Why Do Hearing Aids Make My Voice LOUD? | The Occlusion Effect

Why Do Hearing Aids Make My Voice LOUD? | The Occlusion Effect. Dr. Cliff Olson, Audiologist and founder of Applied Hearing Solutions in Phoenix Arizona, discusses why hearing aids make your voice sound different.
Website: www.DrCliffAuD.com
Clinic Website: www.AppliedHearingAZ.com
One of the first comments that new hearing aid wearers have when first being fit with hearing aids is, "why does my voice sound so different?". Well, there are two possible answers to this question. It is either your own voice being amplified by your new hearing aids, or you are experiencing the Occlusion Effect.
Let's discuss the first culprit. There is a solid chance that you haven't heard your own voice in a long time. Hearing aids are primarily designed to amplify speech. Due to this, it is highly likely that your own voice will also be amplified to a higher level. This results in your own voice becoming abnormally loud compared to what you are accustomed to. Fortunately, this is something that new hearing aid users tend to adjust to pretty quickly.
However, the second culprit, the Occlusion Effect, is often a different story. The Occlusion Effect occurs when the sound of your own voice, or the sound of you chewing on food, is bone conducted through your jaw and skull. This vibration of sound eventually ends up in your ear canals. Typically, this vibration would escape your canals, but if it cannot escape due to the use of a hearing aid or ear mold, it will vibrate your eardrums causing your voice to become loud to yourself. Some people describe this as a Hollow Sound, a Loud Booming Sound, like your are Talking in a Barrel, or Talking in a Tunnel.
It is generally east to determine which one you have by either performing an objective measurement using Probe Microphone Measurements, which are also used for Real Ear Measurement, or by muting your hearing aids and having you talk to see if the booming perception goes away or remains. If this perception remains, you have the Occlusion Effect.
The Occlusion Effect is typically experienced more often by individuals who have Really good Low-Frequency Hearing thresholds. This is because the Occlusion effect is perceived at frequencies below 500 Hz. The better you hear sounds below 500 Hz, the more you will perceive Occlusion. On the other hand, if you have bad hearing in the frequencies below 500 Hz, then you are unlikely to experience the Occlusion Effect.
So, if you have the Occlusion effect, is there a way to eliminate or reduce it? The answer is Yes! There are two ways to reduce the perception of the Occlusion Effect. First is to increase the venting of your ear mold or use an open dome. This will allow for the bone conducted sound in your ear canal to escape. The bigger the vent, the less risk you have of experiencing Occlusion. Second, is to have a deeper inserted ear mold or hearing aid. The less space between your eardrum and the tip of your hearing aid or ear mold, the less space that your voice has to vibrate, reducing occlusion as well.
Seems simple right? Wrong. The larger you make a vent, the more risk you have of allowing amplified sound to leak out and cause feedback or whistling. The deeper you go inside of an ear canal, the more sensitive it becomes so inserting a hearing aid or ear mold too deep could cause comfort issues. That being said, if your hearing care professional is good at what they do, they will be able to find the right balance between an acceptable amount of Occlusion, and an appropriate amount of Amplification at the same time.

[@williamnorton4750]

Great explanation of a complex topic. Thanks Doc Cliff.

[@sidhimagoel2802]

The way you teach is amazing. You go audiologist 🌺

[@arunar6280]

I am an audiometry student..your videos are very useful to me..thank u Dr.Cliffaud

[@vljenewein]

BTW Great job in teaching and information you share!! I have saved a bunch of "YOUR" videos to my computer to watch again. BRAVO !!

[@bdaugher]

SLP Masters student- Thank you for the video! Very helpful for our section in Auditory Masking.

[@OldDogNewTrick]

Good information. Thanks again.

[@DrCliffAuD]

Thanks OldDogNewTrick!

[@gregsettle9725]

Your vids are a wealth of knowledge about a most misunderstood area of medicine.

[@jameseubanks1509]

Thanks, Dr. Cliff. I have good low frequency hearing and a 'ski slope' high frequency loss. An open ear tip and Signia's Own Voice Processing feature worked for me.

[@DrCliffAuD]

Nice!

[@juvn9310]

Thanks so much for all your videos Dr. Cliff, they're so informative it's such a blessing :) Could you kindly clarify if a person with a sloping hearing loss can wear an iic ?

[@GodskidUr1]

Thanks. I started wearing ear plugs to sleep and hear sound like a radio wave sound. Very strange but now I get it

[@VideoNash]

thanks

[@larrycummings7300]

A little of this topic but thanks for your video on getting hearing aids from the VA. I was Air Force flight line and seeing the VA worked out great for me. They fitted me with 2 Phonak hearing aids and sent me in for a battery of other tests. I ended up with an 80% disability. 0% service connected for hearing loss, 10% for tinnitus and the rest for non hearing loss items.

