Apple AirPods Pro as "Hearing Aids"

Advancements in today’s hearing technology are often focused on making things more affordable and accessible to people who have hearing loss, and encouraging more people to evaluate and manage their hearing healthcare. 

That’s because so few people who could benefit from amplification are using hearing aids. For example, here in the UK, about 6.7 million people could benefit from hearing aids but less than one-third (about 2 million people) use them. A similar percentage of the population in the United States—about one-third of those over age 70—who could benefit from hearing aids actually use them.

If you've seen any of my other recent product reviews, such as the Jabra Enhance Plus or the Olive Union Pros, you know how passionate I am about bringing hearing aid technology into as many people's ears as possible—even if it's not the typical process of having hearing aids fitted by an audiologist like me. While I still strongly recommend seeing an audiologist, I understand that hearing aid costs can be prohibitive. For example, in the United States, the average hearing aid price is $2372 each and the devices are usually not covered by insurance.

Can You Use an Apple AirPods Pro as a Hearing Aid?

Recognizing this, Apple has been progressively improving and adding capabilities to their operating system (iOS) and AirPods Pro for those with hearing loss. Over the last few years, they've introduced some pretty smart technology to ensure that they stand out in what is, without a doubt, a crowded market.

As a result, there is a huge amount of tech crammed into the AirPods Pro, which means that if you're an Apple user and have a set of them, you may already possess what you need to improve your hearing—today! And that does include some hearing-aid-like, or what’s now referred to as “hearable,” functionality.

Before, we get into using AirPods Pro as a listening enhancement device, it’s worth noting that this functionality is really suitable only for people who have mild to moderate hearing loss–but that’s the lion’s share of hearing aid users. However, for more severe hearing losses (i.e., about 65 dBHL or more on a hearing test), the amplification just isn’t strong enough. We also encourage you to visit the [Consumer Ear Disease Risk Assessment (CEDRA) webpage](Consumer Ear Disease Risk Assessment (CEDRA) tool) from Mayo Clinic and Northwestern University just to rule out any serious health problems associated with hearing loss.

Acknowledging the above, a recent study found no significant differences regarding speech perception between AirPods Pro and hearing aids in quiet, although there were some notable differences in background noise. The researchers conclude AirPods Pro may have the potential to be a hearing assistive device for adults with mild-to-moderate hearing loss.

How to Set Up Apple AirPods Pro as Hearing Aids

On my iPhone, I'm using iOS 15.4.1, which includes features designed to assist people with mild to moderate hearing loss. There is a special section on Apple's website covering all their accessibility features for folks with hearing loss.

In this video, HearingTracker Audiologist Matthew Allsop explains how to set up your Apple Airpods Pro as hearing aids. Closed captions are available on this video. If you are using a mobile phone, please enable captions clicking on the gear icon.

So let’s go over each of the essential features of AirPods if you wish to use them for hearing enhancement. To access these features on your iPhone, follow this bread-crumb trail:

Settings app > Accessibility > Audio Visual

When you get to the Audio Visual screen, you'll discover some of Apple’s hearing-related features, such as:

Background sounds: Plays background sounds to mask environmental noise and may be helpful for people with tinnitus.

Mono audio: Useful if you have hearing only in one ear.

Sound balance: Helps balance the level of volume between your ears.

However, the best features are located within the Headphone Accommodations section at the top of the menu, and we’ll focus on these later in this article.

How to get and/or upload your hearing test

To get the most out of your AirPods Pro hearing features through the 'Headphone Accommodations' section, you’ll first need to share your hearing test results with your iPhone.

Starting with iOS 14, Apple allows you to enter your hearing test results using two basic methods, both of which are found in the Apple Health App which comes with your iPhone.

You can then use this bread-crumb trail on your Apple Health App to get to the Audiogram section:

Browse (at the bottom of screen) > Hearing > Audiogram

There are two methods for obtaining and entering your hearing test results:

Method #1: Upload an audiogram that you already have.

By far, the most accurate way to obtain a proper hearing test and audiogram is via a hearing care professional (HCP). Once you get your audiogram from them, you can take a photograph of it using the iPhone camera, and then enter the information directly into the Audiogram section. If you submit a photo, it does the same thing.

