Could Apple AirPods Pro Kill The Hearing Aid Industry?

Apple’s AirPods Pro, released on October 30th 2019, are a complete redesign and refresh of the iconic (love it or hate it) white wireless Bluetooth Airpods that have become a staple of gyms, Starbucks, and commutes everywhere.

The new Apple AirPods Pro ($249) feature active noise cancellation, improved fit, and a new feature called “transparency mode” that make them much more appealing for many earbud users. They also still feature a travel case that acts as a portable charger.

As a hearing care professional and an audio electronics enthusiast, I am very aware of changes that are happening in the audio world. I’m a Doctor of Audiology and own and operate a hearing care practice that focuses on treating hearing loss with hearing aids. So, not only am I interested in major shifts in the consumer audio market as a consumer, I also have a vested interest as a professional and small business owner.

For the past 5 years I have predicted that major consumer companies like Bose, Sony, Sennheiser, and Apple would make entries into the world of “over-the-counter” hearing aids.

Consumers of hearing aids have long expressed frustration about the high cost and hands-on care associated with the treatment of hearing loss. My industry certainly appears, at least from the outside, to be one that’s ripe for disruption.

Big Changes in Consumer Headphones

I’ve used AirPods for the past two years, and have generally felt that they are decent-sounding, convenient, and intelligently designed Bluetooth headphones.

They have been my go-to in the gym (even though I have to wear adaptors to make them stay in my ears), and I often use them at work when I need to talk on the phone for an extended period of time.

A few months ago, whispers started to surface that Apple was filing multiple Active Noise Reduction (ANR) patents, leading many to believe that a new AirPod with ANR was on the horizon.

When the AirPods Pro were announced in mid-October, it turned out that was true, and more. Not only do the AirPods Pro actively kill outside noise, but they also feature several other smart features that make for a pretty impressive user experience.

So, for science, I went out and bought a pair.

Hands-on With the AirPod Pro

I’ve had my AirPods Pro for about 2 weeks now, and I’ve had the opportunity to use them in a wide range of situations.

I’ll hit the highlights of my experience with a brief review, and tie it all back in with what I believe these devices mean for the future of hearing care.

Fit and Sound Quality

I list these two attributes together because in my mind (and my experience fitting thousands of hearing aids) you can’t have one without the other. If you don’t have a good fit and seal in the ear, sound will leak out, leading to tinny and thin sound quality.

With my previous AirPods, which apparently fit nicely for about 80% of the population, fit was always an issue for me. If I didn’t put a silicone adaptor on the earpieces they would constantly slip out, leading to poor sound quality and the annoyance of constantly having to adjust the fit in my ear.The new AirPods Pro come with 3 sizes of silicone earbuds. When you purchase the earphones they come included with pre-attached medium buds, which fit me nicely.

One issue that many hearing aid users have is that they can’t tell whether their hearing aids are inserted properly. I’m sure the same is true for consumer earphones. Apple has fixed this problem with a smart and innovative solution.

They have embedded a microphone inside the speaker port, and once the devices are paired with an iPhone you can perform a quick and simple fit test, where they play music in your ear and the microphone in the earphones measure your ear acoustics. Then the app either lets you know that you need to improve the fit by adjusting the size or bud placement, or it tells you that you’ve achieved a good seal.

The embedded microphone also constantly measures the sound in your ear and makes adaptive changes to sound quality to achieve good ongoing sound even if the fit shifts slightly.

To me, this feature feels a lot like they’ve created technology similar to what we use daily in our hearing clinic called “real ear measurement”, where we measure the output of hearing aids at the patient’s eardrum to ensure a good fit and sound prescription.

Once you’ve achieved a good fit, the earphones honestly sound great. Bass is strong but not overpowering, mids sound clear, and highs are crisp. I have a set of premium over-the-ear Sony WH-1000xm3 headphones that truly don’t sound much (if any) better than these AirPods.

The other thing I’ll say about these earphones — they’re light, comfortable, and I almost forget I’m wearing them (especially with transparency mode, which I’ll discuss in a minute).

Active Noise Cancellation and Transparency Mode

The new AirPods allow you to wear them with in one of two modes: Transparency and Noise Cancellation.

Noise cancellation uses an external microphone that’s built into the outside of the device to measure ambient noise and significantly cut down the volume.

This feature works great for listening to music while working in a coffee shop, exercising solo at the gym, or taking phone calls in a noisy office environment.

The background noise is greatly reduced, although it’s not eliminated completely. Turning on Noise Cancellation mode does improve the quality of music or audio that you are streaming through the devices.

The mode that I’m fascinated by is Transparency mode. By clicking a button on your phone or on the stem of the earpiece, you go from isolated silence to complete environmental awareness. It truly feels like the devices aren’t even in your ears.

Earlier today, I was going for a walk at a nearby park, listening to an audiobook with noise cancellation mode turned on. There was a drizzling rain, but no outside sound was coming through.

I took a detour off the main route and walked down a trail to a nearby creek, and turned on Transparency mode. The auditory world opened up, and I was able to hear the rain drops on the leaves and the running water in the creek. It was honestly a pretty magical experience.

So - Are AirPods Pro Hearing Aid Killers?

The short answer - not yet.

The devices do have noise cancelling technology, in ear acoustic monitoring, good sound quality, and nice fit. They have a “Live Listen” feature that lets you use your iPhone microphone as a remote microphone.

Plus, they’re in the Apple ecosystem, which means that millions of people will end up owning a set.

However, for now anyway, the devices don’t amplify external sound enough to compensate for hearing loss.

That could be as simple as Apple adding “Hearing Profile” feature where users upload their hearing test results (or even do an in-app hearing test) and Apple custom-tunes the audio to your hearing ability. They could even use the transparency mode to turn your AirPods into amplifiers or OTC hearing aids.

Apple is definitely getting into the health game, with multiple health trackers on the Apple watch, and a robust health suite of Apps on iOS.

Update 2020: With iOS 14, AirPods can now be programmed to your hearing profile using the Apple Health app. It would appear that for a mild hearing loss you can achieve acceptable amounts of amplification to experience a hearing improvement. The reservations listed below still apply.

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Here Are a Few Reservations Around AirPods as Hearing Aids

1. Wearing earphones is a social cue that says “Don’t talk to me”. Wearing these devices as hearing aids would likely make you appear rude an anti-social, even though your goal is to be the opposite.
2. You still have to be pretty tech-savvy to use these. I consider myself to be very tech-literate, and I still had to spend some time Googling how to use several of the features. I know that a good portion of the hearing aid market is only interested in technology that is very simple and hands-off.
3. I doubt their speech in noise reduction features would be competitive with major hearing aids. Transparency mode sounds pretty great, but using them in a Starbucks makes it apparent that the Apple engineers haven’t focused on hearing in noise - they just pick up sound without any processing. This would be a serious problem for people with hearing loss.
4. Hearing aids are not an effective stand-alone solution to hearing loss treatment. Treating hearing loss effectively is a rehabilitative process that requires a professional who understands how to gradually help the patient rewire their brain for better hearing.

All of that said, I do think that Apple is potentially laying the groundwork for a hearing industry play - even though I doubt it would be a primary focus.

They very well could help some people open their eyes to the need for hearing care treatment, and increase the access to amplification for more people.

Apple is a major thought leader in the tech world. If they were to lead the way, I suspect that a lot of innovation and disruption in the hearing device industry would follow.

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