[HN Gopher] FDA Authorizes First Over-the-Counter Hearing Aid So...
       ___________________________________________________________________
        
       FDA Authorizes First Over-the-Counter Hearing Aid Software
        
       Author : mgerdts
       Score  : 384 points
       Date   : 2024-09-12 22:24 UTC (1 days ago)
        
 (HTM) web link (www.fda.gov)
 (TXT) w3m dump (www.fda.gov)
        
       | neilv wrote:
       | Consider the plausible scenario of Apple developing a _superior_
       | hearing aid -- a medical device.
       | 
       | If that happens, will people be able to use best medical device
       | _without_ being subject to the various liberties that tech
       | companies take with users -- violating privacy, and exercising
       | leverage to other purposes?
       | 
       | We've become acclimated to expect violation from the "tech"
       | industry, but what about the _medical_ field?
        
         | candiddevmike wrote:
         | The FDA, for all of its warts, is pretty good at curbing bad
         | behavior like this. All medical devices are pretty rigorously
         | controlled, to the point where you can't really add anything to
         | it that isn't absolutely necessary for the device to function.
         | And if you do, there's an encyclopedia worth of paperwork
         | you're going to have to write to defend why the functionality
         | is needed.
         | 
         | FDA likes to "duck type" things, and if your duck doesn't look
         | like the other ducks, you need to create a new animal or make
         | your duck look like other ducks.
        
           | neilv wrote:
           | Interesting. Do you think the FDA will be more proactive and
           | sharper, than regulatory authorities that got confused in the
           | past by tech companies (Airbnb, Uber, RealPage (YieldStar),
           | and others)?
        
             | candiddevmike wrote:
             | The opposite, they're going to be ridiculously stubborn and
             | require all of these high tech gadgets to be "less". The I
             | in FDA stands for innovation.
        
               | chrisweekly wrote:
               | > "The I in FDA stands for innovation."
               | 
               | LOL. I hadn't seen this before. Quote? Or did you coin
               | it?
        
               | gwern wrote:
               | Especially here. Expecting good faith in hearing aid
               | regulation - from the _FDA_?! Remember, Congress
               | authorized OTC hearing aids back in the Trump
               | administration, in _August 2017_
               | (https://en.wikipedia.org/wiki/Over-the-
               | Counter_Hearing_Aid_A...). For perspective, GPT-1 didn't
               | even exist yet. But the FDA slow-walked it so long that
               | the Biden administration had to intervene (and is now
               | trying to claim credit for it all, of course), which is
               | part of why the OTC hearing aid explosion has taken so
               | long, been so tentative and slow, and you're only seeing
               | it really taking off the past 2 years or so.
        
               | tomrod wrote:
               | If they hadn't intervened, would it have happened?
        
           | sureIy wrote:
           | I think this event proves you absolutely wrong.
           | 
           | They approved hearing aid "software", meaning it can run on
           | arbitrary hardware that may or may not have the restrictions
           | you're talking about... as part of other "software"
        
         | mike_d wrote:
         | > We've become acclimated to expect violation from the "tech"
         | industry, but what about the medical field?
         | 
         | Oh, you sweet innocent child.
         | 
         | Look at price gouging on EpiPens, J&J "lifelong" hip implants
         | needing replacement every few years, insulin pumps with
         | proprietary batteries, glucose monitors that actively prevent
         | you from reading data, etc.
         | 
         | Big bad tech companies don't hold a candle to the medical
         | industry.
        
         | StressedDev wrote:
         | How is Apple violating people's privacy? They have done a far
         | better job than other companies from what I'm have seen.
        
           | zie wrote:
           | I mean they are the best of the big tech companies, by a
           | country mile, but that's not really saying a lot. If you want
           | the full details, go read the privacy policy with a skeptic's
           | perspective.
        
             | Angostura wrote:
             | "Do your own research "
        
             | thowawatp302 wrote:
             | Everything in there seems fine to me, not sure what you're
             | talking about
        
           | kevin_thibedeau wrote:
           | Scanning for image hashes on everyone's phone is one.
        
             | echoangle wrote:
             | They aren't doing that currently though, right? The only
             | thing I remember is the NeuralHash thing which was delayed
             | and then never came.
        
         | cm2012 wrote:
         | Big tech - including even Meta but definitely including Apple -
         | have an insanely better track record of keeping user data safe
         | than traditional non-tech companies.
        
         | olalonde wrote:
         | If you take away economic incentive from Apple, the plausible
         | scenario is that Apple is simply not going to develop such
         | superior devices.
        
       | abtinf wrote:
       | > This application was reviewed under the FDA's De Novo premarket
       | review pathway, a regulatory pathway for some low- to moderate-
       | risk devices that are novel and for which there is no prior
       | legally marketed device.
       | 
       | Does that mean that if Android/Bose/Sony/etc were to develop a
       | comparable solution, they would not be able to use the "De Novo
       | premarket review pathway" because AirPods Pro is now a "prior
       | legally marketed device"?
       | 
       | How much more onerous is the normal pathway?
        
         | tootie wrote:
         | Sony already has OTC hearing aids on the market
        
           | CharlesW wrote:
           | Neat: https://electronics.sony.com/more/otc-hearing-
           | aid/c/all-otc-...
           | 
           | So what does "first OTC Hearing Aid Software" mean, given
           | that both are hardware/software systems?
        
             | Spooky23 wrote:
             | It does some tuning based on a hearing test.
        
             | tootie wrote:
             | It seems like it's software to conduct a hearing evaluation
             | to tune the airpods.
             | 
             | There's actually loads of OTC hearing aids on the market
             | already although most seem fairly pricey.
        
         | squidgedcricket wrote:
         | > Does that mean that if Android/Bose/Sony/etc were to develop
         | a comparable solution, they would not be able to use the "De
         | Novo premarket review pathway" because AirPods Pro is now a
         | "prior legally marketed device"?
         | 
         | Nope, they'd use the 510k process, which is less onerous than
         | de novo. De novo is a quicker alternative to the traditional
         | path for brand new classes of devices. The 510k process is used
         | to develop a new device within an existing class.
        
         | ijustlovemath wrote:
         | Med device startup cofounder here.
         | 
         | In terms of difficulty in your path to market, from hardest to
         | easiest (and ignoring some less common pathways):
         | 
         | 1. Pre Market Approval: you're addressing a completely unproven
         | technology in a novel and or dangerous space. Usually Class II
         | and above.
         | 
         | 2. De Novo: you're adding a new technology to a somewhat well
         | known space. Usually Class II+
         | 
         | 3. 510(k): There's already something in the market that
         | addresses a similar problem and works using similar technology
         | to your device. FDA understands these things well and have a
         | very clear approval guideline, which usually just takes time to
         | rubber stamp if the submission is of sufficiently high quality.
         | 
         | This is all ignoring Breakthrough Medical Devices, which have a
         | ton of red tape cut (max 30 days to hear back about any
         | submission, and if they run out of time, it's an approval).
         | These kinds of devices are pretty rare, though.
        
           | dannyw wrote:
           | As much as I am in favor of cutting red tape, medical devices
           | should not be received in 30 days max.
        
             | cruffle_duffle wrote:
             | Why? I do this sort of technique all the time at work to
             | keep things moving. "I'm gonna ship this code on Friday and
             | if I don't hear anything before then I'll assume no news is
             | good news and do it!".
             | 
             | There should always be an upper bound to how long somebody
             | can block your progress. If something was so important that
             | they want to block me, why didn't they tell me before
             | Friday? That was ample time to raise objections.
             | 
             | It's just an SLA and holds people accountable.
        
             | ijustlovemath wrote:
             | Really what happens is your application is given a higher
             | priority level and dedicated reviewers. They're still going
             | through the full review process, its just they're focusing
             | on your submission.
        
             | danudey wrote:
             | "Breakthrough" devices have to be devices which show a
             | significant improvement to quality of life over existing
             | treatments for "life threatening or irreversably
             | debilitating" conditions, using breakthrough technology in
             | a space where an existing device doesn't exist yet.
             | 
             | So it's less "we made a better pacemaker that uses ChatGPT"
             | and more "this new ventilator can keep people alive even
             | when their lungs are filling with fluid and they're going
             | to die otherwise".
        
