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Hearing Protection - Help Needed

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Hi all!

I've got a question on how to improve my hearing protection situation. This is the situation: + tinnitus in both ears + hyperacusis. According to my , SNHL is not so bad (yet) that I need hearing aids. What I am trying to do ATM is protecting my remaining hearing as best as I can. I live in a loud environment, and also have developed a fair amount of "noise anxiety" due to my hyperacusis. Because of this I am wearing hearing protection 5 days/week, and for extended periods of time (4-10 hours per day).

Until now, my go-to solution have been custom-mold silicone musician's ear plugs with a filtered design. I am using the "short-fit" molds, i.e. they don't fill out the entire ear canal - basically they are about 1 inch long. The molds attenuate on average 14 decibels, while still allowing you to follow along conversations.
When they work they are awesome: well-fitting, protect in settings like loud traffic, office noise or loud social gatherings.

Now finally here is my issue: either I am misusing my molds, or they are just not designed for extensive usage times - but with every pair I bought the experience is as follows:

  1. Works perfectly for about 4 - 6 months
  2. After that slow degradation starts, usually in only one ear first: clicking sounds due to the mold shifting around, noticeably less attenuation. Applying some firmer pressure for a couple of times over the day still makes them usable. This usually goes on for 2-3 months.
  3. After that they become unusable: the mold starts popping out on its own, there is almost no noise being dampened anymore, and - worst of all - I experience an occlusion effect.

My questions to anyone who also uses ear plugs over extended periods of time:

  1. Is this just how it is: ear plugs have to be renewed every 9-12 months?
  2. Are there better alternatives out there? Different materials, different designs?
  3. I was also thinking about mixing things up a little bit: maybe just use ANC headphones for situations like commuting, and reserve mold use for situations where they are really needed (office, social events).

Any insights & pointers in the right direction are highly appreciated!

6 people in this conversation13 min readJump to latest

Will do once I get home. If memory serves correctly the last one showed a 25 loss across low-to-mid frequencies, and sharply increasing to 60 dB loss at 8 khz. Higher frequencies are not tested by in my country.

The situations that you mention do not sound like they are necessarily situations where noise levels would be expected to be damaging. Overuse of hearing protection can cause or exacerbate hyperacusis. Are you connected with a professional who is helping you wean yourself off of the earplugs?

Oh boy, I have to say you got me figured out there :sweat_smile:

So, rationally I absolutely know that many of these situations are not considered harmful. I am also aware that over-isolating yourself makes hyperacusis worse - something I can attest to. The worst part for me is the social isolation: I have gotten into a habit of avoiding larger gatherings, just out of fear something bad might happen. I am not talking to anyone right now, but I am trying to force myself to use the hearing protection less.

But there are also situations that are objectively loud and annoying to me, traffic/waiting for the bus while heavy trucks pass by in 2 meter distance, and worst of all the motor cycles - which in my country can basically be as loud as the driver wants them to be. Also, my office is quite loud - regularly going above 80 decibels. Which I consider peculiar since we are just sitting in front of computers, but what can you do. Social gatherings are also very loud where I live - 90 decibels seems to be the baseline.

So I am a bit torn between "you are overdoing it, relax a bit" and "but darn this feels incredibly loud and uncomfortable".

Edited

In reply to @trombonist

Lol, that is my issue also, but not to that level as OPs. Mainly due to that:

@trombonist said:

and worst of all the motor cycles - which in my country can basically be as loud as the driver wants them to be.

Many extremely selfish drivers in Poland install modified silencers in their cars and motorcycles, which specially emit even more than 120 "just for fun". And they like drive that even in the middle of the night. They should face severe penalties for exposing them to bodily harm in the form of hearing injury risk.

I don't know your and sensitivity to occlusion effect, but I have now P receiver with power domes from Unitron, which have thick silicone. Here's my earplug effect (REOG) for 80 dB input:

However, I need UP receiver, which is only with cShell. With titanium the smallest possible vent is 1 mm, which I found insufficient for satisfactory noise isolation and efficiency of antinoise features like Phonak Spheric Speech in Noise program.

I am about to take my order of UP receiver in titanium cShell with no vent. However, I have completely no problem with occlusion effect.

Please upload your earplug I am curious. Here's my plug which I used previously for rehabilitation to isolate my better () ear:

And, for interested (@Jackhammer, @jim_lewis ,maybe you).

REOG (earplug effect) with Phonak Paradise P90-RT with P receiver in titanium cShell and 1 mm vent - relatively minor eaplug effect despite minimal vent available for Phonak's titaniums:

In reply to @trombonist

Still, noise exposure of a motorcycle going by is brief enough that you probably don't need to worry about noise damage. If you're in a call center or open office space, those can sounds busy but they don't typically reach damaging levels--maybe talk to your health and safety person at work.

Often with hyperacusis there's a big anxiety component and professional support can be pretty critical, but at the very least an action that you can take immediately to start getting your brain used to sound again is to increase sound enrichment at home. Use something that you like, music, nature sounds, and put it on at a comfortable background volume all hours. Overuse of earplugs can lead you to perceive sounds as louder and more annoying, but you can train your brain to calm that back down again, you just need to work on reducing your earplug use and increasing your sound environments with an initial focus on pleasant sounds. If you're trying to block out annoying noises, you're probably better off looking for noise cancelling headsets and music so that your brain has something to listen to.

