Trying to have a conversation in a noisy environment, like a loud restaurant, can be extremely frustrating. You often have trouble understanding the person you’re speaking with and keep saying, “Huh?” or asking them to repeat themselves.
So, is it just extra noise? Or could it be a sign of hearing loss or auditory processing difficulty?
Hearing loss and auditory processing difficulty can happen at mild to moderate levels, which you may not notice until you’re struggling to have a conversation with someone while in a crowd.
Keep reading to learn more about difficulty hearing with background noise and when to see a doctor about your ears.
Here’s what you’ll learn:
- Why Can’t You Hear People with Background Noise?
- How Your Brain Processes Different Noises
- Auditory Processing Disorder
- High-Frequency Hearing Loss
- Other Types of Hearing Loss
- Possible Causes of Hearing Loss
- Treatment Options for Moderate Hearing Loss
- Negative Effects of Hearing Loss
- When to Get Your Hearing Checked
- Final Thoughts: Why You Can’t Hear with Background Noise and What to Do
Why Can’t You Hear People With Background Noise?
If you can’t hear conversations when there’s background noise, it’s likely because your ears have trouble filtering out the environmental sounds. Trouble hearing even with mild background noise is often the first symptom of moderate hearing loss or auditory processing disorder (APD).
Since difficulty hearing can get worse if left untreated, you should get your hearing checked by a doctor to find out the true cause. After all, you regularly get your eyes and teeth checked, so why not your ears?
How Your Brain Processes Different Noises
Here’s a quick rundown of what happens when you hear different sounds:
Your body has two main processing centers for sound: the ear and then the auditory cortex in your brain. Your ear turns sound waves into chemical signals, which go to your brain and are processed in the auditory cortex.
When you hear a noise, sound waves enter your outer ear and travel through your ear canal to get to the eardrum. The eardrum sends the vibrations from the sound waves to the middle ear, where they’re amplified and sent to your cochlea inside the inner ear.
The cochlea has fluid that vibrates with the sound, which causes sensory hair cells to bend. That sends chemical signals through the auditory nerve to your brain’s auditory cortex for the next part of processing.
Next, your auditory cortex takes those chemical signals and basically “decodes” the information so you can better understand it. One of the jobs your auditory cortex has is filtering out unnecessary and irrelevant information, such as background noise.
In other words, your brain dims the sounds in the background so you can focus better on important sound patterns, like speech.
If you can’t hear a conversation even with mild background noise, then you may have damage in one of these sound processing centers.
Auditory Processing Disorder
Auditory processing disorder (APD) is a condition where your brain has trouble processing the auditory signals it gets from your ear. That’s to say that your ear works fine, but your auditory cortex can’t decode the sounds well enough.
People with APD often notice symptoms starting in childhood, but it can happen in people of any age.
Symptoms of APD include:
- Mixing up similar sounds (such as “hand” and “plan”)
- Difficulty following conversations or responding quickly
- Trouble identifying where a sound came from
- Difficulty hearing with background noise
APD can only be diagnosed by a hearing specialist, also known as an audiologist. Since APD isn’t a type of hearing loss, it isn’t treated with hearing aids. If you or your child is diagnosed with APD, treatment and management options include classroom support and speech therapy.
High-Frequency Hearing Loss
High-frequency hearing loss has to do with the ear’s inability to hear high-pitched sounds, and it’s usually caused by damage to the hairs in your inner ear. It affects up to 14% of people under the age of 65 and 30% over the age of 65. Two common causes of high-frequency hearing loss are aging and noise exposure.
Symptoms of high-frequency hearing loss include:
- Hearing what’s being said but misinterpreting the words
- Difficulty understanding speech in noisy places
- Trouble hearing consonants (such as s, h or f)
- Asking others to repeat themselves, speak slowly, or enunciate
- Tinnitus (ringing or buzzing in the ears)
If you’re experiencing the above symptoms, an audiologist can use hearing tests to determine whether or not you have high-frequency hearing loss.
Treatments for high-frequency hearing loss include hearing aids and auditory training.
Other Types of Hearing Loss
APD and high-frequency hearing loss are two of the most common causes of difficulty hearing with background noise. But your symptoms could be caused by other types of hearing loss, which an audiologist can diagnose:
Sensorineural Hearing Loss
Sensorineural hearing loss (SNHL) is an umbrella term that means hearing loss caused by damage to the inner ear nerves and hair cells, and it includes high-frequency hearing loss.
Other types of SNHL, such as congenital sensorineural hearing loss or sudden sensorineural hearing loss, can also cause difficulty hearing in social situations.
Those conditions are less common than high-frequency hearing loss, which accounts for roughly 90% of hearing loss cases. But note that all types of sensorineural hearing loss can be tested for and diagnosed by an audiologist.