       | xucheng wrote:
       | Interestingly, in the end of the article, the FDA links to an old
       | article hosted on web.archive.org[1] even though the linked
       | article was originally published by FDA themselves. Considering
       | the linked article was only published at 2022, a merely 2 years
       | ago, maybe the FDA should do more to prevent dead links.
       | 
       | [1]:
       | https://web.archive.org/web/20221028042729/https:/www.fda.go...
        
         | bigiain wrote:
         | > maybe the FDA should do more to prevent dead links
         | 
         | Perhaps government departments (and companies) taking advantage
         | of archive.org storing their old docs should be appropriately
         | supporting them?
        
           | FinnKuhn wrote:
           | I don't know how much money the internet archive has received
           | from official US government institutions, but they do receive
           | at least some as you can see from their list of foundations
           | that help with funding them: https://archive.org/about/
        
         | galleywest200 wrote:
         | This could also make is more difficult for new administrations
         | to "disappear" documents from government sites by storing them
         | on an archival site.
        
       | Nursie wrote:
       | I'm very positive about this development.
       | 
       | I don't personally need hearing aids (yet) but I know people that
       | do, and dear god are they expensive pieces of equipment.
       | 
       | Even if the AirPods aren't perfect for everyone (not everyone
       | wants in-ear devices) a big name like this getting in at that
       | price-point might shake up the market.
        
         | duskwuff wrote:
         | > I don't personally need hearing aids (yet) but I know people
         | that do, and dear god are they expensive pieces of equipment.
         | 
         | They aren't as bad as they used to be. You can get over-the-
         | counter hearing aids in the $200-500 range nowadays.
         | 
         | Even so, at $250, AirPods Pro are in a pretty good spot. The
         | main drawback I see is that the earbuds don't have all-day
         | battery life; users will need to recharge them in the case
         | periodically.
        
           | BOOSTERHIDROGEN wrote:
           | any recommendations ?
        
             | thebigman433 wrote:
             | You should go to Costco and try a bunch if you have one
             | near you. Its hard to recommend specific hearing aids to
             | people without knowing what they need. If you dont have a
             | Costco, go to any reputable hearing aid store near you and
             | try from their stock
        
             | Nursie wrote:
             | Just to echo what the other poster said - Costco seem to
             | have very good prices and will give you a free hearing test
             | with an audiologist (in Australia anyway)
             | 
             | Their range is fairly limited, but not necessarily in a bad
             | way. Compared to what other audiologists
             | recommend/prescribe, Costco's stuff was about half the
             | price.
             | 
             | OTC hearing aids - no idea.
        
           | Nursie wrote:
           | I guess the big question there is, which market segment will
           | the airpods be comparable to - OTC or prescription?
           | 
           | Because the 'good' hearing aids cost thousands of dollars,
           | and a lot of their added value is in various forms of sound
           | processing. I can see apple doing quite well at that.
           | 
           | > The main drawback I see is that the earbuds don't have all-
           | day battery life; users will need to recharge them in the
           | case periodically.
           | 
           | Yeah definitely, though if we are comparing them to 'good'
           | hearing aids then at that price you could buy two pairs and
           | rotate them through the charging case and still come out
           | ahead.
        
           | lotsofpulp wrote:
           | I've seen Costco sell AirPod Pros for $170 or $180 a couple
           | times a year.
        
         | jillesvangurp wrote:
         | Adam Savage (of Mythbusters fame) discussed his use of very
         | high-end hearing aids on his Youtube Channel. He has hearing
         | loss and he's of course pretty clued in when it comes to
         | hearing aids. He did a review on the specific brand he's using.
         | From what I remember, he was quite critical on the lack of
         | access to good products for most people that need to get these
         | via some insurance coverage. It would be interesting to get his
         | perspective on airpods.
         | 
         | Because of all the legislation, it's actually a hard market to
         | break into and the resulting products aren't necessarily very
         | good or competitive. The focus is on keeping the insurers happy
         | and getting approved; not the end user. The better products can
         | get really expensive too. So the FDA approving consumer grade
         | products could be a big deal.
         | 
         | Apple's airpods probably have quite a lot of non trivial tech
         | on board that probably overlaps significantly what some hearing
         | aids try to do. For example, AI that isolates sound and things
         | like noise suppression that work in a very targeted way are
         | game changers. Instead of just amplifying sound, selectively
         | blocking some sound is probably very helpful.
         | 
         | Thankfully I have no issues but I know some people that do that
         | wear hearing aids. Despite that, talking to them can be
         | challenging and they have all sorts of issues communicating in
         | loud places.
         | 
         | I imagine these could be useful for people that are completely
         | deaf even. They wouldn't hear anything but they might benefit
         | from e.g. live audio transcription; which is something that's
         | probably not that hard anymore for the likes of Apple or
         | Google.
        
         | dadadad100 wrote:
         | I think I'm the target market. Old enough that my hearing
         | requires some help, but still working in tech from home. The
         | hearing aids I've looked at - I have a prescription - have
         | Bluetooth for listening but no microphone for talking. I use my
         | AirPods for teams calls all day long. Switching back and forth
         | to a hearing aid seems too much trouble so I haven't taken that
         | step. I will get these new AirPods the day the feature ships. I
         | may need two pairs to deal with the battery life but it's still
         | cheap.
        
       | mgerdts wrote:
       | I'm conflicted on use of AirPods as hearing aids. I use one
       | hearing aid and have normal hearing in the other ear. I often
       | listen to things on my phone over the one hearing aid. It would
       | be nice to have stereo. For this reason, AirPods for both
       | listening to stuff and hearing assistance would be great.
       | 
       | On the other hand, when I see someone wearing AirPods I assume
       | they are listening to something else or are otherwise trying to
       | shut the world out. If I were wearing them to be able to engage
       | more, I think I would just be sending the opposite message.
        
         | garyfirestorm wrote:
         | This problem could be solved easily. One could put some kind of
         | tiny sticker on their AirPods - it would take sometime for it
         | to become mainstream - like an orange color ring - indicating
         | the user is using the AirPods as hearing aids. (This is a
         | people problem...)
        
           | wpollock wrote:
           | The answer is handicap hang tags, like those used in cars,
           | but worn as earrings. <wink>
        
           | hunter2_ wrote:
           | The sticker/paint could change all of the white into a skin
           | tone, the way many hearing aids are. Maybe similar to
           | wrapping a car with vinyl, or nail polish.
        
           | sneak wrote:
           | Some RGB LEDs in the airpods that change color depending on
           | the mode could also achieve this.
        
             | ChrisMarshallNY wrote:
             | The issue would be battery use. The batteries in these
             | things are _tiny_ , and using them as hearing aids could
             | mean longer use.
             | 
             | Having a phone lockscreen indicator of status would be a
             | good way to show this.
             | 
             | I think the phone interface for audiograms is ridiculously
             | complex. They need to improve that.
        
               | echoangle wrote:
               | How would a phone lockscreen indicator work? If someone
               | walks up to you in a store with AirPods in, how are you
               | seeing the indicator on the phone in their pocket? The
               | situations where I can look at the lock screen of the
               | phone of the person I'm speaking to are pretty limited.
        
               | ChrisMarshallNY wrote:
               | Good point.
               | 
               | But LEDs would probably take too much battery power.
               | 
               | Not sure if the new color eInk would be useful.
        
               | echoangle wrote:
               | Quick maths on the LED thing:
               | 
               | According to Wikipedia, AirPods Pro Gen 1 have 0.16 Wh of
               | battery per AirPod (There's no data on Gen 2). With 5
               | hours listening time, that gives a power draw of 0.032
               | watts or 32 milliwatts. This answer
               | https://electronics.stackexchange.com/a/640179 (I know,
               | not the best source, but I'm just guesstimating anyways)
               | gives a current of 1 mA at 5 V for an indicator LED. So
               | the LED would need 5 mW. That increases power draw to 37
               | milliwatts and gives a new battery life of about 4 hours
               | and 20 minutes. If using 5 mA, which the answer calls
               | "blindingly bright for some clear LEDs, even from 10 feet
               | away", the LED would draw 25 mW and reduce listening time
               | to only 2 hours and 50 minutes. The answer is also about
               | non-diffuse LEDs so the indicator would only be visible
               | from a narrow angle, but since it would point forward,
               | that's probably fine. Making it diffuse would reduce
               | perceived brightness again.
               | 
               | Brightness could be fine indoors, but outside with direct
               | sun is probably harder. Since you would have the LED on
               | both AirPods, you could probably expect that at least one
               | of them is in the shadow at any time though.
        
