Wearing earbuds while using hearing aids is possible, but success depends heavily on the specific devices involved. Hearing aids amplify sound, while earbuds deliver audio directly into the ear canal. The physical fit and acoustic interaction determine if dual use is comfortable and effective. Increasingly, new technologies allow the hearing aid itself to function as the sole audio device, eliminating the need for separate earbuds.
Physical Compatibility of Devices
The primary challenge in wearing both devices is managing the physical space and fit within and around the ear. Hearing aids are categorized by placement: Behind-The-Ear (BTE), In-The-Ear (ITE), and Completely-In-Canal (CIC) or In-The-Canal (ITC) styles. These different forms interact differently with common earbud and headphone designs.
Completely-In-Canal (CIC) and In-The-Canal (ITC) hearing aids fit mostly or entirely inside the ear canal. They offer the best physical compatibility with traditional earbuds or over-the-ear headphones. Since these aids are deep within the ear, an earbud can sometimes be comfortably seated in the outer ear, or a headphone cup can fit over the entire ear without interference. However, adding an earbud can still cause discomfort by crowding the ear canal.
Behind-The-Ear (BTE) and Receiver-In-Canal (RIC) models, which have a component resting behind the ear, present the greatest physical challenge for earbuds. The shell or the wire/tube connecting to the ear canal can be easily dislodged or pinched by the pressure of an earbud or glasses arm. Over-the-ear headphones are typically the most suitable option for BTE users. The large cup can completely encompass the outer ear and the hearing aid without direct pressure.
Trying to force a standard earbud, such as an AirPod, into an ear occupied by a BTE or RIC aid is often physically impossible or uncomfortable. The interference can cause the hearing aid to shift, affecting its acoustic performance and seal. Users of any hearing aid style should prioritize comfort and ensure the earbud does not create excessive pressure, which can become painful during extended use.
Overcoming Acoustic Challenges
Beyond physical fit, using both devices simultaneously introduces significant acoustic hurdles, primarily the risk of acoustic feedback. Feedback is the high-pitched whistling sound that occurs when amplified sound leaks out of the ear and is picked up again by the hearing aid’s microphone. When an earbud or headphone is placed over the ear, it can push the hearing aid slightly, breaking the seal and allowing sound to leak out.
The volume settings of both devices must be carefully managed to prevent over-amplification. Hearing aids already amplify incoming sound, and adding earbud volume can stack the amplification, potentially exposing the ear to high decibel levels. To protect residual hearing, users should keep the earbud volume low to moderate, generally below 85 decibels.
A practical solution to minimize feedback and volume issues is adjusting the hearing aid’s program settings. Many modern hearing aids include a specific “music” or “media” program that reduces the overall gain or modifies the frequency response. This accommodates the close proximity of an external speaker. If feedback persists, using a high-quality, over-ear headphone that creates a good seal can prevent sound leakage. Alternatively, an audiologist can fine-tune the hearing aid’s feedback suppression settings.
Hearing Aids as Wireless Headphones
The most effective solution for many users is bypassing the need for separate earbuds by using the hearing aid itself as the audio receiver. Modern hearing aids frequently incorporate Bluetooth technology, allowing for direct audio streaming from compatible devices. This direct streaming eliminates the physical and acoustic problems of dual device use, delivering sound directly into the hearing aid’s processor and speaker.
Two major protocols facilitate this wireless connection: Made For iPhone (MFi) and Audio Streaming for Hearing Aids (ASHA). MFi enables direct connectivity between the hearing aid and Apple devices, such as iPhones and iPads. The ASHA protocol, built on Bluetooth Low Energy (BLE) Audio Transport, allows direct streaming from compatible Android phones. Both technologies are energy-efficient, minimizing battery drain on the small hearing aid devices.
For users with hearing aids that are not directly Bluetooth-compatible, older but still effective methods exist. The telecoil, or ‘T-coil,’ feature, common in many aids, picks up an electromagnetic signal transmitted by an audio induction loop system. This system is often found in public venues like theaters and churches. Specialized intermediary devices called streamers can be used. These small accessories plug into an audio source, such as a television or computer, and wirelessly transmit the sound to the hearing aids, turning the aids into personalized wireless headphones.