One hearing aid vs. two

If you are ready to confront your untreated hearing loss once and for all, you may have lots of questions about the process. One of the most frequent questions we get asked at Healthy Hearing is whether or not two hearing aids are better than one.

Why you need two hearing aids

We almost always recommend two hearing aids if you have hearing loss in both years, because you will hear far better with two hearing aids instead of one. Your hearing care provider or audiologist will program each hearing aid separately, to match the precise levels of amplification you need in each ear (it’s normal to have different levels of hearing loss in each ear).

This is a well-known recommendation. For decades, research in the field of hearing science has supported the commonsense idea of wearing two hearing aids (with a few exceptions, which we discuss below). Here are a few convincing reasons to equip yourself with a pair of devices instead of just one:

Two hearing aids fully stimulate your brain

You probably know one of the best ways to keep your body healthy and in good working order is to use it–that means getting regular exercise, taking the stairs instead of the elevator and getting your steps in for the day. Conversely, when we don’t move and use our muscles, they tend to weaken and can even atrophy over time.

Don’t risk ‘auditory deprivation’

Even though your ears aren’t muscles, depriving them of sound can make the auditory nerve pathways and the associated centers in the brain less effective at decoding the sound around you. Understanding speech, particularly in the presence of noise gets more difficult even when the sound is loud enough for you to hear it. Hearing healthcare professionals call this auditory deprivation. 

Wearing two hearing aids means each ear picks up sound and gets the stimulus it needs to stay at peak performance. A study published in the Journal of the American Academy of Audiology looked at the word recognition abilities of people fitted with one hearing aid versus two. The researchers found that a significantly higher number of the study subjects wearing only one hearing aid experienced a decline in their word recognition compared to those who had two hearing aids. 

Video: Should I get one or two hearing aids?

Far better sound quality with two hearing aids

One of the biggest reasons you may be considering getting hearing aids is that, besides not being able hear at normal levels, you find that even if you can hear speech, the sound isn’t clear. This may mean you have trouble understanding what others are saying, even in your good ear. This is especially true if there is background noise competing. Understanding speech is the foundation of good communication and there’s no better reason to seek hearing treatment. 

Research has shown wearing two hearing aids makes for clearer conversation, making it possible to better understand sound. The study concluded a pronounced improvement in sound quality and clarity and higher speech discrimination test scores for subjects who had two hearing aids compared to those who wore hearing aids in only one ear. 

You won’t have to set the amplification as high

Wearing two hearing aids provides binaural summation. According to the Encyclopedia of Otolaryngology, Head and Neck Surgery, binaural summation is when a listener perceives greater intensity (volume) of sound when both ears are presented with a stimulus at once compared to hearing the stimulus in either ear alone. This phenomenon also is associated with an improved ability to discriminate frequencies and improved speech understanding whether you’re in noise or in quiet.

Having an increased perception of volume from wearing two hearing aids means you’ll be able to get more “bang for your buck” in terms of loudness. Neither of your two devices will need to have the power output or be turned up as high as a single device trying to do the work of two. This can help you conserve hearing aid batteries and may even mean you can wear smaller hearing aids since not as much power is needed. 

You’ll better know where sound is coming from

Knowing what direction a sound is coming from, or sound localization, is something people with normal hearing take for granted. From the time we are born and we learn to turn our head in the direction of our mother’s voice, we learn to perfect this skill. Not only is finding the source of sound helpful in everyday life, it can be an important safety consideration. Knowing where those ambulance sirens are in relation to your car helps you know when and where to pull over to allow emergency vehicles to pass. 

Our two ears work in delicate harmony to make localization easy, and people who have single-sided deafness can attest to having difficulty with this skill. Dr. Francis Kuk writes in the Hearing Review that to improve localization, the first requirement is binaural cues from wearing two hearing aids. 

Higher user satisfaction

If the above reasons aren’t enough for you, many hearing healthcare professionals know their patients report higher hearing aid satisfaction when they wear two hearing aids instead of just one. In a 2011 study, while 46 percent of people reported a preference for wearing only one device, it was the people who reported having more hearing difficulty in daily life that showed a strong preference for two hearing aids. That means for all those spontaneous, dynamic listening situations you are in where your success can’t be measured by any test in a hearing care professional’s office, wearing two hearing aids will bring more satisfaction. And, isn’t that why you want hearing aids to begin with?

When is one hearing aid better than two? 

Some research indicates that for people with cognitive delays or dementia, one hearing aid may work better than two, even if a person has hearing loss in both ears. It’s thought that two hearing aids are over-stimulating for the brain and auditory pathways. 

If you have normal hearing in one ear, and mild hearing loss in the other, you’re probably fine to just wear one hearing aid—just remember to get regular hearing tests to make sure your “good ear” is still hearing well. 

Curious about hearing aids?

If you aren’t sure whether or not you need to wear two hearing aids (or one for single-sided hearing), or are curious about the best type of hearing aids for you, visit our directory of consumer-reviewed clinics to find a hearing aid clinic near you. You’ll receive a thorough hearing test and receive the best advice for how to get back to hearing your best.