Hidden Hearing Loss: Symptoms, Causes, and Treatments

Reading Time: 3 min
by Laura Prigge, AuD

Although hearing loss is a common condition, at times, it can be difficult to diagnose or detect - especially for those who have hidden hearing loss (HHL). Continue reading this blog for an overview on this condition.

What is Hidden Hearing Loss?

Hidden hearing loss, or HHL, is defined as hearing loss that’s not detectable through a standard audiogram. Most cases of sensorineural hearing loss are due to damage to the hair cells in the inner ear, however in the case of hidden hearing loss, the hair cells, or stereocilia, are healthy, which is why audiograms reflect normal hearing. When experiencing hidden hearing loss, it’s due to a compromised connection between the ears and the brain and can only be diagnosed through other extensive tests by an audiologist.

Hidden Hearing Loss Symptoms

The signs and symptoms of hidden hearing loss include:
• The patient struggles to hear properly despite a normal audiogram
• The patient prefers quiet environments
• The patient finds it difficult to focus in noisy settings
• The patient often misinterprets what people say

The Cause of Hidden Hearing Loss

The three main causes of HHL are noise exposure, age, and ototoxicity. Repetitive exposure to loud environments for extended amounts of time increase the risk of developing hidden hearing loss. The second main cause is age—as you get older, your nerve synapses reduce, and overtime, this can affect your ability to hear. Lastly, ototoxic medications cause damage to the inner and outer hair cells causing hearing loss.

Living with Hidden Hearing Loss

For those experiencing the challenges that come with hidden hearing loss, these tips are recommended to navigate living with HHL:
• Asking those around you to speak more slowly
• Sitting or standing directly facing the person you are wanting to hear
• Asking to be seated in a booth or quieter location when dining out
• Using closed captions on videos when possible
• Sitting or standing with background noise behind you
• Utilizing directional microphone apps on your phone: Ear Machine or Live Listen

Hidden Hearing Loss Treatment Options

Outside of the communication strategies listed above, mild amplification may be suggested to help reduce the signal-to-nose ratio. These devices allow those experiencing hidden hearing loss to better understand speech, even in noisy environments. Hidden hearing loss can be a difficult diagnosis—but with the proper support from friends, family, and audiology professionals, along with the backing of tools and adjustments to your lifestyle, coping with this disorder is promising for those experiencing this type of hearing loss.

Dive Deeper into Hidden Hearing Loss

The study of Hidden Hearing Loss is still an active field of research. Are you looking to learn more about this condition? Take a deeper dive into Hidden Hearing Loss by viewing the sources below.


Hidden Hearing Loss: Causes, Current Knowledge, and Future Directions ( main.pdf (

Laura Prigge, AuD is the Manager of Clinical Education and Training at GSI. Laura received her Doctorate of Audiology degree from AT Still University, a Master's of Arts in Audiology from UCONN and a Bachelor's of Science degree in Communication Disorders from Western Illinois University. Laura’s 20+ years of experience includes providing manufacturing support for a leading hearing aid manufacturer as well as technical audiology training and support for an international audiologic equipment company. Prior to that, she managed education and training at another hearing aid manufacturer and conducted audiologic evaluations on children, adults, and geriatric patients at a retail hearing center.