         | sureIy wrote:
         | Is it? I think that thanks to transparency mode and
         | conversation detection people are keeping them in "full time".
         | In noisy environments I just keep them on without music and
         | they help me hear people talk.
        
           | mgerdts wrote:
           | It really depends on the awareness of product features and
           | evolution of the actively used devices. My lived experience
           | is that those with white things in their ears can't hear you
           | or can barely hear you and have to pull one out to have a
           | conversation.
           | 
           | Those that know you probably understand how you use them. If
           | I were to see you walking in my neighborhood with your
           | AirPods I would probably not bother saying hi unless I
           | already knew you. If you were a new neighbor that always wore
           | AirPods, that means we would probably never become more than
           | strangers to each other unless you initiated conversation.
        
             | latexr wrote:
             | > If I were to see you walking in my neighborhood with your
             | AirPods I would probably not bother saying hi unless I
             | already knew you.
             | 
             | You can still do a slight but friendly wave or nod. That
             | would open the door for them to verbalise a "hi" or "good
             | morning" and strike up a conversation. And it only needs to
             | happen once for you to know.
             | 
             | Also, anecdotally, over a decade ago I used to wear non-
             | white headphones or earphones in public frequently. Yet I
             | was still accosted by strangers all the time, asking for
             | directions or other information, when there were plenty of
             | other people around with nothing in their ears. Still I
             | tried to always be helpful and friendly, even if it could
             | get tiresome: I was always listening to a book, not music,
             | so interruptions were meaningful distractions.
        
         | geoelectric wrote:
         | I'm pretty pumped about it actually. I have high-frequency
         | hearing loss in one ear (along with replacement tinnitus) that
         | just randomly crept in on me a few years ago, probably after
         | some ENT infection or the other.
         | 
         | The hearing specialist who tested me said it's fairly
         | significant--eg I can't hear consonants at the end of words
         | clearly, think he rated it as 75yo hearing and I was ~45, and
         | he asked me if I happened to shoot guns on that side. But he
         | did not recommend going so far as a hearing aid yet.
         | 
         | I personally am skeptical, especially a few years later. What
         | the AirPods solution might do is let me audition the idea. If
         | it turns out whatever it does is beneficial, that will
         | certainly prompt me to get myself retested for the real thing.
         | I should get re-tested anyway, but there's not much better to
         | motivate you than concrete evidence.
        
         | Angostura wrote:
         | The fact that Airpods _don't_ look like hearing aids is a key
         | advantage for some people. it's especially important to some
         | young people for whom there is a bit of a stigma around wearing
         | them.
        
           | ghaff wrote:
           | The flip side is you're wearing something that (today) is
           | generally considered an entertainment device or something
           | used to communicate with someone not in the room.
           | 
           | To be clear, I think this is great. My dad bought something
           | off Amazon as a backup for his hearing aid and tried to get
           | remote tech support from me. Who knows what Chinese piece of
           | crap he bought and what he needed to make it work?
           | Fortunately the return was easy.
           | 
           | I'd have a lot more confidence in an Airpod.
        
           | talldayo wrote:
           | It's a huge double-edged sword. I don't think twice about
           | people wearing hearing aids at the movies or walking down a
           | busy parking lot. If I see someone with Airpods doing the
           | same thing, I'm going to assume they're not using the rare
           | FDA-authorized feature and instead are fully noise-cancelled.
           | 
           | Hell, there's an entire meme of "Oh no, they have their
           | Airpods in!" that certainly won't abate after the release of
           | a rarely-used feature.
        
           | AyyEye wrote:
           | > it's especially important to some young people for whom
           | there is a bit of a stigma around wearing them.
           | 
           | Anyone who has a stigma about wearing hearing aids around
           | people they are talking to but not a stigma about wearing
           | earbuds while conversing needs to do some deep reflection.
        
       | userbinator wrote:
       | _The rule enabled consumers with perceived mild to moderate
       | hearing impairment to purchase hearing aids directly from stores
       | or online retailers without the need for a medical exam,
       | prescription or seeing an audiologist_
       | 
       | Is it just me or does this article sound (pun intended) a bit
       | tone-deaf? All this talk of them "authorizing", when earphones
       | with built-in mics, transparency modes, and adjustable equalisers
       | have existed for years before this, available for everyone to
       | purchase, and can function as a "hearing aid".
        
         | adgjlsfhk1 wrote:
         | Authorization is a big deal. It means it can be payed for by
         | insurance or explicitly prescribed.
        
       | herpderperator wrote:
       | It's kinda crazy hearing Apple mention during their event that
       | they expect FDA approval "very soon", and it actually happening 3
       | days later. I would have thought that governments can't promise
       | timelines to anyone, especially something like FDA approval.
        
         | playingalong wrote:
         | I don't think they can promise. But in a formal process with so
         | many steps involved, you know what else is left to be done. And
         | if there's nothing left, you assume "very soon" completion.
         | Also Apple's announcement was kind of a pressure put on the
         | gov: "hey, enough, unless you want everyone angry at you".
        
         | ivoflipse wrote:
         | If you've submitted a 510k for your medical device, you can
         | advertise it as "510k pending".
         | 
         | There is a risk that you never receive the clearance or
         | approval, but in this case Apple probably knew they had already
         | addressed any feedback the FDA had so it was very likely there
         | would be no further stumbling blocks
        
         | sqs wrote:
         | Rule of law FTW! Governments can't usually promise timelines,
         | but when the process is well documented and predictable, that
         | is a very good thing.
        
           | sneak wrote:
           | Literally nobody wants the government telling them what kind
           | of headphones they are allowed to wear. This is a failure of
           | the rule of law.
        
             | viherjuuri wrote:
             | The government is not telling you which headphones you can
             | wear. They are saying that these particular headphones work
             | well enough as a hearing aid that it is ok that market them
             | as such. This protects you from quacks that claim their
             | device is a hearing aid but that doesn't actually work.
        
               | mikaraento wrote:
               | To be fair, in the case of hearing aids you are both in
               | the right.
               | 
               | Excessive regulation has created oligopolies and kept
               | prices high in the US. The OTC hearing aid category is
               | meant to help. Before that, low-cost devices tended to
               | remain niche.
               | 
               | OTOH the regulation(s) were introduced due to blatant
               | sales of substandard devices, esp in the 1970s. A high-
               | amplification device runs the risk of further damaging
               | your hearing. Many hearing aid users are vulnerable
               | elderly.
        
             | barryrandall wrote:
             | Nobody is telling anyone what kind of headphones they're
             | allowed to wear. They do, however, tell _companies_ that
             | they can't claim their product has medical benefits without
             | proving (to some kind of standard) that the product is safe
             | to use, and does what it claims to do. This system was put
             | in place after businesses spent decades scamming the public
             | with "medicine" that didn't do what it claimed to do and,
             | in many cases, was also poisonous.
        
         | latexr wrote:
         | The event was prerecorded. It doesn't seem farfetched1 to think
         | they already had the approval but legally couldn't say it
         | without the FDA making it officially public. But if the FDA had
         | announced it before the event, it would've stolen the surprise.
         | Not only of the feature, but that new AirPods would be
         | announced. Apple would've hated that so they may have asked for
         | the announcement to be delayed.
         | 
         | 1 Maybe it is. I'm not an expert on the USA's health and
         | government policies.
        
           | robertlagrant wrote:
           | The approval process requires steps on both sides; Apple
           | could've just delayed sending the last bit of finalising
           | paperwork until they were sure it would drop after the
           | announcement.
        
         | not_the_fda wrote:
         | 510ks have a 90 day timeline. The FDA can "stop the clock" to
         | ask for more information and clarification. Buts its 90 days
         | from submital to approval or rejection if your paperwork is in
         | order.
         | 
         | Novel devices have a different path.
         | 
         | Once cleared the FDA can and will come by at anytime and do an
         | audit of your processes and if they aren't up to snuff they can
         | shutdown sales.
         | 
         | Its a trust but verify system.
        
         | HumblyTossed wrote:
         | What in Apple's statement made you think the FDA promised them
         | anything? They were probably all the way through with
         | everything they needed to do for the FDA process and, well,
         | there's a timeline for this process so that's why they knew.
        
