Tinnitus = hearing extra sound from hyperactive hearing system
Hyperacusis = hearing extra loud sound from hyperactive hearing system
Combination hearing aids are HAs with the option of added sound therapy.
They’re for people with T-H who have normal hearing or hearing loss: amplification on/off; sound therapy on/off. Starting in the 1990s, combination hearing aids were analog tech, called tinnitus instruments and combination devices. For hyperacusis, they were really the only option for wearable sound with fine soft volume control adjustments needed for treatment, and amplification that could be turned on gradually once the hyperacusis had improved. These early analog combination HAs had limited amplification tech features, only 1 choice of sound type, and sound quality so bad, including high static, most people with T-H couldn’t stand wearing them.
Digital HAs first hit the consumer market in the 1980s. Tech advanced rapidly right along with audio and communication systems tech. More and more performance features were added including telecoils, directional microphones, multiple channels for different listening situations, Bluetooth wireless streaming, compatibility with phones and assistive listening devices, and so on, and so on, and so on, and so on. T-H combination aids were still analog; same old features. Some audiologists started recommending digital HAs to people with T-H because of their clear sound quality and advanced tech features. It was hard to recommend analog combination HAs when their antiquated amplification tech had fallen so far behind what was possible with digital. Better communication trumped wearable analog sound therapy. Tick tock. Tick tock.
In the 2000s, 2 decades after digital HAs hit the market, a HA manufacturer finally offered a digital combination HA. More HA manufacturers have followed, after finally realizing there are more than a few potential consumers in their tinnitus target market. Sorry, hyperacusis consumers, they completely forgot to include you in naming/marketing the new combination HAs. Even though combination HAs have been used for hyperacusis therapy since the 1990s—only about 20 years.
So this is good news, right. Digital combination HAs are finally here. When I found out, I screamed and clapped with joy. I even jumped off the couch and did a little dance—gingerly so as not to flare up my fibromyalgia. Except there are issues. The British Tinnitus Association describes how science has proven that HAs help people with T-H cope better. There is limited science on the new combination HAs to confirm if they help people with T-H cope better. Which is true.
But we know the analog combination HAs helped people with T-H cope better, or they wouldn’t be an important part of therapy for over 2 decades. The new combination HAs have better sound quality and better amplification/communication tech. Finally combination HAs include all the high tech HA features like multiple channels, Bluetooth, phone/smartphone compatibility, control apps. In my opinion, they’re a wearable sound therapy product upgrade. How could they be worse?
Hansaton, in business since 1957, has sold low cost (<$500/HA) Over-The-Counter HAs in the past, and also through audiologists. In independent scientific electroacoustic and performance testing by Smith et al. (2016), their HAs were the only ones with acceptable sound quality and performance features that actually worked among manufacturers tested. They offer a basic Tinnitus Solutions combination HA with sound generator. I haven’t seen independent testing on this product.
These are options from prescription HA manufacturers.
There is limited science on what sound types and T-H related features give the most benefit. Scientists are starting research studies on this. In my experience, it takes about 2 years for scientists to do a study, analyze the results and then get it published. So in about 2 years, people with T-H will find out what experts recommend for sound therapy in combination HAs based on science. The irony is that sound therapy is very individual. I like sounds other people hate and vice versa. So the products that let the individual choose custom sound mixes might be what ends up helping people with T-H the most. Imagine that. You decide on your own sound mix.
The combination HAs are still developing as a product. Some features are offered by every manufacturer. Some aren’t. For example, to me the ability to download my personal music library to a pair of combination HAs is a must have feature. I’d much rather listen to my music through safe open fit combination HAs than using unsafe personal listening earbuds or headphones that block off my ears. Manufacturers still haven’t completely settled on features. For example, with back up cameras, one car manufacturer was the first. Consumers liked that feature. Now all the car manufacturers offer it. Lane departure alerts are at that stage. Some manufacturers offer the feature; some don’t. Eventually, they probably all will. The same can happen with combination HA tech. What will consumers want most?
Paired hearing is really important for hearing loss and hyper ears. If you can hear in both ears, you’ll need a pair. What features do you want? This could make a difference on pricing. Shop around. Comparison price between clinics and models. Any deals like BOGO or seasonal sales? Any sales on last year’s models or loaner aids? Just like you might if car shopping.
Photo Credit Hayes Potter at Unsplash
Jan L. Mayes MSc writes horror fiction and non-fiction, and is an international Eric Hoffer Award winning author, blogger and audiologist specializing in ghosts, noise, tinnitus-hyperacusis, hearing health education and plotting murders. Her writing has been featured at Tinnitus Today, Communique, silencity.com and The Horror News Daily.