Tired and sluggish at the end of the day? Hearing aids might be the answer

Our well-being is directly related to our ability to engage fully in our daily activities.¹ This includes communicating readily and easily and having enough energy to sustain all activities throughout the day.

It is well known that unaddressed hearing loss can significantly impact much more than audibility. Effortful listening means we have less energy to spend on other activities and often leads to feelings of exhaustion and fatigue, which can have a negative impact on quality of life.²

Fatigue, a difficult concept to measure

One person’s perception of fatigue can be different from another due to it being a multi-dimensional construct. Albeit difficult to measure and define, studies have developed indirect measures of listening effort and fatigue to understand the impact of hearing loss on fatigue and the impact of amplification of reducing fatigue.

This includes subjective measures such as self-report and objective measures such as reaction time, performance on dual-task paradigms, EEG (electroencephalography measures), cortisol measures, and pupillometry.

Unsurprisingly, previous research has found that, when unaided, hearing loss leads to greater mental exertion and fatigue compared to those who are aided.^3-5 While previous studies have shown the beneficial impact of hearing aids on listening fatigue, the test paradigms do not accurately reflect the everyday listening situations those with hearing loss experience.

Phonak’s research team sought to examine the relationship between listening effort and listening-related fatigue further with paradigms more reflective of everyday life.

So how did we do this?

Briefly, 20 participants with hearing loss took part in a Time-Compressed-Acoustic-Day (TCAD) that consisted of five different acoustical scenarios were combined with four different listening test paradigms.

This acoustically compressed day is an ecologically valid test sequence described as a sequence of listening experiments that emulate challenging hearing situations experienced in daily life for those with hearing loss. Participants experienced the TCAD twice – with and without amplification. During the TCAD the participants were required to undertake subjective and objective measures of listening effort (measured through concentration) and listening-related fatigue.

Various measures were taken multiple stages of the ‘day’ and following different listening tasks. A TV connector was also used in certain test environments to determine the benefit of tools that support listening in the far field.

What did we find?

Naturally, concentration and fatigue increased in both groups (aided and unaided) throughout the day. However, concentration and fatigue ratings were significantly lower in the aided conditions by the end of the day. Further, reaction time was considerably faster and more accurate when hearing aids and a TV connector were being used to stream signal from a TV versus the unaided condition.

Plus, subjects who were unaided also had greater levels of fatigue. Meeting far-field need through solutions such as Roger™ to reduce listening fatigue is well documented in the literature, particularly for children.^6,7  And it would follow that this also supports adults in the same way (i.e. improving SNR in challenging listening environments – read more about Roger benefits here).

Thus, it is no surprise that using additional technology to support listening helps in reducing fatigue related to hearing loss. You can read the full results here.

Summary

• Hearing aids can reduce listening effort and fatigue. This has significant implications for overall well-being.
• Addressing far-field needs is an important consideration as it can have a positive impact, such as decreasing cognitive load, particularly in challenging listening environments such as in noise and over distance.
• Reduced listening effort and fatigue through amplification is part of an overarching goal of improving well-being through hearing well.
• Measures of listening effort and fatigue could, in future, be considered in context of the wider benefits of amplification beyond improving audibility.

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References

1. Whicker, J.J., Ong, C. W., Muñoz, K., & Twohig, M.P. (2020). The relationship between psychological processes and indices of well-being among adults with hearing loss. American Journal of Audiology. 29(4): 728–737.
2. Kramer, S. E., Kapteyn, T. S., Houtgast, T. (2006). Occupational performance: Comparing normally-hearing and hearing-impaired employees using the Amsterdam Checklist for Hearing and Work. Int J Audiol, 45, 503–512.
3. DeLuca, J. (2005). Fatigue, cognition, and mental effort. Fatigue as a window to the brain, 37.
4. Holman, J.A., Drummond, A., & Naylor, G. (2021). Hearing aids reduce daily-life fatigue and increase social activity: a longitudinal study. Trends in Hearing, 25.
5. Hornsby, B.W.Y. (2013). The effects of hearing aid use on listening effort and mental fatigue associated with sustained speech processing demands. Ear and Hearing 34(5): 523-534.
6. Davis, H., et al. (2021). Listening-related fatigue in children with hearing loss: Perspectives of children, parents, and school professionals. American Journal of Audiology 30.4: 929-940.
7. Gabova, K. et al. (2022). Parents’ experiences of remote microphone systems for children with hearing loss. Disability and rehabilitation. Assistive technology, 1-10.