         | bpodgursky wrote:
         | They definitely broadcast almost-definite timelines. You see
         | regularly SpaceX prepping launch sites for FAA approval that
         | comes less than a day before launch.
        
       | 14 wrote:
       | This is so cool to see. As a health care worker I see lots of
       | people who simply can not afford heating aids as they run for
       | thousands of dollars and then things like they hop into a shower
       | and they stop working happen all the time.
       | 
       | What a lot of people don't realize is that hearing loss is a loss
       | of ability to hear certain frequencies. You can't simply turn up
       | the volume although that does help to some degree. So what
       | happens is you see a doctor who determines what frequency loss
       | you have and the hearing aid when it picks up that frequency
       | shifts it to another frequency that you can hear. So I do see why
       | up until now ya it was regulated. We don't want some company
       | selling a device that simply cranks the volume and potentially
       | causes more damage. But with today's technology we are more then
       | ready for this to be a reality. With an app we can offer hearing
       | tests and determine what areas the client needs improved. This I
       | feel will be a game changer for some.
       | 
       | The only thing I wonder about is how well do air pods hold up to
       | waxy ears? With regular hearing aids they need cleaning and often
       | have things like a wax trap which is a tiny plug that catches wax
       | and can be swapped out easily.
        
         | left-struck wrote:
         | This is a minor point but cranking the volume doesn't
         | necessarily mean hearing loss.
         | 
         | You could for example have a device that amplifies external
         | sound so that you your hearing is enhanced over all frequencies
         | but has a max volume that it will not exceed. This compresses
         | the dynamic range and makes the quietest sounds easier to
         | detect. It would reduce your ability to distinguish sounds in a
         | noisy environment though I imagine.
        
       | bagels wrote:
       | They need to legalize glasses.
        
         | sneak wrote:
         | Zenni has historically been good about shipping without a
         | prescription (not sure about present day), and you can buy
         | contacts in Europe without a prescription and have them
         | shipped, although the shipping is a bit higher.
        
           | ewoodrich wrote:
           | > Zenni has historically been good about shipping without a
           | prescription (not sure about present day)
           | 
           | They still are. As long as you don't confuse them by
           | including a few pairs of glasses with similar but slightly
           | different values in the same order. Then they might demand an
           | actual copy of a prescription. Don't ask me how I know...
        
       | hungie wrote:
       | FDA with a reasonable bar - demonstrate that this is equivalent
       | to a professional fitting.
       | 
       | I'll take any opportunities for assistive technology to be a
       | cheaper option.
        
       | sneak wrote:
       | Hearing aids are neither food nor drugs. Same goes for glasses
       | and contact lenses, and CPAP machines.
       | 
       | These should never have required approval or prescriptions in the
       | first place. So many people are kept from getting what they need
       | by these arbitrary restrictions.
        
         | wtallis wrote:
         | > Hearing aids are neither food nor drugs.
         | 
         | Do you really believe that the FDA needs to be renamed before
         | it is reasonable for them to be the agency responsible for
         | regulating medical devices? Is there a _different_ agency you
         | think would be a better fit?
        
           | IncreasePosts wrote:
           | The NIH?
        
             | wtallis wrote:
             | That's purely a research organization, with no existing
             | regulatory role.
        
               | IncreasePosts wrote:
               | Sure. But it would work if you're just looking at names,
               | as it seemed OP was doing.
        
         | avianlyric wrote:
         | While we're at it, the FDA shouldn't regulate pacemakers,
         | glucose monitors, artificial hearts, cochlear implants, hip
         | replacement joints, or any other kind of surgical implant.
         | 
         | None of them are either food or drugs, and so many people are
         | prevented from getting what they need thanks to these arbitrary
         | restrictions!
         | 
         | Hmmm, on second thought, I'm not sure allowing ali express
         | implants to be marketed the same as rigourously tested
         | implants, with clear evidence of safety and _efficacy_ , is
         | such a great idea.
        
         | bregma wrote:
         | Same with pacemakers, joint replacements, insulin pumps,
         | glucose test strips, heck even bloodletting razors and leeches.
         | You should be able to just order them online from an Amazon
         | reseller or pick them up down at the Quickie Mart and take the
         | risk entirely on yourself, your dependents, or your co-
         | conspirators without no gov't meddling from so-called experts.
        
         | stevesimmons wrote:
         | So FCA regulation of CPAP machines just gets in the way of
         | people getting what they need?
         | 
         | How about Philips Respironics have to recall something like 15
         | million CPAP devices in 2021 because they contained foam liable
         | to disintegrate and which the user would then inhale...
        
           | autoexec wrote:
           | Yeah, if anything that showed we need more regulation and
           | even more importantly a better justice system. They knew
           | their devices were going to cause cancer and kill people, and
           | they not only continued to sell their devices, but they went
           | out of their way to try to hide the facts from the public so
           | that they could continue to kill as many people as possible.
           | 
           | The people at Philips Respironics were/are literal serial
           | killers. Their product has been linked to hundreds of deaths,
           | but not one person spent even a single day in jail.
        
             | hooverd wrote:
             | Eh, we need better regulation. Regulation proponents should
             | distinguish between bullshit hoops that only the big boys
             | can jump through vs targeted regulations that prevent this
             | kind of thing from happening.
        
               | autoexec wrote:
               | You're right. Regulations are critically important, but
               | they're just tools and they can be used for evil or good
               | depending on what they're doing and whose interests they
               | serve.
        
         | echoangle wrote:
         | Do you think having companies make defibrillators without any
         | approval is a good idea? Those aren't food nor drugs either.
        
         | theshackleford wrote:
         | I'd prefer more oversight of things like CPP, preferably it
         | would been before I spent years inhaling cancerous chemicals.
        
       | car wrote:
       | With the AirPods now officially becoming hearing aids, it will
       | hopefully reduce the stigma and attitude towards hearing aids and
       | allow many more people to realize how bad their hearing actually
       | is.
       | 
       | I have been wearing hearing aids for a few years now (Phonak).
       | I've also used the AirPods Pro with the accessibility audiogram
       | feature (basically making them hearing aids), which is really
       | good and has also been around for a few years. I'm very glad,
       | that Apple has made this official and even gotten FDA approval.
       | 
       | When I started to loose my hearing a decade ago, for a long time
       | I refused to wear hearing aids, probably due to the perceived
       | stigma. Even though it made life harder and harder -- imagine
       | work meetings with a mumbling boss or me accusing my family to
       | intentionally whisper -- it took years to change my mind. In
       | hindsight I should have gotten hearing aids years sooner.
       | 
       | My 'real' hearing aids are nothing short of a technological
       | marvel. They are tiny and run for a few days on zinc-air
       | batteries (312/Costco but made by Varta), while providing all-day
       | BT streaming. Btw, funny how most hearing aid brands come from
       | Denmark. In contrast, the AirPods run out after a few hours and
       | are also destined to become landfill due to their built in
       | battery.
        
         | spookie wrote:
         | I have got to say it was fantastic seeing my grandmas eyes glow
         | when, for no reason, I thought "wait my xm4's could help her"
         | and put them on her.
         | 
         | She was then able to hear our conversations even though the xm4
         | are not as good the real thing.
         | 
         | She didnt want hearing aids before that, but afterwards she
         | wanted ones.
        
           | vitorbaptistaa wrote:
           | The Sony WH-1000XM4? I'm still on the Bose QC 35, but you got
           | me curious. Could you explain how using it as a hearing aid
           | works? I searched the web but couldn't find good references.
        
             | xaqfox wrote:
             | There is a noise canceling mode that let's you hear what is
             | received by the microphone array and an option to "filter
             | in voices while suppressing noise" (they call that voice
             | passthrough). That section of the app is called "Ambient
             | Sound Control" if that helps your research.
        
