This is what hearing loss looks like.

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The problem with identifying hearing loss is that many people don’t know what they are missing.

One study found that about 24% of people between the ages of 20 and 69 who think they have excellent hearing actually have measurable hearing damage.

To keep track of hearing health, audiologists say people should have hearing tests every year, just like any other regular health checkup.

After a hearing test, you can receive an array called audiogramwhich gives you detailed information about your hearing status in both ears.

Audiograms show how well – or poorly – you hear sounds at different frequencies or pitches, providing a visual representation of how well you hear the world.

The horizontal axis of an audiogram maps the pitches audible to your ears, from low-pitched sounds, shown on the left, to high-pitched sounds, shown on the right.

Water drops a faucet in a sink would represent a low-pitched sound on the left of the graph. A little chirping bird would register as a high-pitched sound on the right.

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The vertical axis on your audiogram shows how loud a sound needs to be for you to hear it well. The sounds at the top of the graph are quiet, while the sounds at the bottom are very loud.

A scream ambulance siren would appear at the bottom of the graph.

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When a person speaks, the frequency and intensity of the sounds they emit are generally within a “U” shape in the center of the audiogram.

The audiogram of an affected person normal hearing might look like this, showing that they can hear soft sounds that are between 0 and 20 decibels.

The blue area shows the frequencies and decibel levels a person can hear. The area above indicates the range of sounds they cannot hear.

Press play to hear how those hard-to-distinguish words sound with normal hearing.

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Two people with the same level of hearing loss can hear the world very differently, depending on which frequencies they have trouble hearing. This animation shows how hearing can go from Ordinary has a benign, moderate Where deep high frequency hearing loss.

Someone with a moderate level of high frequency hearing loss has more trouble with high-frequency sounds, such as “s” Where “e” sounds. Some words may seem less clear to them.

Press play to hear how these hard-to-distinguish words resonate with high-frequency hearing loss.

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Someone with a moderate level of low frequency hearing loss would have the opposite problem – they have trouble hearing low-pitched sounds. Some words may sound nasal or harsh.

Press play to hear how those hard-to-distinguish words sound with low-frequency hearing loss.

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Some people suffer from mid-frequency hearing loss. They might have trouble hearing some speech sounds that fall into this range. It’s called a “bite of cookie” hearing loss and can make words muffled.

Press play to hear the sound of those hard-to-distinguish words with “cookie bite” hearing loss.

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Hearing aids work by amplifying sounds to frequency channelswith the aim of giving wearers the ability to hear a more normal range of sounds.

Once you know your audiogram profile, you can purchase a hearing aid that optimize sound for the specific type of hearing loss you have.

An in-person hearing test with an audiologist gives the most accurate results, said Cleveland Clinic audiologist Sarah A. Sydlowski. An audiologist can also diagnose the source of hearing loss, which in some cases could be repairable, she said. Health insurance does not always cover this service, which usually costs around $100-150.

Another option is to try a hearing center run by hearing care professionals, such as at Costco or Sam’s Club, who often offer a free or discounted hearing test, but may try to persuade people to buy their products afterwards. Hearing aid professionals cannot offer a complete medical or diagnostic examination, but can perform hearing tests for the purpose of fitting hearing aids.

If an in-person or telehealth test isn’t an option, some online tests can give fairly accurate results and could be used as filters, experts say.

Anyone with hearing loss should treat it, experts said. Untreated hearing loss can lead to changes in the brain that make it harder to hear even after receiving hearing aids, said Heidi Hill, an audiologist at the Hearing Health Clinic in Osseo, Minnesota.

“The parts of their brain that process sound slow down and become a bit inactive,” she said.

Research also shows that untreated hearing loss is associated with increased risks of falls, dementia and heart attacks, and has been linked to more hospitalizations, emergency room visits and higher medical bills.

Someone with mild to moderate hearing loss may be able to purchase over-the-counter hearing aids. Here is a guide to help you choose the right one. For people with more severe hearing loss, experts recommend seeing an audiologist, as they will likely need more powerful and complex hearing aids that need to be professionally fitted.

Garland Potts and Ariel Plotnick contributed to this report.

Laura Sinnott, audiologist and device manager at Tuned, a hearing health company, provided audio and guidance for this story.

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