[@DrCliffAuD]

The VA gets a bad rap, but they really do take good care of veterans.

[@thewanderer577]

Another knowledge filled video explained in simple terms! Great job as always!

[@DrCliffAuD]

Thanks again Wanderer!

[@user-ms1zn1tp6h]

Thanks so much for the vid because i have occlusion effect and i don’t know how to stop and at first i was like ‘uh my ear is clugged, no big deal’ but my dad is a doc and he still did not know it’s occlusion effect

[@jaredcharney8540]

Off topic as always but I love that this creates another space for feedback besides my audiologist etc: do you think that Phonak since they are not updating their CROS to work with the current iPhone OS and considering they are not making their Marvel line to work with CROS that they are more or less done w/the SSD community? It's been a little over 2 years since I lost all hearing in my right ear and "gained" 24/7 tinnitus in that ear, etc. although I believe I might opt (if we can get insurance to cover) for a Med-El implant, my audiologist told me that the newer Oticon CROS is stepping things up of course my biggest issues are in crowded situations and the ever present parasite that is tinnitus thanks again your site has been very helpful

[@michaelsmith697]

Hi Doctor , i just got my behind the ear Resound Hearing Aids. They are great. But I’m concerned with the different Types of domes. What’s the difference between the small closed dome and the tulip dome?

[@seq1jav]

I recently purchase a set of Phonak Virto Titanium M70 devices and I am now experiencing occlusion which I did not have with my 5 year old Starkey IIC Sound Lens devices. I was fitted for the Phonaks with an inner ear canal mold so can the vent hole be made larger or should I return these for a different vendor. Great videos! Thanks!

[@seajay9681]

Do hearing aids help with clarity and tinnitus for high frequency hearing loss ? (3000hz to 7000hz with a max hearing loss of 65 db at 6000 hz)(both ears but tinnitus is mainly in the left ear)

[@emtenan7317]

Thank you for the information! Side question; Do you know if there is Naida Marvel line in the future? and when they will releasing it?

[@DrCliffAuD]

No idea, but fingers crossed. The Audeo Marvel does have up to an Ultra Power Receiver.

[@vljenewein]

I have a Kirkland Signature 10.0T (same as Phonak Paradise 90RT) and was fitted with Medium Power Domes. My plugged up feeling and me talking is horrible. I did buy some Closed domes with 2 tiny vents in them, and tried them. I did not end up with feedback issues, the Occlusion improved DRAMATICALLY but high pitches were annoying loud.. too loud. I understand that any time you change a dome style it changes the overall acoustic of the ear canal. So would I need to "suggest" to the Costco hearing aid specialist that I want closed domes (with vents) and have the hearing aids "tuned" using REM to those? I have been fitted with a Power receiver and Power domes. My hearing loss stars just below 40dB and at 1.5 Khz starts sloping pretty drastic down to 4K which is at 100dB.

[@misterzee5736]

Hi Dr Cliff. I have high frequency hearing loss. I sometimes have some usual internal sounds get much louder. Sounds of my footsteps, voice, and sometimes my pulse. I am SCDS clear. Could that be fluid in the ear causing this same occlusion effect or inflammation? Or would that be some other cause like microvascular compression?

[@allanpennington]

Just got fitted for Resound Omnia 9 with M&RIE receiver. My audiologist is loathed to try anything but a closed dome because of the likelihood of feedback at high freq. At 500Hz I'm less that 20dB loss but quite a slope down past 2K so all the amplification is at higher frequencies. The occlusion I get however is not really tolerable. Coupled with the noise reduction capabilities of the Omnia and it often feels like Im just walking around with my fingers in my ears.

[@LonestarTrent]

Yea I have the issue of not knowing how load I am some people sometimes wonder why in yelling

[@DrCliffAuD]

If people feel like you're yelling, perhaps your hearing aids are under amplified.

[@melhaniegean903]

Is the hearing aid too loud? I'm planning to buy one but my condition is not that worst. I still can hear, but not that clear

[@danielmarquez5424]

Hey Doctor Cliff! Would the occlusion effect amplify your voice to the point of possibly damaging your hearing after long exposures?

[@anilori262]

I have the occlusion effect and i dont even wear hearing aids, but it seems the ENTs cant explain.

[@DrumZet]

Can singing with earplugs cause any kind of hearing damage due to occlusion effect?

[@ktenn7972]

Hi I'm looking for advice on how to get rid of occlusion in my CIC hearing aids. My audiologist drilled vents in them but its not enough. Can I drill multiple vents in them or is there another way?

[@kaylasmusic]

I had REM’s done on my hearing aids today with my costom molds and it showed that it met my prescription… if it was too small a vent size, how would I be able to tell? I mean ive always had a bit of the occlusive feeling with hearing aids in general but with the molds its more of just when i bite down as opposed to when i speak but its mainly just a little.. is my vent too small??