         | AshamedCaptain wrote:
         | Note also phonaks are traditionally a couple thousand euros a
         | piece while even the most expensive airpods are still around
         | 300 the pair. Certainly the phonaks are impressively small,
         | lasting, good quality, and imperceptible, but is the almost 10x
         | price markup justified?
         | 
         | The biggest problem with hearing aids (and
         | doctors/calibrators/whatever) is that they are ridiculously
         | expensive... the attitude/stigma much less so. (And in any case
         | airpods are about the opposite of "imperceptible" so I fail to
         | see any appeal other than the price)
        
           | alias_neo wrote:
           | I don't think I've ever seen someone with a hearing aid and
           | though anything negative of it, I get it people can be self-
           | conscious, but for something like a hearing aid I think it's
           | unjustified.
           | 
           | On the other hand, I can't bring myself to keep earbuds
           | (airpods or w/e) in my ears while talking to someone,
           | regardless of if I can hear them properly, I just seems
           | incredibly rude.
           | 
           | My uneducated opinion, is that someone using airpods as
           | hearing aids is more likely to face stigma for that reason,
           | than someone wearing what are clearly hearing aids, unless
           | people actually know they have hearing issues.
        
             | ghaff wrote:
             | It almost certainly depends how social norms develop.
             | 
             | When Borg bluetooth earpieces first came out, they
             | definitely carried a tech bro/fin bro/VC/etc. vibe that, at
             | any moment, someone more important than you might want to
             | get in touch with me.
             | 
             | I do think Airpods today carry a certain I'm not
             | necessarily giving you my full attention vibe whereas an
             | obvious hearing aid is a medical prosthetic. To the degree
             | that Airpods replace hearing aids for some number of people
             | or just assist people who aren't quite at the prescribed
             | medical device level, that probably changes.
        
               | AshamedCaptain wrote:
               | The one thing that I do believe Apple managed with the
               | iPhone is the removal of this "tech bro" vibe from
               | carrying a smartphone overall. So I guess it's not
               | entirely out of the question that Apple will remove the
               | stigma from wearing huge headsets 24h long...
        
               | ghaff wrote:
               | I'm skeptical about big headsets but small earpieces seem
               | headed towards becoming pretty normalized.
        
             | magicalhippo wrote:
             | A buddy had a girlfriend who had reduced hearing. I noticed
             | that people would raise their voice and really dumb down
             | when speaking to her, like they were talking to a senile
             | elderly. It'd happen before she'd said a word, so they
             | clearly saw the hearing aid and assumed.
             | 
             | She admitted she disliked wearing the hearing aids, due to
             | such things. But the alternative was not following
             | conversations, which meant she'd get excluded because she
             | missed important information.
             | 
             | Gave me a whole new perspective on hearing loss.
        
               | AshamedCaptain wrote:
               | Maybe it's because I have been wearing aids through all
               | my life, but I see things this way. I don't care much
               | what stigma wearing one carries, considering the
               | alternative is being "that guy" who needs everything
               | repeated twice, and that is a stigma I hate.
        
             | kasey_junk wrote:
             | I don't think the stigma is around hearing loss it's about
             | age.
             | 
             | And stigma is probably not the right word, it's an internal
             | acceptance issue.
        
               | car wrote:
               | You are right, I thought about it a bit more, and I think
               | it was more vanity for me, since I was fairly young when
               | the hearing loss started. But hearing aids nowadays are
               | so inconspicuous that most people don't even notice them.
        
             | autoexec wrote:
             | > I don't think I've ever seen someone with a hearing aid
             | and though anything negative of it, I get it people can be
             | self-conscious, but for something like a hearing aid I
             | think it's unjustified.
             | 
             | Neither have I. On the other hand, I have seen people
             | wearing air pods and thought they looked ridiculous, as if
             | they had qtips sticking out of their ears. Especially if
             | they're sticking out at different angles.
        
         | josefresco wrote:
         | You're certainly not alone in resisting hearing aids. My dad
         | just got some from Costco (most affordable) and really likes
         | them. He probably waited 5-10 years too long.
         | 
         | My father-in-law however doesn't like hearing aids because he
         | feels they amplify things he doesn't want to hear. Granted he's
         | never been fitted to actual hearing aids. I understand his
         | concern, but he's told me multiple times his hearing loss
         | leaves him isolated during conversation. He told me one night
         | that he has a lot to say, but can't hear so he spends a lot of
         | time just smiling. It makes me sad that his pride (and
         | stubbornness?) is causing him this stress.
        
           | vel0city wrote:
           | > he feels they amplify things he doesn't want to hear.
           | 
           | I mean that's kind of the whole point of having them adjusted
           | with an audiologist. They're tuned to your specific needs.
           | 
           | It's too bad so many people think they're just mics and
           | amplifiers. Modern hearing aids do _a lot_ of signal
           | processing.
        
             | Arrath wrote:
             | > It's too bad so many people think they're just mics and
             | amplifiers. Modern hearing aids do a lot of signal
             | processing.
             | 
             | This is what I'm still trying to convince my dad of, after
             | he found the pair he was fitted with ~20 years ago
             | absolutely useless. He found that they simply made
             | everything louder which did nothing to help him pick out
             | what he wanted to hear.
             | 
             | But he's always been picky about his soundscapes, wanting
             | the TV muted during ad breaks etc etc.
        
               | xur17 wrote:
               | > But he's always been picky about his soundscapes,
               | wanting the TV muted during ad breaks etc etc.
               | 
               | I'm with him on this one. Commercials always end up being
               | louder than the rest of the content, and are just..
               | annoying.
        
               | geocrasher wrote:
               | I thought I had hearing loss. I don't. I have Audio
               | Processing Disorder. When I found out about APD and read
               | its symptom list, I cried. It's me, all over. Between
               | that and ADHD I now understand how my brain processes (or
               | doesn't process) sound properly and why even a well
               | intentioned (but clueless) audiologist told me I had
               | "selective hearing".
        
               | vel0city wrote:
               | > he found the pair he was fitted with ~20 years ago
               | absolutely useless
               | 
               | IKUK but that's like having bad vision so you put on a
               | pair of your glasses from 20 years ago, still having bad
               | vision, and deciding glasses just don't work well.
               | Hearing and vision change over time. And that's assuming
               | those were good hearing aids 20 years ago compared to
               | what is available today.
               | 
               | I hope your dad ends up taking a chance.
        
           | qup wrote:
           | My grandmother did that, as well. She was brilliant, but she
           | was reduced to nodding a long, often inappropriately, because
           | she couldn't hear.
        
             | josefresco wrote:
             | It's rough now that I know it bothers him. Late at night,
             | when the house is quiet and it's just you and him, he'll
             | talk your ear off and hear every word you say.
        
           | RcouF1uZ4gsC wrote:
           | > because he feels they amplify things he doesn't want to
           | hear.
           | 
           | Could that be your mother-in-law telling him things to do?
           | 
           | Is he afraid of losing plausible deniability - "Sorry, honey,
           | I didn't hear that, you know how bad my hearing is."
        
           | phkahler wrote:
           | >> he feels they amplify things he doesn't want to hear.
           | 
           | Modern hearing aids can be adjusted to amplify _only_ the
           | things you want to hear, and even reduce the things you don
           | 't want to hear.
        
           | car wrote:
           | Costco is great for this I found out. Free audiogram, and all
           | name brand hearing aids.
           | 
           | I used to be like your father-in-law, pride, vanity,
           | stubborn, not wanting to be told what to do, whatever it was.
           | And my dad was like this too (the hearing loss is heritable),
           | I used to mock him about not wanting hearing aids before my
           | own hearing declined. When I finally got fitted, it was
           | shocking to me how much my hearing had suffered. Suddenly I
           | could hear birds and crickets again, and most importantly
           | speech!
           | 
           | Maybe you can get your father-in-law to first play around
           | with AirPods as hearing aids to win him over to get proper
           | ones. The latest generation hearing aids, like the AP's, have
           | amazing AI signal processing that will suppress noise and
           | enhance speech. It's always cool when my Phonak's detect
           | noise and shut it down.
           | 
           | The important thing about hearing loss in elderly, especially
           | if someone has an elevated risk of cognitive decline, is the
           | resulting social isolation, and the increasing risk of
           | dementia [1]. It should be addressed sooner than later.
           | 
           | To sum it up, the AP's have the potential to provide an
           | affordable on-ramp for more hearing impaired people to
           | experience hearing restoration and warm up to better ones
           | (hopefully covered by insurance). I don't think AP's would a
           | permanent hearing solution, other than for people who are
           | uninsured and can't afford real hearing aids (sadly).
           | 
           | Edit: I could not imagine wearing AP's all day, great as they
           | are, while I don't even notice my receiver-in-ear hearing
           | aids anymore.
           | 
           | Edit: While AP's are not perfect, having any kind of hearing
           | aid is a 100% improvement over having none, which is probably
           | also why the FDA allowed OTC hearing aids.
           | 
           | Edit: [1] https://www.nih.gov/news-events/nih-research-
           | matters/hearing...
        
