Masks have been a mainstay of public health advice to prevent the spread of the coronavirus. But they also provided an unfortunate revelation to some – that they relied on lip reading to compensate for unrecognized hearing loss.
“Everyone lip reads, even people with normal hearing,” said Meredith Duffy, Au.D., a MUSC Santé audiologist.
For example, in a noisy, crowded environment like a restaurant, our brain uses lip reading to “fill in the blanks” and determine if a friend said she was “sad” (lips parted and teeth visible by making the “s “) Or” mad “(lips closed against each other while making the” m “) about a situation.
But Duffy saw a marked increase in the number of people coming because they realized that with so many people wearing masks, they can’t hear as well as they thought they could.
Hearing loss is common as people get older, especially when they reach their 60s. The typical age-related hearing loss called presbycusis affects the high frequency range of hearing that provides clarity of speech.
Duffy said that studies have shown that masks muffle higher frequencies – 3 to 4 decibels for medical masks and up to 12 decibels for N-95 masks.
“This is important when a person has hearing loss and the intelligibility of their speech is already affected,” she said.
Lindy Brennan started wearing a hearing aid several years ago due to a birth problem, so she was aware of her hearing loss before the pandemic. But hearing aids aren’t a perfect replacement for natural hearing, and masks have definitely made life more difficult, she said.
“Very frustrating,” she said. “I didn’t realize how well I lip read, even with the hearing aid, until the masks.”
“It’s just tiring trying to hear what people are saying and having to ask them to repeat it, so it’s not fun,” she said.
Hannah Burrick, Au.D., noted that two hearing aid manufacturers responded to the problem by adding a “mask mode” to the settings menu that hearing aid users can switch between. Mask mode increases the volume of high frequencies to compensate for the way masks muffle these sounds.
While simple aging can lead to hearing loss, excessive noise is also a factor. In fact, the Centers for Disaster Control and Prevention reports that 40 million Americans between the ages of 20 and 69 suffer from noise-related hearing loss – and 24% of people in that age group who report having “excellent hearing” actually have measurable hearing damage.
Brennan was seeing Duffy for a new hearing aid. After carrying the aids for several years, she describes them as lifeguards. Other patients, however, don’t necessarily embrace hearing aids right away, Duffy said. The average patient waits seven years before seeking help for hearing loss, and even if they suspect hearing loss, they may not be ready to accept that they need help. However, surveys of people with hearing loss indicate that people with hearing aids report much higher satisfaction with their ability to hear in a variety of situations that people without hearing aids report.
Duffy said people who suspect hearing loss will get a full hearing test first, usually after a recommendation from their doctor. If they are hearing aid candidates, they can schedule a free hearing aid consultation where they are advised on all available options. If the patient decides to use hearing aids, they will be ordered and at the fitting appointment they will be programmed for each ear individually and in steps. The patient will then have 60 days to try the hearing aids, she said.
But with or without hearing aids, there are things we can all do to make ourselves more intelligible through masks, she said: Speak up. Speak more slowly. Face the person you are talking to. And have patience.