Method #2: Test your hearing using the Mimi App, and share your results with your Apple Health app

There are several free online apps that allow you to test your hearing. One of the best and most popular is the Mimi Hearing Test which can be found toward the bottom of the “Audiogram” screen. Once you download this app, you’ll see a button that allows you to share your hearing test information with the Apple Health App. You can then take the hearing test in a very quiet place, and the information will be transferred to your iPhone for customized hearing.

Audiologist Matthew Alsop provides a quick demonstration of the Mimi app. Closed captions are available on this video. If you are using a mobile phone, please enable captions clicking on the gear icon.

Because it’s probably the most common way for users to set up the Airpods Pro as a hearing aid, I also plan to provide a mini-review of the Mimi Hearing Test app in addition to the short video above. But, in a nutshell, I have some reservations about recommending this method for customizing your AirPods, because you’ll benefit so much more by seeing an audiologist. However, it is certainly better than doing nothing!

What happens after uploading your hearing test

If your test results show the same hearing loss in each ear, the headphone accommodations will take the average of the two ears and apply that profile to the appropriate audio channels. However, if you have an uneven hearing loss, the left and right audio channels will be positioned towards your better ear. So, once your hearing test is uploaded into your iPhone's health area, it will display neatly in the Headphone Accommodations, instantly boosting sound reproduction.

How do your test results affect the sound of the earbuds? When you stream sounds from your phone to your AirPods Pro—such as phone calls, music, videos, the radio, or podcasts—your phone will automatically adjust the sound at the specific pitches (frequencies) to compensate for your hearing loss.

Hearing-aid-like features of the Airpods Pro

When wearing the AirPods Pro, you can switch between Active Noise Cancellation and Transparency Mode (on and off). You should know that both of these modes work best when the devices fit well and you’re using the optimal-size eartips supplied with the earbuds.

I won’t go into detailed instructions about how to employ these features because there are several different ways they can be accessed in your AirPods Pro menu using Apple’s own instructions. For example, you can gain access to several of the listening and Headphone Accommodations features by pressing AirPods in the Accessibility screen and then choosing Audio Accessibility Settings. You can also go to the Bluetooth menu and click on the blue “information” icon to access the Ear Tip Fit Test, quickly turn on/off Noise Cancellation and Transparency, etc.

Note that some of these areas could change soon with the introduction of AirPods Pro 2 (or whatever name Apple chooses for their second-generation product line).

Active Noise Cancellation

The most prominent feature is Active Noise Cancellation, which detects external sound using the AirPods Pro's outward-facing microphones. Your AirPods then counter this noise by a process called “phase inversion,” which essentially means they generate a sound wave that is the mirror image of the noise. This effectively cancels out external noises before you can hear them. After that, there's an inward-facing microphone that listens within your ear for undesired internal sounds, which are subsequently canceled, leaving you with only a limited range of sounds from your surroundings. As a bonus, the active noise cancellation in the AirPods Pro 2 earbuds has been shown in a 2023 study to be fairly effective in providing hearing protection.

Transparency Mode

In a way, Transparency Mode is the opposite of Active Noise Cancellation; it lets environmental sounds into your ears, allowing you to hear everything that's going on around you. And, to be honest, it's a little strange when you first hear it because your brain tells you that your ears are blocked, but you can still hear everything!

As you click on and move into the Customize Transparency Mode setup, you can further change the volume or different facets of the sound. You can adjust the left or right balance, and place greater emphasis on the bass or treble of whoever's speaking in front of you while wearing the AirPods. The bass contributes to the fullness and richness of a person’s voice, while the treble accentuates the clarity of their voice.

Finally, you can set the ambient noise reduction, which lets you control the amount of background noise picked up by the AirPods Pro from the world around you.

Conversation Boost

The most recent addition to the hearing features, Conversation Boost, is tucked down at the bottom of the menu, but I believe it should be at the top! Apple claims that this feature focuses your AirPods Pro on the person in front of you by using computational audio and directional beamforming microphones—features we've traditionally seen in hearing aids. This provides forward-facing directionality with an ultra-narrow beam, isolating sounds coming from in front of you so you can hear more clearly in noisy environments.

How to enable Conversation Boost:

1. Settings app > Accessibility > Audio/Visual
2. Tap and Enable Headphone Accommodations
3. Tap Transparency Mode
4. Enable Conversation Boost

Are the Apple Airpods useful for people with hearing loss?

Some pretty intriguing objective studies have been published by audiologists evaluating the effectiveness of the AirPods Pro in boosting conversations and helping people hear better in noise.

