What are the Causes and Effects of Hidden Hearing Loss?

by | Apr 30, 2022 | Client Resources, Hearing Health, Hearing Loss

Because hidden hearing loss is generally not detectable by standard testing, it can leave affected individuals baffled as to what the problem is.

Hidden hearing loss, as the name would indicate, is typically tricky to identify due to the nature of the condition. Because hidden hearing loss is generally not detectable by standard testing, it can leave affected individuals baffled as to what the problem is. This can lead to the issue going untreated and continuing to deteriorate over time.

So, what is hidden hearing loss exactly?

You may be thinking, how is it possible that standard hearing tests are not able to pick up on this problem that is causing loss of hearing? Isn’t that what these tests are designed for? There are a couple of reasons why detecting hidden hearing loss can be so complicated.

Speech Comprehension in Noisy Places

One problem is that standard tests focus on hearing across all frequency ranges under normal conditions. Issues with hidden hearing loss often become evident when attempting to decipher speech in noisy environments. This is part of the reason why the condition often goes unnoticed during standard testing.

Physical Damage

Standard hearing tests focus on problems within the ear, including structural damage and functionality. Sensorineural hearing loss generally occurs when the tiny hair cells in the inners, the stereocilia, become damaged. These hair cells help soundwaves entering the ear get converted to a recognizable message in the brain.

With hidden hearing loss, the stereocilia appear healthy and it is rather the underlying auditory nerve fibres that are damaged. This impacts the pathway between the ear and the brain, making some sounds received in loud areas incomplete and incomprehensible.

Signs & Symptoms of Hidden Hearing Loss

It is not really known just how many people are currently suffering hidden hearing loss. There is no official guideline or set of requirements for diagnosing hidden hearing loss.

Typical signs that may indicate the presence of hidden hearing loss include:

  • Frequently hearing people incorrectly.
  • Struggling in noisy environments.
    • Difficulty deciphering speech.
    • Trouble staying focused and becoming easily distracted.
  • Avoiding loud places with a high preference for quiet spaces.
  • Even after passing a professional hearing test, there is still a strong feeling there is existing hearing loss.

Causes of Hidden Hearing Loss

It is often a combination of factors that lead to the onset of hidden hearing loss. In many cases, prolonged exposure to noise is a contributing factor. Even being repeatedly in the presence of low-level noise can be a problem. This perpetual contact with loud sounds builds up over time which usually makes age another common factor. It is thought that age merely reveals the issue as physical and mental decline continues.

Autoimmune disorders and viral infections can also play a role in hidden hearing loss. These conditions can affect the production of myelin in the body. Myelin is responsible for providing insulation for nerves. When myelin is attacked it may result in nerve impulses being interrupted or blocked.

Treatment for Hidden Hearing Loss

The first step toward effective treatment is getting the issue accurately diagnosed. If standard tests didn’t detect any issues and you still feel there is a problem, other efforts can be made to identify the condition.


One option is to take a pure tone audiometry test. This measures hearing sensitivity involving the peripheral and central auditory systems to determine the softest sound thresholds audible to the individual. If this test doesn’t reveal anything it can be followed up with a speech-in-noise test administered by a hearing professional.

Auditory Brainstem Response (ABR) testing can also be used. Electrodes are placed on the head while sounds are played through a set of headphones. The electrodes are used to measure the response of the auditory nerve to the sounds being presented.


Options for the treatment of hidden hearing loss are fairly similar to the approach taken with regular hearing loss. Some of the most effective treatments include:

  • Hearing aids – most common and effective treatment
    • Helps re-establish the ear-brain connection for problematic frequencies
    • Can help affected individuals function better in noisy environments
  • Behaviour modification – reducing exposure to loud noise is recommended
    • Choosing environments that beneficial to your situation
  • Surgery – if structural damage is considerable, surgery may be required

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Jennifer Abbott

Jennifer Abbott brings over 25 years of experience in business. She has worked in multiple industries, including insurance brokerage, aviation, and health. Her career journey enabled her to acquire impeccable skills to help people find solutions in any situation. Jennifer is well travelled. She has lived and worked in Dubai for award-winning Emirates Airline. Jennifer has enjoyed working in a multicultural environment. Her offshore work empowered her to learn about various cultures from over 100 different nationalities. Upon her return home, Jennifer pursued her studies as a Hearing Aid Practitioner. While working in a hearing clinic, she became aware of some people’s challenges getting to their appointment. She realized that those people were not getting the proper hearing aid help they needed, which compromised their hearing. People’s struggles inspired her to establish the first unique 100% mobile hearing clinic in the lower mainland. As the founder of Hear at Home Mobile Hearing Clinic, Jennifer’s mission is to improve her client’s quality of life at any age. She has in-depth experience with hearing testing fitting, recommending hearing aids and working with older populations suffering from cognitive decline and Dementia.

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