Conductive Hearing Loss
Conductive hearing loss happens when an obstruction in the ear, such as wax buildup, causes hearing impairment. It can also be caused by:
- Ear infections
- Damage to the outer or middle ear
Symptoms of conductive hearing loss include:
- Muffled hearing
- Difficulty hearing softer noises
- Feeling of stuffiness in the ears
- Ear pain
This type of hearing loss can be diagnosed by an audioligist or ear, nose, and throat (ENT) doctor — or even a primary care physician if there’s a visible obstruction.
Depending on the cause, conductive hearing loss can be treated by cleaning or medication. In some extreme cases, such as a badly ruptured eardrum, your doctor may recommend surgery.
Possible Causes of Hearing Loss
Hearing loss can be caused by several factors, including genetics, your environment, and other medical conditions. Here are a few major players in hearing loss:
Exposure to loud noises remains one of the most common risk factors for hearing loss. Over time, coming into contact with sounds like lawn mowers, large engines, and loud music can damage the hairs in the inner ear and lead to hearing loss.
Age and Other Medical Factors
Almost 50% of individuals over the age of 75 suffer from some form of hearing loss. Age-related hearing loss, or presbycusis, affects both ears and often runs in families.
Other conditions that can develop as you age, such as diabetes, stroke, and hypertension, can also cause hearing loss.
Many medications have been associated with hearing loss, including aspirin (at very high doses), some antibiotics, and medicines used to treat cancer.
Some drug-induced hearing loss can be reversed, but other damage is permanent. If you experience hearing loss as a side effect of a new medication, speak with your doctor right away.
According to the Centers for Disease Control and Prevention (CDC), genetics play a role in 50% to 60% of hearing loss in babies.
Genetic hearing loss is often caused by mutations in the genes that contain instructions for the proper functioning of the ear. In most cases, genetic hearing loss symptoms appear in childhood.
Foreign Objects and Damage
Obstructions in the ear canal interfere with your body’s ability to turn sound waves into chemical signals for your brain. Foreign objects stuck in the ear can lead to infections and temporary hearing loss.
Negative Effects of Hearing Loss
Loss to any one of your five senses can create a negative ripple effect in your daily life. In particular, hearing loss and symptoms like difficulty hearing with background noise can cause problems communicating and even lead to increased isolation.
Social isolation resulting from hearing problems can impact mental health and self-esteem in people of all ages, and even contribute to the development of dementia as you age.
Treatment Options for Moderate Hearing Loss
If you have trouble keeping up with conversations in most environments, including those with low background noise, you may be experiencing moderate hearing loss.
If your hearing loss is caused by an obstruction or infection, then it may be cured by cleansing or medication. Otherwise, your doctor will recommend treatments to manage the loss.
Here are the common treatments used to manage moderate hearing loss:
Hearing aids help you manage moderate hearing loss by amplifying the sounds that you have trouble hearing. Like glasses, they’re a device that you wear to improve your senses.
Hearing aids use microphones to amplify the sound waves from your environment and send them through the middle ear.
Most hearing aids are digital and can be calibrated according to your level of hearing loss.
You’ll need to have your hearing tested by an audiologist or hearing aid dispenser before you get hearing aids so they can eliminate other causes of hearing loss. A specialist can also help you choose the best hearing aid for you and monitor a trial period to see if it’s the right solution.
LACE Auditory Training
LACE stands for Listening and Communication Enhancement, and it’s an auditory training program that uses science-backed brain training exercises. LACE’s exercises focus on improving your listening and comprehension skills to help you with:
- Hearing in loud environments
- Understanding fast talkers
- Listening to competing voices
- Auditory working memory
LACE training can be used both with and without hearing aids. If you’ve just begun using hearing aids, LACE can help your brain adjust to hearing the new sounds they amplify. The program also includes communication tips and strategies that can improve your ability to socialize with hearing loss.
When To Get Your Hearing Checked
Sometimes hearing loss happens gradually, and it can be hard to notice at first. The Cleveland Clinic recommends going to an audiologist in your early 20s for a baseline hearing test and then having your hearing tested every five years to check for changes.
If you notice any changes to your normal hearing, you can talk to your doctor about it during your annual physical.
But if you start having trouble hearing even with low background noise, you can schedule an appointment with your doctor to get your ears checked. Your regular doctor can check for issues like earwax buildup and refer you to an audiologist or ENT for further testing if needed.
Final Thoughts: Why You Can’t Hear With Background Noise and What To Do
Over time, you may notice that you have more difficulty hearing conversations when there’s background noise. If you experience these changes, there are treatments out there that can help. It’s important to talk to a hearing health specialist who can help you identify the cause so you can get the right treatment.
If you’re experiencing trouble hearing with background noise, LACE can help. Explore our Speech-In-Noise Auditory Training exercises that help train your brain to better filter out background noise.