Acclimatisation goes faster alongside structured listening practice, which is the point of our auditory rehabilitation program
Why Do My Hearing Aids Sound Tinny? It May Not Be the Hearing Aids
One of the comments we occasionally hear from people wearing new hearing aids is:
“They sound a bit tinny.”
Voices may sound sharper than expected. Cutlery can suddenly seem very noticeable. Paper rustling, birds, running water and even your own footsteps can sound different from what you remember.
It is tempting to assume this means there is something wrong with the hearing aids or that they haven’t been programmed correctly.
Sometimes an adjustment is required — but sometimes the hearing aids are doing exactly what they are supposed to do.
A recent video from American audiologist Dr Cliff Olson highlighted an important part of hearing rehabilitation that is often overlooked: even when hearing aids have been appropriately programmed and verified using Real Ear Measurement, the restored sound can initially seem unnatural because your brain has to become accustomed to hearing that information again.
Watch Dr Cliff Olson’s original Instagram video
Hearing loss doesn’t just make everything quieter
One of the misconceptions about hearing loss is that it is simply like turning down the volume on a television. For many people with age-related or noise-related hearing loss, the reduction is greater in the higher frequencies.
These frequencies contain a great deal of important speech information, particularly consonant sounds such as s, f, th, sh, t and k. If those sounds have gradually become softer over many years, your brain becomes accustomed to receiving less high-frequency information.
Then we fit a hearing aid.
Suddenly those sounds are available again.
A clock may tick.
Paper may rustle.
Birds may seem surprisingly loud.
The indicators on your car may suddenly become noticeable.
And speech can initially have a brighter, sharper or even slightly “tinny” quality.
The hearing aid hasn’t necessarily created those sounds.
It may simply have made them audible again.
Your ears detect sound — but your brain makes sense of it
Hearing is not purely an ear function. Your ears collect sound and convert it into signals, but your brain has the much more complicated task of deciding:
- What is speech?
- What is background noise?
- Which sounds are important?
- Which sounds can be ignored?
- What does this particular pattern of sound mean?
When hearing changes gradually, the brain adapts to the reduced information it receives. When properly fitted hearing aids restore some of that missing information, another period of adaptation can occur.
This is commonly referred to as hearing-aid acclimatisation.
Research examining the brain’s response following hearing-aid fitting has demonstrated changes in auditory processing over time. Some changes have been observed within the first few weeks, while other changes continued to develop over several months.
That is one reason why your experience on Day 1 with hearing aids isn’t necessarily the experience you will have several weeks later.
But there’s an important catch: the hearing aids need to be fitted properly first
This is where I believe the message needs some balance. We shouldn’t simply tell every new hearing-aid wearer:
“You’ll get used to it.”
Before blaming the brain, we need to make sure the hearing aids themselves are providing appropriate amplification.
At AIM Hearing, one of the tools we can use is Real Ear Measurement (REM).
Rather than relying solely on the manufacturer’s computer software, Real Ear Measurement allows us to measure the sound produced by the hearing aid inside your actual ear canal. A very small probe microphone is placed near the eardrum and we can measure how speech is being amplified across different frequencies. We can then compare that response with an evidence-based prescription target.
Why does this matter? Because everyone’s ears are different.
Two people can have exactly the same hearing test but different:
- ear canal sizes,
- ear canal shapes,
- acoustics,
- earmoulds or domes,
- receivers,
- vents.
That means the same hearing aid programmed identically for two people will not necessarily produce exactly the same result in both ears.
Professional guidelines recognise probe-microphone or Real Ear Measurements as the preferred/direct method for verifying the performance of hearing aids.
So what if my hearing aids still sound tinny after Real Ear Measurement?
This is where we need to look at the whole picture.
If the hearing aids have been objectively verified, we may consider whether you are simply experiencing newly restored high-frequency sound.
Rather than immediately removing large amounts of high-frequency amplification, there can sometimes be value in allowing your auditory system an opportunity to become accustomed to the new sound.
Why?
Because those high-frequency sounds aren’t there just to make birds louder.
Much of that information contributes to speech clarity.
Turning it down excessively simply because it initially sounds different can potentially take away some of the very information we’re trying to restore.
That doesn’t mean you should be uncomfortable.
Good hearing rehabilitation involves balancing:
Audibility + speech clarity + listening comfort + your individual preferences.
Sometimes small adjustments are appropriate.
Sometimes we may introduce amplification progressively.
And sometimes what sounded unusual during the first week becomes completely normal after your brain has had an opportunity to adapt.
How long does it take to adjust to hearing aids?
There isn’t one magic number.
Some people adapt remarkably quickly, while others require several weeks.
Research into auditory neuroplasticity following hearing-aid use has found changes in neural responses occurring at different stages, including changes within approximately two weeks and further changes over subsequent months.
The important thing is consistent exposure.
If hearing aids are worn for only an hour occasionally, the auditory system receives relatively little opportunity to adapt.
For many patients, consistent daily use provides the brain with repeated exposure to everyday sounds so it can gradually relearn what is important and what can fade into the background.
When should you come back for an adjustment?
Please don’t assume that every uncomfortable sound simply needs to be tolerated.
Contact your hearing care professional if:
- speech remains excessively sharp or distorted,
- particular sounds are painfully loud,
- your own voice sounds excessively hollow or blocked,
- you cannot tolerate the hearing aids,
- one hearing aid sounds noticeably different from the other,
- speech understanding has become worse rather than better,
- you are experiencing feedback or whistling,
- the sound has suddenly changed.
There may be something that needs adjusting.
The important distinction is between “different” and “wrong.”
New sound can initially be different.
It should not be painful or persistently intolerable.
Hearing aids are only part of hearing rehabilitation
Modern hearing aids are remarkable pieces of technology, but simply putting them into someone’s ears doesn’t complete the hearing rehabilitation process.
Successful hearing care involves:
accurate hearing assessment → appropriate hearing-aid selection → evidence-based programming → Real Ear Measurement → counselling → acclimatisation → follow-up and fine tuning.
That follow-up is particularly important. The goal isn’t simply to make things louder.
The goal is to help you hear speech as clearly, naturally and comfortably as we reasonably can.
So if you have recently received hearing aids and things initially sound a little brighter, sharper or “tinny”, don’t immediately assume you’ve made the wrong decision.
Have the fitting checked. Make sure the amplification has been properly verified.
Then give your brain an opportunity to rediscover sounds it may not have heard properly for many years.
Want to read the evidence yourself?
We believe patients should be able to check the information we discuss rather than simply taking our word for it.
Original video
Real Ear Measurement and hearing-aid verification
- American Speech-Language-Hearing Association (ASHA) – Guidance on verification of hearing devices using probe microphone measurements
- ASHA – Guidelines for Hearing Aid Fitting for Adults
Hearing aids, acclimatisation and the brain
- Frontiers in Aging Neuroscience – Neural Plasticity Induced by Hearing Aid Use
- American Journal of Audiology – Effect of Hearing Aid Acclimatization on Speech-in-Noise Perception and Auditory Processing
- National Acoustic Laboratories – NAL hearing research and hearing-aid fitting
AIM Hearing Bundaberg
Locally owned. Independent hearing care.
If your hearing aids don’t sound right — whether they were fitted by us or elsewhere — a comprehensive hearing assessment and hearing-aid review can help determine what is happening.
Acclimatisation also goes faster alongside structured listening practice, which is the point of our auditory rehabilitation program.
Helping Bundaberg Stay Connected.
This article provides general educational information and is not intended to replace individual clinical assessment or medical advice.