For example, a recent study (March 2022) was published by a group of respected researchers from the National Acoustic Laboratories (NAL) in Australia. They found that both the Conversation Boost and Ambient Noise Reduction features of AirPods Pro improved hearing in background noise by around 7 decibels when measuring speech in front a listener in a noisy environment. In other words, it works quite well!

The researchers concluded: “With these hearing aid-like features, AirPods Pro have the potential to help some people with hearing loss understand and communicate during conversations.” (Also see NAL’s earlier review of Apple’s Headphone Accommodations feature.)

What are the key disadvantages when using AirPods Pro as a hearing aid?

The Airpods Pro might be sounding pretty good to you right now, but there are a few things to keep in mind if you're thinking about using them as hearing aids.

Battery life

First and foremost, the AirPods Pro have a very limited battery life. They are only good for about 4.5 hours of use on average. However, if you’re using features like Transparency Mode and Conversational Boost, I'm confident battery life will be substantially shorter. You don't want to start wearing a hearing aid at 8 AM and have it die before lunchtime.

Traditional hearing aids are far better in this regard: a 3-4 hour charge typically done overnight should provide for around 16-24 hours of use based on that full charge.

The AirPods Pro's batteries are also non-replaceable. So, after a couple of years of heavy daily use, your battery life will be significantly reduced. Hearing aids with rechargeable batteries will also gradually lose power in the same way; however, you can usually get the batteries replaced, often without cost depending on the warranty and your HCP. There are also many hearing aids that use disposable button-cell batteries, and these are simply replaced as needed.

Own-Voice Issues

Another issue with using headphones to manage hearing loss is the occlusion effect, which relates to how you hear your own voice when talking. With age-related hearing loss, the user often has good low-pitch (low-frequency) hearing and will wish to have their ear canals as open as possible for a more natural listening experience. With the AirPods Pro blocking your ears, my concern is that it will feel like you have your fingers jammed in your ears all the time, which may not be ideal. For example, when speaking or eating, you'll perceive your voice to be “boomy” and confined inside your head; chewing might sound much louder than normal. Depending on your hearing ability, this could limit the benefit of using the AirPods Pros as hearing aids.

However, the Transparency Mode is beneficial in this regard. For the first time in any analogous technology I've evaluated, the occlusion effect is significantly reduced when the transparency option is enabled.

However, there are also a few advantages to occluding your ears and getting a good acoustic seal. To begin with, if the ears are entirely occluded, it can result in improved hearing and less background noise, since every sound that enters your eardrum is routed through the hearing device which can then clean up the signal. Conversely, a loosely fitting ear-tip may allow sound that hasn't been cleaned up to enter, and sound quality can also worsen if there are large differences in time between the digitally processed sounds from your devices versus the environmental sounds reaching the eardrum (known as the “latency effect”).

Sound reproduction can also be improved by a more blocked ear when listening to streamed music or other audio. A better acoustic seal between the device and your ear canal should produce more fullness, richness, and depth in sound quality.

My verdict on using Airpods Pro as hearing aids

In conclusion, I believe that the Airpods Pro is a great “first foray” into managing hearing loss. Still, they should be fitted with caution because the hearing testing process using external apps is not currently as accurate as it should be. The best thing to do would be to have a complete hearing evaluation with an audiologist and then use that audiogram for the fitting procedure.

I'm also not convinced that the world is ready for people to walk around with their headphones on. Would people think I was being disrespectful or rude—believing I’m listening to music instead of them—when wearing headphones and sitting down for dinner with them? If they knew I was wearing hearing aids, I’m pretty sure they wouldn’t be. However, I suppose this new idea of using headphones as hearing aids must begin somewhere. So we may be marching toward a new perception of what headphones are and when/where they’re acceptable.

While I don't believe AirPods Pro will be as effective as traditional hearing aids for all of the reasons I've discussed, I'm thrilled that Apple is making waves in hearing technology. And I would advise anyone with hearing loss to try amplification instead of doing nothing.

So, if you're not sure a regular hearing aid is for you because of the cost or you just aren't ready to wear a hearing aid, the Airpods Pro is a low-risk way to dip your toes into the waters of hearing amplification—especially since they're only $250 versus thousands of dollars for professionally fit hearing aids. In my opinion, they are an excellent first intermediary step toward acquiring regular hearing aids.