[@geraldinemcardle2418]

I'm getting my hearing aids in 2 week feel scared.Ive titinius in both ears will orandary hearing aids help?

[@MichaelGoulding]

Great video thank you. Can I ask if this is the same effect one experiences with in ear headphones like Galaxy Buds or Airpods Pro when you get a pounding/thump/thud with every foot step? I've always had issues with anything that fully covers or plugs my ears with this so stick to Galaxy Buds Live which are open. I'm considering the Airpods Pro 2 recently announced but if I'm likely to get the same issue I'm thinking I'm better going for Airpods 3 which are open?

[@DrCliffAuD]

Yes you can get this with earbuds. Transparency mode can help, but not occluding your ear canal would be better.

[@MarshaKiehl-pl2lu]

What type of Hearing Aid do you recommend?

[@user-tr1dm1fq2h]

If my voice is 70 db how it could be as a result of occlusion effect?

[@highcheeseman667]

Ok i got a good idea for a vid, hearing aides slipping out of ear :custom ear molds vs rubber ear molds

[@jkat9196]

Ear mold refers to what are custom molded to your ears. Do you mean domes? Or just soft vs hard ear molds?

[@jimferris6762]

Can venting be adjusted on a hearing aid that has already been fitted and purchased? Specifically pertaining to the Signa 17NX for just one sided hearing loss. Occlusion is very distracting. Thanks for addressing my questions Sir.

[@DrCliffAuD]

Yes it can.

[@JustHumblePerson]

Despite almost no hearing loss at 500 Hz (max 20dB) I don't like large venting, because I loose benefits from e.g. FM/Roger systems, noise reduction systems, etc. (the noise get into ear canal via venting). Does it make sense to get earmold with no venting if I have no problem with occlusion effect?

[@DrCliffAuD]

Having a closed ear mold would be beneficial if someone is not bothered or does not perceive occlusion. You are correct, having open domes or large venting can limit directional effects from hearing aids.

[@JustHumblePerson]

@@DrCliffAuD, thanks for info! I will try Audeo M90 with REM in January. I have used Bolero V70-P until now, fitted with REM first time in my life, but has no benefit, probably because of too weak power in high frequency (which REM show) or/and too close loudspeaker during REM (~30 cm to my face). I will try it again!

[@GaleAbraham]

When I first received the Phonak Audeo Marvel HAs and tried to put the open domes in my ears both HAs were whistling. The domes were changed and no whistling but I hear my voice with strong buzzing. Is it occlusion?

[@DrCliffAuD]

Most likely yes.

[@GaleAbraham]

@@DrCliffAuD When open domes cause whistling and close domes most likely cause occlusion what are possible solutions?

[@renb4866]

Doc can I ask..what is happening to my ear because I can hear my own breath when im breathing and i needed to close my nose and inhale so that it will be back to normal then seconds or a minute ago it happen again.

[@Rozzawood]

Sounds like Patulous Eustachian Tubes, If this is happening quite often, try and see someone familiar with PET and ask if they can check if you could have it. All the best :)

[@Mulberry2000]

I have this occulation effect without hearing aids or anything in my left ear. So this video does not help me.

[@Normiteeee]

how come people use hearing aids when they can hear alrdy..

[@larry5203]

Dr Cliff, does the Signia OVP help reduce occlusion and own voice loudness effectively? Are there any other brands that also help reduce these effects as well as Signia?

[@jameseubanks1509]

Larry, in my case the OVP really works! When I was fitted with the Signia NX7, the audiologist told me to start counting slowly out loud from 21. The NX7 corrected the problem automatically. When I reached 28, she told me to stop counting. The loudness problem was gone, Yes, it really works!

[@DrCliffAuD]

Technically, OVP does not address occlusion directly, but perhaps indirectly. It actually reduces amplification given to your own voice through the hearing aids. This also may reduce the amount of vibration added to bone conducted vibration, possibly reducing some occlusion.

[@lindasewell7926]

So this is why I feel like I'm hearing a tin can on my head when wearing my aides, thank you

[@stanleychuks4161]

I was punched in the ear, now I’m Hearing echo sound and ringing

[@dorothyphillips9165]

Wish you didn't talk so fast.

[@DrCliffAuD]

I'm sorry Dorothy. I truly am trying to get better at this.

[@JustHumblePerson]

@Dorothy, you can set 0,75x or 0,5x speed in the setting of the clip :)

[@dorothyphillips9165]

@@DrCliffAuD Thanks. I did not want to miss any of the valuable information you give. As a very senior ,senior voice recognition is difficult.

[@thebossman60]

You can slow the video down