           | hanniabu wrote:
           | > He probably waited 5-10 years too long.
           | 
           | What's the downside of waiting?
        
             | lukas099 wrote:
             | Diminished quality of life during the waiting period
        
         | freedomben wrote:
         | > _In contrast, the AirPods run out after a few hours and are
         | also destined to become landfill due to their built in
         | battery._
         | 
         | Also will entrench the user in a walled garden ecosystem from a
         | very specific giant tech company that isn't big on making their
         | products compatible with other companies.
        
           | systemtest wrote:
           | I have no issues using my AirPods on Android.
           | 
           | Automatic device switching doesn't work but that doesn't work
           | on my Sony headphones either.
        
             | explorigin wrote:
             | +1 on this. I use them with my android phone, steamdeck,
             | windows computer, TV. They work great!
        
             | vel0city wrote:
             | The new hearing aid features are gatekept behind an iOS
             | app. You can't tweak the hearing aid settings without an
             | Apple device.
        
               | systemtest wrote:
               | The Samsung Galaxy Buds only have 360 audio and the
               | better audio codec if you use a Samsung Galaxy
               | smartphone. Doesn't even work on other Android devices
               | let alone iOS. And as far as I know you can't tweak the
               | hearing aid features of Galaxy Buds on any device.
        
               | vel0city wrote:
               | If you can't actually tweak audiogram settings, they're
               | not really hearing aids. In fact, Samsung doesn't sell
               | them as hearing aids and from what I can tell never use
               | the term "hearing aid" in any of the marketing, branding,
               | or feature listing of the devices.
               | 
               | They're not FDA approved as hearing aids, so they're not
               | hearing aids.
               | 
               | Either way, pointing to another company being shitty
               | isn't really a good justification of the first company
               | being shitty.
        
               | freedomben wrote:
               | Just trying to understand your argument: Samsung does it
               | so that makes Apple ok? I hear a lot of people argue
               | (when defending Samsung, Google Play, etc) that Apple
               | does it so it's ok, but not usually the other way around.
               | I guess it makes sense that it would devolve into the
               | spiderman meme, but the real losers in that are everyone
               | else that isn't making money from it.
               | 
               | Personally I thinks it's shitty when anybody does it.
        
           | Terretta wrote:
           | > _will entrench the user in a walled garden ecosystem from a
           | very specific giant tech company that isn 't big on making
           | their products compatible with other companies_
           | 
           | Are you suggesting AirPods aren't Bluetooth 5.3 and aren't
           | compatible with Bluetooth audio sources? Or that it doesn't
           | play AAC, MP3, and FLAC?
           | 
           | The proprietary capabilities (such as instant smart switching
           | between active devices) are all incremental, taking nothing
           | away from normal Bluetooth usage.
        
             | korhojoa wrote:
             | Seems like a rage bait post but: how do you update the
             | firmware without an apple device?
        
               | mcculley wrote:
               | You need to do more than update the firmware. You need to
               | upload your personal audiogram into the device.
        
               | davweb wrote:
               | At an Apple Store[1].
               | 
               | [1]: https://support.apple.com/en-gb/106340
        
             | jajko wrote:
             | As mentioned elsewhere you can't tweak its setting outside
             | Apple's walled garden.
             | 
             | Better wait for more open competition to catch up unless
             | you are already deep in their ecosystem and not intending
             | to move.
        
               | abdullahkhalids wrote:
               | Do you need your own iphone, or can you use a friend's
               | iphone to fix the settings once?
        
               | currency wrote:
               | It probably should be your own device; the audiogram ends
               | up in the iPhone's health app. It can probably be done by
               | someone else if they don't care and don't need to apply a
               | different audiogram for themselves.
        
               | detourdog wrote:
               | That is some nice integration. Having one's own up to
               | date audiogram stored in a health record and available to
               | doctors and devices.
        
               | joquarky wrote:
               | I was able to use my partner's iPhone to configure some
               | settings.
               | 
               | It's frustrating that the settings can't be changed on
               | Android, and macOS seems to have a subset of settings
               | compared to iOS.
        
             | Rebelgecko wrote:
             | Can you use them as hearing aids without an iPhone?
        
           | whiterknight wrote:
           | Is the hearing aid market big on modularity and
           | compatibility?
           | 
           | isn't it good to have multiple options so consumers can pick
           | what they value?
        
           | chipotle_coyote wrote:
           | That's an argument against buying an iPhone and AirPods Pro
           | together as a combination instead of buying a hearing aid,
           | but
           | 
           | - it's not an argument against using AirPods as an aid with
           | mild hearing loss if you're already an iPhone user
           | 
           | - it's not _necessarily_ a great argument against buying an
           | iPhone and iPods Pro anyway, given that hearing aids can
           | easily run hundreds or even thousands of dollars more than
           | that combination
           | 
           | - the vast majority of smart phone customers, both on and off
           | HN, have either factored "walled garden" into their buying
           | considerations at this point or never will
           | 
           | - let's not pretend Samsung is not already trying to figure
           | out how to cram this into their next Galaxy Buds for Android
           | users anyway, which will somehow work best with Samsung
           | phones, not so well with other Android phones, and not at all
           | with iPhones, but nobody will really complain about it
           | because whatevs, it's not Apple
        
             | dickersnoodle wrote:
             | I'm looking forward to this going live. I've worn the "we
             | have an app!" BLE enabled hearing aids and am currently
             | wearing a pair of amplifiers I got on Amazon for $200 and
             | they've lasted almost two years. AirPods Pro + this
             | software should make it a lot easier for me to follow
             | conversations and filter out high frequency noise (like you
             | get when there's nothing but bare walls and ceilings and
             | floor space). I mostly ignore the Apple-haters.
        
           | SoftTalker wrote:
           | And will put some people off from talking to them. I don't
           | talk to people with AirPods stuck in their ears until they
           | take them out. Too many times I have tried to start a
           | conversation or just say "Hello" but they are oblivious
           | because they are on a call or have music or something else
           | playing.
        
             | karmajunkie wrote:
             | that sounds more like a you problem. i use mine pretty
             | frequently as hearing aids, especially in noisy
             | environments.
        
             | spaceguillotine wrote:
             | Sounds like a feature and not a bug.
        
           | RobotToaster wrote:
           | If ever there was an opportunity for apple to earn some easy
           | goodwill, it would be opening accessibility features like
           | this to other platforms. Keeping accessibility features
           | locked to iphones only isn't good optics IMO.
        
         | righthand wrote:
         | Most people don't wear hearing aids because they don't like how
         | it looks and think their hearing isn't bad enough to warrant
         | social stigma from it. I don't see how Airpods solve that
         | problem as they are very unsightly, no matter how much pundits
         | say they love them.
         | 
         | In fact you mentioning how they are like hearing aids has made
         | me justify never wanting a pair.
        
           | rmccue wrote:
           | The advantage of AirPods for social stigma is they aren't
           | _solely_ hearing aids, so you have a type of (casual)
           | plausible deniability about why you 're wearing them. They
           | won't draw people's attention in the way that hearing aids
           | (because they're different/unique) do.
        
             | righthand wrote:
             | But a lot of people don't wear Airpods because they look
             | dorky and look like something is growing out of your ears.
             | This is what I'm saying, coolness doesn't trump looks even
             | if pundits say "I love my Airpods". A lot of people do not
             | like wearing headphones for a similar reason.
             | 
             | If i see someone wearing AirPods or headphones my initial
             | reaction is they don't want to be talked to or interacted
             | with. Even if that's not true and they have passive
             | throughput.
        
             | AyyEye wrote:
             | Having earpods in while talking is an entirely new and
             | worse social stigma than wearing hearing aids.
             | 
             | > you have a type of (casual) plausible deniability about
             | why you're wearing them
             | 
             | "He doesnt even give enough of a shit about talking to me
             | to remove his earbuds" isn't a good thing.
             | 
             | > They won't draw people's attention in the way that
             | hearing aids (because they're different/unique) do.
             | 
             | They won't draw peoples attention in the same way because
             | normal humans only begrudgingly interact with people
             | wearing earbuds in conversations and only for a bare
             | minimum.
             | 
             | I really can't stand this website sometimes. But at least
             | you all got the AirPods(tm) branding right instead of just
             | calling them earbuds.
        
