Why Background Noise Makes Hearing So Much Harder

If I had to pick one thing that brings people through our doors more than anything else, it would be background noise.

Noisy places have become harder than they used to be. You’ve started to wonder whether it’s your hearing.

You can sit across from someone at the kitchen table and follow every word. No problem. Move that same conversation to a busy restaurant or a family birthday with everyone talking at once, and suddenly you’re lost. You can hear that people are talking. You just can’t make out what they’re saying. Following speech becomes harder when other voices and room noise compete with it. Hearing loss can make that difference more noticeable, but this pattern alone cannot tell us the cause.

You can hear an example of hearing loss in background noise with our hearing loss simulator.

In this article

• Volume is only part of the problem
• How hearing loss can affect the inner ear
• How your brain separates speech from noise
• The cocktail party problem
• It’s tiring. Properly tiring.
• So do hearing aids fix it?
• Why speech-in-noise testing matters
• Hearing better in restaurants
• What to do if background noise is becoming difficult
• Common questions

Volume is only part of the problem

Most people assume hearing loss means everything is quieter, so turning it up should sort it.

Sensorineural hearing loss affects the inner ear or hearing nerve. It can affect how much speech you hear and how clearly you hear it. The consonants can be particularly hard to distinguish. The bits that separate “time” from “dime” or “cat” from “cap.”

With less competing sound, it can be easier to follow the words and use the context to fill in what you miss.

But in a noisy place, the speech signal is competing with everything else. Other voices, background music, the coffee machine, cutlery, and children at another table.

The signal-to-noise ratio is how loud the voice you want is compared with the noise around it. Many people with hearing loss need speech to stand out more clearly from competing sound. A busy restaurant may not give them enough separation.

Turning up the volume can help you hear sounds you were missing. But if speech and background noise become louder together, the words may still be hard to follow.

How hearing loss can affect the inner ear

Inside your inner ear are thousands of tiny hair cells. Their job is to pick up sound vibrations and convert them into electrical signals your brain can interpret. When they’re damaged, which can happen with age or noise exposure, the signal they produce becomes less detailed.

I sometimes describe it to clients like watching a film in 4K versus watching the same film with the resolution dropped to about 360p. In a quiet scene with just two people talking, you can probably still follow the plot. But throw in an action sequence with explosions and twenty characters all shouting at once, and that low resolution really starts to show. You lose track of what’s going on.

How your brain separates speech from noise

Your ears collect sound. Your brain does the hearing.

It works out where different sounds are coming from by comparing what arrives at each ear. It identifies which sounds are speech and which aren’t. It locks onto the voice you’re trying to listen to and tries to suppress everything else. Much of this happens without you having to think about it.

When hearing loss makes speech less clear, following one voice among several can take more effort.

Two people can sit in my clinic with almost identical hearing assessment results and have completely different experiences in noise. One copes reasonably well. The other really struggles.

The cocktail party problem

Researchers have been calling it the cocktail party effect since the 1950s, when a British scientist called Colin Cherry first studied how people manage to follow one voice in a noisy room.

Following one voice at a loud pub table relies on being able to separate it from the others. Hearing loss can make that harder, though the difficulty varies from person to person.

A 2021 study from Oregon Health & Science University and VA Portland tested 11 people with normal hearing and 10 with hearing loss. Researchers played a different vowel sound to each ear through headphones. People in both groups sometimes heard the two vowels as one sound. In the hearing-loss group, this blending continued across larger differences in pitch.

The findings suggest one possible explanation for difficulty separating competing voices. They do not establish the cause of an individual person’s difficulty in a restaurant.

It’s tiring. Properly tiring.

Following speech in noise can mean using context to fill in missed words, watching lips and trying to pick out one voice among several. That takes concentration.

I see this in clinic more often than I’d like. Someone comes in and says their hearing is fine. And then their partner, who has come along, quietly mentions that they don’t go out for meals anymore. Or they’ve gone quiet at family dos. Or they come home from work completely drained and can’t explain why.

Someone can follow the conversation and still find it exhausting.

The extra work is called listening effort. Listening fatigue describes the tiredness that can follow sustained listening. That tiredness often gets put down to getting older, being a bit antisocial or not being a “going out” person any more.

So do hearing aids fix it?

Hearing aids can make speech easier to follow in background noise. They do not restore normal hearing or remove every difficulty in a busy room.

They amplify sounds according to your hearing loss. Directional microphones can give more emphasis to speech from a particular direction, while noise reduction can make some background sounds less intrusive. Several people talking at once can still be difficult.

The result depends on your hearing, the room and how the aids are fitted and adjusted. Premium hearing-aid technology may offer more options for handling noise, but the price alone cannot tell us what will suit you. At Alto, the recommendation includes the hearing aid, the dome or custom earpiece, any accessories and the follow-up support you need.

A remote microphone picks up speech closer to the person talking and sends it to compatible hearing aids. This can give you more of their voice relative to the room noise. A microphone worn by one person favours that voice. Our hearing-aid accessories guide explains personal and table microphones and how they are used.

Why speech-in-noise testing matters

Alto’s Complete Hearing Assessment includes more than a basic pure-tone test.

A basic hearing test, the one with the beeps, tells you how loud sounds need to be before you can detect them. That is useful information, but it does not show how well you can understand speech when background noise is present. For many people, that is the problem they actually came in to talk about.

Measuring how you follow speech in noise helps us discuss the technology, settings or accessories that may be useful, and where you may still have difficulty.

At Alto, speech-in-noise testing is part of every Complete Hearing Assessment. It measures how you follow speech with competing sound, giving us information that hearing levels alone cannot provide.

Hearing better in restaurants

In a restaurant, sit with your back to a wall, away from the kitchen and speakers. Let the noise be behind you and the people you want to hear in front of you. Corner tables are usually better than the middle of the room.

Lighting matters too. Seeing the person’s lips, facial expression and body language can help you follow what they are saying. Dim lighting makes those cues harder to see.

Smaller groups can be easier to follow. If you have the choice, a table of four may be more manageable than a table of fourteen.

If you wear hearing aids, tell your audiologist which noisy situations are still difficult. Real Ear Measurements help check the sound reaching your ear. At follow-up, your audiologist can review how you are hearing in everyday life and adjust the fitting as needed.

What to do if background noise is becoming difficult

If you haven’t had your hearing assessed

If you keep missing words in busy places, arrange a Complete Hearing Assessment. At Alto, this includes ear-health checks, hearing-level measurements and speech-in-noise testing. We discuss the conversations you are missing and explain whether hearing aids, other support or medical advice are appropriate.

If you already wear hearing aids

Arrange a follow-up with your audiologist and describe a few situations that were difficult. Perhaps one person was hard to hear across a table, or you lost the conversation whenever someone changed seats.

Your audiologist can check the condition and fit of the aids, review the settings and discuss any accessories. They can also decide whether your hearing needs reassessing.

For sudden hearing loss, hearing that has worsened over days or weeks, or hearing loss with earache or discharge, seek an urgent GP appointment or contact NHS 111. Do not wait for a routine appointment.

Talk to Alto about the conversations you are missing

A Complete Hearing Assessment takes 90 minutes and costs £75. We can help you arrange an appointment.

Request a call back

If you are only beginning to wonder whether your hearing has changed, you can start with SoundCheck.

Common questions