other side of the AI with hearing aids beside the Deep Neural Network processor is the app. So a lot of these manufacturers now have fall detection. So you can set up the app with the hearing aid. So if your loved one falls, you can set it up to send people alerts. Like, hey, so-and-so fell, that means you can check on them. You don't have to wear the necklace anymore. As long as they're wearing their hearing aids, they have to be wearing their hearing aids. The other one is one manufacturer does respiratory rate. So it's detecting how many breaths you take, maybe for pulmonary issues. What I perceive happening is hearing aids will now be able to detect blood sugar levels for diabetics. I see that coming.

How would that work?

It's just your ear is a sensitive spot. And it can sense things. They have the sensors here for the diabetics. It's probably more sensitive in the ear to have something like that. So I mean, when we're talking about AI, that's the stuff that we're talking about in that form. So we have our neural processing in the computer chip, and then we have the stuff in the app. You can also track your steps, your miles, just like a Fitbit.

What about on the personalization side? Can AI help make your personal hearing aid work better for you?

Oh yeah. And you can personalize other programs if you feel like when it's in automatic mode, it might not be enough. So you can definitely personalize based on your activity. I know we've got some people that play pickleball, and they've created their own programs in their apps specifically for that sport.

So you wear hearing aids yourself. Have you tested all these different AI models? And tell us about what you've found, or what have you noticed?

I think my listening effort is not as much, because it's processing so my brain can interpret it much easier. So it's not this, you're still saying what, and you're still doing all that stuff. But again, your best outcome is early detection, early intervention, no matter what kind of AI you have.

You said something I'm not familiar with, listening effort. And as you said that, I was like, wow, I have not thought about that before. But if you have a hearing aid that maybe isn't working well, that strain, you wouldn't think of it maybe to listen, but over time, how exhausting that would be.

It can be exhausting.

So how do you measure that?

So like today, we had someone. She had a significant drop in her hearing. She got the hearing aids elsewhere. And she said, it's to the point where I can't even communicate with my son on FaceTime. And I had to cut the phone call short, and I'm so frustrated. She's still a very active woman. Still works. And she had her hearing aids reprogrammed based on her drop. And I said, you are not getting the prescription that you need. No wonder your listening effort is horrible and you're frustrated. You need a stronger computer chip, and we need to do speech mapping to make sure that you're hitting all of your prescriptive targets. And we've kind of talked about the speech mapping before. So when I know that I've done all that, I know that I've maximized what those hearing aids can do. And that's with any hearing aid. And that is going to reduce your listening effort.

So I would imagine that if you just get something that amplifies, or something that isn't doing the sampling like AI is doing, that obviously makes it a lot harder for you to hear anything. You're having to work harder and strain harder to listen and understand. Tell us now when you say you've tested a bunch of these. What is a feature that surprised you?

I think what surprised me is the manufacturers that had last year's hearing aid chip and you compare it to the DNN AI stuff, the huge jump and the wow effect of people saying, these are so much better. Even though they're one generation to the next generation, it's just a huge jump. So my curiosity is, so what's next you're going to bring? So we went from here to here with this satisfaction and this wow effect. Now the bar is set here. Where are we going to go from here? So I'm curious to see what the future brings that way.

Have you had any teasers that they've given you, like we're working on this or watch for this?

Nothing. Because they already teased what they just brought out.

All right. So sometimes we talk about sometimes the juice isn't worth the squeeze. When you think about price point and all the bells and whistles in a very high end model, is the price worth it on some of these really high end AI?

It is worth it when you find a provider that's doing the gold standard of care. You can have this high end hearing aid, your provider isn't verifying, doing speech mapping, getting the correct prescription. That high end hearing aid isn't going to function the way you need it to. So you really need to find somebody that's doing the gold standard of getting the right prescription and doing speech mapping, real ear measurements, verifying their fittings.

In some areas of business where I've seen, not necessarily in your space, but there's a lot of AI hype and sometimes the execution doesn't always match the promise. Do you see that in any space here yet, where everyone's promising a lot of things, but it's just not quite there yet?

I think you can avoid those promises as long as you're doing everything that you're supposed to do as a provider to maximize those hearing aids. And there's a lot of counseling and expectation conversations that go with it. No hearing aid's ever going to replace the natural hair cells that we had that controlled soft speech conversations and loud speech. But it sure is much better to have a hearing aid than to not have a hearing aid.

That makes sense. So how would you explain to the layperson, if you were in the line at the post office, and they find out that you're an audiologist? And they're like, well, I think I'm just going to use my AirPods. Or my son said I can use my AirPods. How would you explain the difference to that person?

Well, I can say it might work for a while. And you might get that wow effect for a while. But over time, you'll realize you need something more. It's a place to start. If you're not quite ready to just go full force and see an audiologist or a hearing care professional. If you're still in denial, you can wear the AirPods. Or I can get by. I'll just get by for a while.

How long does that phase usually last?

A year. A year until you need a real test and get that taken care of. But I really commend people that actually try to do something, instead of avoiding it altogether.

That makes sense. Anything else that you would want people to know about the AirPods and using those for hearing aids? Anything that you would want people to think about before picking those up?

If you're already to the point of, I know I need something, but I'm not ready. I would say just go get a baseline hearing test somewhere and look at your options. Instead of just jumping to the less expensive, and it's not necessarily the easiest to convert your AirPods. But yeah, just go get your options. I always say look into it. Don't feel like you have to make a decision at that point, but just get the information.

And I have family members who've said like, oh, my uncle or my friend went, they never work. I'm not going to spend all that money on hearing aids because they just don't work. What would you say, especially now with the AI capabilities and the ability to sample more so it's more accurate, what would you say to those folks?

I mean, we hear that all the time. But my answer is there are so many factors that go into that dissatisfaction. Could be the severity of the loss. I mean, the expectation. We don't know that without looking at a hearing test. It could be where you went. Are we selling more amplifier type devices versus prescription hearing aids? Are they doing their real ear measurements? I mean, there's just so many things that you can't generalize it.

OK, so tell us. I know you probably can't pick favorites. Is there a model that you're really excited about that's coming out soon?

So right now, I would say the top two that we are seeing is the Oticon Zeal. And I think a lot of it is the way it looks. It's another alternative for people that don't want something over their ear. And then the over the ear is definitely the Starkey Omega. Those are the top two.

Because they work better?

Yeah, just because of the DNN, the features in there, and just the way it sounds. Because I feel like those two manufacturers really hit the nail on the head when it came to AI and performance. And we'll see. It's like doubling every minute, it feels like. So next year, who knows what will be out? And they're not one manufacturer that fits all. So I always tell people, these are our two that we see the most satisfaction. But that doesn't mean it's the one for you. So I always tell them, find a provider that's willing to work with you. Try this brand. And then if you're not completely satisfied, let's try another one. You should be able to have that option.

So if someone is now listening to this, and they're like, OK, I think I want to check this out. Where do they find you?

Well, you can find us on Google. You can find us on Facebook, TikTok. There's several ways to get a hold of us.

And what should they Google or type into TikTok?

They can type in Sioux Falls Audiology. And you can find us all over.

Easy. Dr. Mandy. All right, well, thank you. We'll make sure to put those in the show notes, too. We'll have those links in the description. So make sure that if you're watching on YouTube, click that description to get those links and connect with Mandy and her team. Thank you so much.

Yeah, thank you.

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