             | insane_dreamer wrote:
             | I think that's more of a negative though. I always remove
             | Airpods/earbuds if I'm in a situation when I may be
             | interacting with others because otherwise I come across as
             | rude, uninterested or unsocial, like having a "do not
             | disturb" sign on.
             | 
             | Whereas I can see myself wearing a hearing aid (and
             | probably need one) because people will recognize that I'm
             | not trying to shut them out but I may have difficulty
             | hearing.
        
           | alnwlsn wrote:
           | If anything, if someone's wearing Airpods, I'm going to
           | assume they can't hear anything I'm saying. "oh no he's
           | wearing airpods" is a meme for a reason.
        
           | ksenzee wrote:
           | > In fact you mentioning how they are like hearing aids has
           | made me justify never wanting a pair.
           | 
           | Why? Because hearing aids are unsightly? Are wheelchairs
           | unsightly? Canes? Prosthetic legs? It looks to me like this
           | idea of what's "unsightly" is being fed by a cultural bias
           | against the disabled. Interestingly, glasses were "unsightly"
           | a few decades ago, and now they're in fashion. It would be
           | nice to see the same thing happen for other assistive tech.
        
         | steve1977 wrote:
         | Sonova (Phonak) is Swiss by the way, not Danish.
         | 
         | They also own the consumer of Sennheiser since a couple of
         | years.
        
           | car wrote:
           | Thanks, I stand corrected.
        
         | BeetleB wrote:
         | > In contrast, the AirPods run out after a few hours and are
         | also destined to become landfill due to their built in battery.
         | 
         | Just looked up AirPod battery run time. Wow - that's short. I
         | have Anker A40 earpods.[1] 10 hours, and the case has enough
         | charge for 50 hours. 10 minutes of charging gives you 4 hours.
         | They're a lot cheaper than Airpods, so you could easily buy a
         | pair (for much cheaper) and be good!
         | 
         | Not sure how accurate they'll be as hearing aids.
         | 
         | [1]:
         | https://www.amazon.com/dp/B0B1LPNDGF/?tag=thewire06-20&linkC...
        
           | Iulioh wrote:
           | Depends on the form factor and what functions are active.
           | 
           | I'd say 4-6-8 is low-average-high duration for the standard
           | form factor and ANC will reduce the duration by 25-30%
           | 
           | 10 hours is exceptionally high, i don't think i even seen
           | that claim
           | 
           | But year, they don't even have ANC, they are just a good pair
           | of buds, the 10h claim is good.
           | 
           | Pro tip:
           | 
           | You know that a pair of buds is good if they offer
           | Multipoint. It is such a hard feature to find in the mid and
           | low end market
        
       | pcardoso wrote:
       | One of my kids was born with a slight hearing loss and I think
       | this is huge.
       | 
       | We got from the local health service some basic hearing aids that
       | cost around 1000 euro but we are contemplating buying some high-
       | end Phonak devices that are around 5000 euro as recommended by
       | some experts.
       | 
       | In comparison to this the AirPods (280 euro?) are almost free.
        
         | tootie wrote:
         | OTC hearing aids are now as cheap as $80 USD. I'm sure they're
         | not the best, but it makes the tech incredibly accessible.
         | Sony, Jabra, Eargo ones are more expensive than airpods, less
         | than prescriptions. Not sure how they will stack up to airpods.
         | 
         | https://www.jlab.com/products/hear-otc-hearing-aid-graphite
        
         | systemtest wrote:
         | Does your nations healthcare system not cover that?
        
       | amne wrote:
       | cue teenagers with "hearing problems" so they must wear the pods
       | during classes in 3 .. 2 ..
        
         | dsr_ wrote:
         | What's your actual complaint?
         | 
         | Is it that teenagers sometimes have hearing issues? That's
         | definitely true; many people are born Deaf or with hearing
         | impairments. Some people get injured.
         | 
         | Is it that teenagers might fake having hearing issues in order
         | to wear pods? Either they will be paying attention in class or
         | they won't; this will be obvious from their grades shortly.
        
           | talldayo wrote:
           | The "actual complaint" is that Apple made hearing aids
           | indistinguishable from an entertainment device. There's
           | nothing wrong with taking initiative to a good thing, but you
           | can absolutely pave the road to hell with good intentions.
           | People would be rightfully outraged if Tesla drivers could
           | ignore the road to play _The Witcher 3_ at 50mph on the
           | freeway. Saying something like  "either they will crash or
           | they won't" isn't going to assuage the problem or change the
           | design issue. The danger is going to persist as a result of
           | first-party design oversight.
        
             | llbeansandrice wrote:
             | Playing video games when you're supposed to be piloting a
             | half ton death trap isn't the same as teenagers lying to
             | authority.
        
               | autoexec wrote:
               | The problem isn't really the lying though is it. It's the
               | fact that they're not being educated if they aren't
               | paying attention.
        
               | HeyLaughingBoy wrote:
               | Worse. It's probably a bit over 2 tons.
        
           | teaearlgraycold wrote:
           | Just require a doctor's note one time?
        
           | jimbob45 wrote:
           | _Is it that teenagers might fake having hearing issues in
           | order to wear pods? Either they will be paying attention in
           | class or they won 't; this will be obvious from their grades
           | shortly._
           | 
           | You can ignore lectures, not participate in teacher-led
           | activities, generally be a nuisance, and still get an A such
           | that your parents would never catch on to you.
        
       | todotask wrote:
       | How do I deal with itchiness? Having trying to wear for a few
       | seconds, can be annoying after been wearing hearing aid for
       | decade.
        
       | dav43 wrote:
       | I am surprised the size of their study where they made
       | conclusions was only 118 ppl. I would have thought a much larger
       | study is required.
        
       | _fat_santa wrote:
       | This is huge. Previously if you were hard of hearing, a pair of
       | hearing aids could cost upwards of $2,000. Now Apple just brought
       | that price down to ~$250.
       | 
       | Even if you use them everyday and assume a shelf life of 1.5yrs
       | (which is roughly mine and others' experience with AirPods), you
       | would be replacing your Airpods for 12 years before the cost
       | caught up with a single pair of hearing aids.
       | 
       | Even if you think Airpods are not on the same bar as regular
       | hearing aids, this will certainly help depress market prices.
       | Every manufacturer will probably start releasing sub $1000
       | hearing aids just to not get destroyed by Apple.
        
         | HumblyTossed wrote:
         | > This is huge. Previously if you were hard of hearing, a pair
         | of hearing aids could cost upwards of $2,000. Now Apple just
         | brought that price down to ~$250.
         | 
         | Woah there fella. Hearing aids last a very long time before
         | needing a new battery. AirPods needs to be charged several
         | times a day. That's a bit of an inconvenience. As is some
         | hearing aids are made to fit one's ear. Where as AirPods are 3
         | sizes fits all.
        
           | jeffhuys wrote:
           | That's a much, MUCH lower barrier of entry, though, fella...
           | and that can be celebrated in my opinion
        
             | HumblyTossed wrote:
             | It's helpful, sure, but it's not the same thing.
        
           | echoangle wrote:
           | Just to be pedantic: AirPods Pro 2 come with 4 sizes for
           | tips. Also, I'm sure you can get third-party tips with
           | different shapes if you wanted to.
        
           | some_random wrote:
           | A condescending reply showing you didn't read the whole
           | comment isn't the best look. The point isn't that they're the
           | bestest hearing aids ever, the point is that they are an
           | option at all at a tiny fraction of the typical price which
           | will force manufacturers to innovate.
        
             | HumblyTossed wrote:
             | Condescending or not, saying "Now Apple just brought that
             | price down to ~$250." is grossly overstating it.
             | 
             | But Apple always gets a pass, so...
        
               | some_random wrote:
               | "You can now buy hearing aids (as defined by the FDA) for
               | $250" is an objectively true statement, so unless you
               | think the FDA is filled with Apple fanboys I have no idea
               | what "pass" you think Apple is getting.
        
           | wintermutestwin wrote:
           | Airpods don't fit in my tiny ear canals. I even bought a
           | smaller aftermarket tip and still no luck.
        