But absolutely start looking for professional support for this. Additionally, sometimes people get into earplug use because hearing in noise gets difficult, but hearing in noise is actually difficult because of hearing loss that needs to be corrected. I don't know where you are, but aren't always a good judge of what kind of "mild" hearing loss actually needs correction. See an audiologist who works with hyperacusis, and if you have more general anxiety consider looking at options for support there as well. Better to nip it in the bud.

Do electronic ear plugs help with this? It seems it could by remaining open to moderate background noise while providing reassurance that actual loud sounds such as a motorcycle will be cut off. That reassurance might help calm the nervous system. Hearing aids probably accomplish that too in similar and additional ways.

In reply to @Neville

@Neville said:

If you're in a call center or open office space, those can sounds busy but they don't typically reach damaging levels--maybe talk to your health and safety person at work.

In my case, there's problem only with that motorcycles and cars. And with signals from the police, ambulances, but these are necessary and understandable.

Everything else is fine, including the traffic noise in my case, including the traffic and office noise. That's all with quite high amplifications in my case.

And I conveniently modified my "Comfort in noise" program.

My motion sensor make my microphones omnidirectional in Autosense Speech in Noise subprogram during walking and talking and I don't feel overwhelmed by normal traffic.

In reply to @trombonist

It'd really be helpful if you posted your to your profile. I can think of a range of things that might be helpful, but I cannot really advise beyond what other posters have already said without further information.

In reply to @Bimodal_user

Thanks for your reply! Well yeah, tell me about those silencers - completely insane. Unfortunately the forum doesn't allow me to upload pictures yet ("account is too new"). But they basically look like this: https://cms.neuroth.com/images/detailansicht-mann-gehoerschutz-schwarz-acrylat-linearer-filter.jpg2

The design of your molds is definitely different: mine don't have that second protrusion, only the one that goes directly into the ear canal. Is the second one for stabilizing the fit?

In reply to @trombonist

Thanks, that was useful information. I think that selective use of the earplugs you have is probably ok and better than the use of noise cancelling earphones. Hearing aids may help with your tinnitus, but I don't think they'll provide much benefit from a speech recognition point of view. Like the other professionals in the thread have suggested, it is important to seek advice from an audiologist or other therapist regarding your hyperacusis. Investigating this more requires more personal questions than most people would want to talk about on the internet, so it's definitely better to do this in person.

In reply to @Neville

Hm,

I believe you do have a point here, thanks for taking the time to answer man! This "over-protection" only started about a year ago - I have hearing issues for much longer than that. Used to be I only inserted the plugs for the occasional loud bar visit. But since I often got spooked by loud sudden noises (e.g. some dude popping a balloon right in front of me) I somehow decided "why not wear them outside, so you are a little safer and do not need to depend on your fellow humans to be considerate".

After my posts yesterday I also got a wake-up call of a different kind: after applying to much force on the earbud I believe I insured my eardrum: hearing is slightly reduced and there is a little pain. Going to see the now and hope this is fixable. Getting injured while overprotecting oneself is stupidity on a whole new level I guess :cry:

In reply to @Hearing_Potential

Thanks for the reply! TBH I have accepted by Tinnitus, its a part of me now. I see it as a kind of internal "stress alarm" which can be quite helpful.

Do you have insights about the lifetime of the molds? Is it normal/expected for silicone to "break down" after ~9 months, would you recommend a different material?

Edited

In reply to @trombonist

@trombonist said:

I have included the audiogram in my profile.

Uhm, you have quite mild hearing loss. That change my point of view and I wouldn't recommend you much occluding earpieces, which work greats for me, but are probably not good for you, unless you have some cash and like to experiment.

BUT, as @Neville said, isolation from most sources of noise isn't good for you.

@trombonist said:

The design of your molds is definitely different: mine don't have that second protrusion, only the one that goes directly into the ear canal. Is the second one for stabilizing the fit?

Definitely yes, as with skeleton of full shell earmolds. If we think about the same, that protrusion goes here (red line):

@Neville, I know that I am theorising and probably it has not good cost-effectiveness ration and not recommended, but what do you think about hearing aids as "imperfect compromise" just for sudden noise features and compression of loud sounds?

That would be require pretty occluding earpiece, I know, this is why I only theorize, because OP has mild hearing loss. But wouldn't that be better than walking around all day with earplugs in?

I think the OP needs to work with a professional. There are potential options for occluding while weaning off, I don't know if the OPs hyperacusis is severe enough to warrant that. It has only been a year that they've been over protecting. It sounds like there's potentially an anxiety component that could benefit from some support and then on top of that if there's a speech in noise problem that is aggravating the ear plug use that should be addressed too.

In reply to @Neville

Yes, I don't take chances there anymore. Turns out the eardrum is fine (*phew*), but the said it was clearly visible that i forced that plug in over the course of the day due to the amount of cerumen that had built up against the eardrum. Got that removed, ear is still a little sore but otherwise fine.

But as I said, this has been a wake-up call that I am overdoing things. My plan going forward is:

- renew the ear plugs (unless some better option pops up in this thread), but only use them when really warranted - which will be seldom. Hope this alone is enough to also make them last longer.

- Not use protection in the office anymore. Will be hard in the beginning for sure, but I can be quite headstrong :joy:

- For commuting specifically I will look into ANC headphones, which are a pretty common sight on my commute anyways. This is less for fear of hearing damage, but more to get some quiet to do my reading while riding the bus.

I hope this gets me back into the "healthy usage" territory. Thank you for your insights - sometimes you need someone else to tell you what in a way you already know but don't want to acknowledge.

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