           | mitemte wrote:
           | Existing hearing aid products are still available for
           | purchase for those who want them. I don't think AirPods are
           | going to replace hearing aids. Hopefully they lower the
           | barrier for entry and perhaps lower the price of existing
           | products.
        
           | kstrauser wrote:
           | You could buy 2 pairs and swap them out. That would still be
           | a 75% discount over the $2000 pair.
           | 
           | This will help more people hear. It might not be the best
           | possible solution, but it surely beats not having it.
        
           | insane_dreamer wrote:
           | > AirPods needs to be charged several times a day. That's a
           | bit of an inconvenience.
           | 
           | that's if you wear them all the time. I have hearing
           | difficulties and know I need aids even without taking a test.
           | But I wouldn't want something in my ear all day long and most
           | of the time I don't need to hear better because I'm working
           | or whatever. But there are situations where it's hard for me
           | to understand what people are saying and that's when I would
           | put them on.
           | 
           | So with that in mind the AirPods would work great. It's
           | unfortunate that it doesn't work with the regular AirPods
           | which are only $100. (I don't have the Pro's).
        
         | teaearlgraycold wrote:
         | My APPs are still going strong after 4 years. I use them daily,
         | but not all day every day. Sure the battery life isn't as good
         | as before. But they're still very usable. Am I just really
         | lucky?
        
           | ChicagoBoy11 wrote:
           | No, that's my experience as well
        
         | cryptoegorophy wrote:
         | 1.5? What happens after 1.5 years? Had mine for 5 years, no
         | issue and sort of the same battery life or not noticeable to me
         | (15% degradation is what I would not notice ) still charge very
         | quick in a case.
        
           | CamelCaseName wrote:
           | You buy a new hearing aid for another $250 that has another
           | 1.5 years worth of technological advancements.
           | 
           | Or maybe you buy multiple instead of just one, so you can
           | hotswap any time.
        
         | skybrian wrote:
         | There are already cheap hearing aids. Airpod Pros will grow the
         | market since they're good for people getting started and okay
         | for occasional use, but they aren't good for wearing all day:
         | too distracting for people you're talking with, not enough
         | battery life.
         | 
         | But now that Apple entered the market, maybe they will come out
         | with wireless headphones that are more suitable?
        
           | caeril wrote:
           | [edit] Disregard, I forgot that HN has been infested with
           | normies with poor reading comprehension. Further posts will
           | be strictly technical.
        
             | roywiggins wrote:
             | > you're better off with them not in your life.
             | 
             | Offer not valid if it's your in-laws, nurse, kid's teacher,
             | your teacher, civil servant who you need to convince, and
             | overall anyone in a position of authority or otherwise
             | capable of gatekeeping you. You can't always just opt out
             | of dealing with people without consequence.
        
               | caeril wrote:
               | [edit] Disregard, I forgot that HN has been infested with
               | normies with poor reading comprehension. Further posts
               | will be strictly technical.
        
               | pdabbadabba wrote:
               | > We've homeschooled before, and it would be trivial to
               | pull them (and a small portion of the district's funding
               | with them) and do it again, and they know it.
               | 
               | You'd homeschool your kids because their teachers find it
               | odd that you're wearing AirPods during a conversation? To
               | each his own, I guess.
               | 
               | > Nurse? If they commit intentional malpractice, my
               | attorney is ready to go.
               | 
               | In what world does subtly judging you for wearing AirPods
               | during a conversation qualify as malpractice?
        
               | roywiggins wrote:
               | Being summarily pulled out of school isn't _without
               | consequence_ , especially to your kid!
        
             | geocrasher wrote:
             | Until wearing Airpods during conversation is normalized,
             | this will be a problem. Why?
             | 
             | I tried conversing with somebody recently, and they were
             | _completely_ ignoring me. Then I saw the Airpods. Of
             | course. They have music or something else going on.
             | 
             | For now, Airpods = "I am listening to something other than
             | you right now." So yes, if somebody were wearing Airpods as
             | a hearing device, I'd probably not talk to them because of
             | that expectation.
        
             | pdabbadabba wrote:
             | I have bad news for you. Everyone judges people for these
             | sorts of fashion choices (though perhaps not that specific
             | one). Though some will do so more harshly than others, of
             | course, and some enlightened folks will manage never, or
             | rarely, to manifest or act on these judgments. And you'll
             | absolutely never convince me that you don't make the same
             | kinds of snap judgments about people based on things like
             | what they're wearing.
             | 
             | It's healthy not to care too much about the fashion
             | judgments of others, as you're suggesting. Is I agree with
             | your first line. But you're otherwise bringing too black-
             | and-white an approach to what is, in my view, an
             | unavoidable part of social life.
             | 
             | Edit:
             | 
             | > Disregard, I forgot that HN has been infested with
             | normies with poor reading comprehension.
             | 
             | OK. You object strenuously to anyone making any sort of
             | judgment about a person wearing AirPods, all of whom should
             | be completely cut out of your life, but are happy to throw
             | out baseless insults at people who disagree with you in the
             | mildest of terms on the internet. Got it.
        
         | rahimnathwani wrote:
         | Do you need an iPhone to use them, or only for the initial
         | setup/audiogram?
        
       | mannyv wrote:
       | This also means that the Apple ecosystem is HSA and FSA eligible.
        
         | solardev wrote:
         | Wait, really? You can use your health savings on a iPhone now?
        
           | mannyv wrote:
           | It's much more justifiable now for sure.
        
       | coupdejarnac wrote:
       | I made a hearing aid app for the iPhone nearly 10 years ago. It
       | was nearly impossible to get anybody to pay $10 or less for
       | it.Also, there is/was a FDA exception for mobile apps, which kind
       | of obviated the need for the grad school class i was taking at
       | Stanford about getting medical devices FDA approved.
        
       | philip1209 wrote:
       | Is it possible to spend FSA/HSA funds on medically-necessary
       | Apple products/services?
        
         | ganoushoreilly wrote:
         | That's a lingering question right now as the software was
         | approved, but not specifically the hardware. I suspect it would
         | be able to be covered, but as with any of those rules, it's
         | kinda murky.
         | 
         | I suspect if it is, we'll see some interesting advertising /
         | marketing from 3rd party resellers.
        
           | philip1209 wrote:
           | Makes sense. Would be great to see iPhones / Apple Watches
           | covered for diabetic CGM users, too.
        
           | HeyLaughingBoy wrote:
           | It's a very good question and Apple may already have an
           | answer.
           | 
           | One of the interesting things I learned in my time building
           | medical devices is the role of insurance reimbursement in the
           | product development process. Before introducing a new device,
           | or a new (blood) test, one of the questions Marketing has to
           | answer is how difficult it will be to get reimbursement from
           | insurance in the US.
           | 
           | It sounds kind of icky, but it's a real concern.
           | 
           | If insurance companies won't reimburse for a particular test
           | or use of a device, then the users are far less likely to buy
           | it, or in the case of a test, the physician may have to warn
           | the patient that their insurance isn't likely to pay for it.
           | This will probably lead the manufacturer to decide that it's
           | too risky to proceed with development.
        
       | ohadpr wrote:
       | Speaking of the AirPods becoming actual hearing aides - how will
       | we reconcile the fact that it is not socially acceptable to wear
       | AirPods when speaking with someone?
       | 
       | Even if you get to explain 'oh my AirPods are functioning as a
       | hearing aide' you likely won't be able to explain that to other
       | people noticing the conversation and thinking to themselves 'oh
       | that's douchey, not taking our your AirPods when talking to
       | someone'.
       | 
       | I just really wonder if this will be able to make wearing AirPods
       | while talking to other people socially acceptable because the
       | current presumption is likely that they are not behaving nicely.
        
       | ChrisArchitect wrote:
       | Related:
       | 
       |  _AirPods Pro 2 adds 'clinical grade' hearing aid feature_
       | 
       | https://news.ycombinator.com/item?id=41491191
        
       | ChrisArchitect wrote:
       | Related Apple study from May:
       | 
       |  _Apple Hearing Study shares preliminary insights on tinnitus_
       | 
       | https://news.ycombinator.com/item?id=41491121
        
       | detourdog wrote:
       | I see this as a major advance for ADA compliance for headphones.
       | This may take a few years but audiogram editing is going to
       | become minimal specification.
        
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