Best Hearing Aids in Background Noise of 2024: OTC & Rx Options

Struggling to hear in background noise? Are your existing hearing aids not helping? We tested over 40 modern hearing aids in an acoustic lab to provide the first list of top-performing hearing aids for background noise based on hard science.

The Problems with Speech in Noise

We've all been there—out at a loud restaurant asking the server to repeat themselves. The combination of music, chatter, and poor acoustics can create the perfect storm for poor communications. Add hearing loss to the mix, and you're pretty much hopeless.

Problems understanding what others are saying can happen when loud sounds in the background drown out, or cover up, the words we're trying to hear. This makes it hard for us to understand what's being said. Our brain has to work hard to "fill in the blanks", often relying on a combination of context clues, facial cues, and lipreading.

This extra effort can lead to listening fatigue and physical exhaustion, and you may find yourself retreating from demanding social gatherings altogether to avoid the effort and potential embarrassment.

The inability to clearly hear speech in background noise, sometimes referred to as the "cocktail party problem", is well known—and a common focus of hearing technology manufacturers. Hearing aids, and other assistive devices, offer various means of improving speech clarity and listening comfort in noise.

How Do Hearing Aids Help in Noise?

Hearing aids and assistive listening devices employ various technologies, like directional microphones, to improve your ability to hear in background noise. The key to any such technology is to improve the signal-to-noise ratio (SNR), i.e. how much louder is the speech of you want to hear versus the noise you don't want to hear. Here are some examples of how hearing aids improve performance in noise:

Directional Microphones

Hearing aids generally have multiple microphones located either above the ear and or down near the ear canal. These microphones provide slight differences in audio input and can be combined in different ways to boost all sounds or mainly those from one direction. More advanced hearing aids even have the power to analyze different microphone combinations in real-time and use the one(s) most appropriate for your environment. One example of this is SpeechSensor in Phonak's Audéo Lumity.

Directional microphones can be found in most prescription and OTC hearing aids—and even advanced earbuds like AirPods Pro and Sennheiser Conversation Clear Plus. The quality of directional microphones can vary between products and the SNR benefits can depend on factors such as individual hearing loss, the environment, noise levels, distance, and more. Most people can likely expect 3 to 6 dB SNR improvement in real-world situations.^{7, 9} However, individual benefits will vary based on many factors.

Digital Noise Reduction (DNR)

Noise reduction is another common type of signal processing offered in hearing aids. These algorithms work by splitting sound into different channels and providing less volume to those with greater noise. In doing so, the relative volume between speech and noise can be improved.

Steady state noise, such as the constant hum of an air conditioner, fan, or car engine, is generally easier for the noise reduction algorithms in hearing aids to manage because its acoustic characteristics are stable over time. Therefore, a hearing aid should be more successful at reducing these types of noise compared to transient or fluctuating noise sources, which change rapidly over time.

By reducing steady state sounds, the hearing aids can enhance the contrast between speech and background noise. However, the actual improvement in speech recognition will depend on several factors including the user's degree of hearing loss, the characteristics of the noise, the quality and sophistication of the noise reduction algorithm, and the individual's ability to adapt to and benefit from the technology.

It's important to note that while noise reduction can help with speech recognition, it's not a perfect solution. Noise reduction algorithms can sometimes inadvertently reduce some aspects of speech, which can make it harder for the listener to understand. Also, there are limitations in reducing non-steady state noises like those coming from multiple talkers in a crowded room.

Given the limited benefits in noisy situations like restaurants, DNR should not be considered a viable solution to the cocktail party problem. However, DNR can greatly improve listening comfort by reducing the annoyance of noise, including background chatter.^{1, 3, 8}

Active Noise Cancellation

Active noise cancellation (ANC) can be found in some advanced earbuds such as Apple AirPods Pro 2, Sennheiser Conversation Clear Plus, and Nuheara IQBuds2 Max. This is a newer form of noise abatement that can effectively reduce constant lower-frequency noises such as hums and whirring.

When ANC is enabled on an earbud, the sounds around you are "cancelled" through an acoustical technique called phase inversion. Basically, the earbud's speaker plays the same sounds that the microphone hears, but completely flipped, or inverted. When the outside sound and processed sounds combine, they interfere resulting in a cancellation of the unwanted sounds from around you.

The quality of ANC varies between companies and it works best with more occluding devices such as earbuds and over-the-ear headphones. We also do not currently see ANC in traditional hearing aids.

Remote Microphones

Remote microphones can wirelessly pair with hearing devices to significantly improve speech understanding. By placing a remote microphone near a person, or clipping it to your spouse's collar, you're effectively bringing their voices closer to your ears. This is much easier than trying to hear someone from across a noisy table. It also minimizes the effect a room play on what you hear.

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Hearing aids are most effective at processing sounds within roughly 3 to 6 feet. Remote microphones can therefore extend the useful range of hearing devices and have been found to offer SNR improvements of 15 dB or more.^{5, 6}

It is worth noting that companies have been using artificial intelligence (AI) and machine learning to further improve the accuracy and effectiveness of their noise reduction algorithms. Starkey Genesis AI is a great example of this and, while the benefits of these systems are not fully understood, we can expect to see AI push the boundaries of hearing aid speech-in-noise performance.

Benefits of Fine-Tuning with a Hearing Care Provider

Hearing devices are marvels of modern science and they work best when programmed specifically for an individual's hearing needs. Real-ear measurements, or REMs, are the gold standard for doing this and it involves a hearing professional using prob microphones to analyze hearing aid output within the ear. REMs ultimately optimize speech audibility by verifying that your devices provide appropriate amplification for your hearing loss.

While REMs are not embraced by all providers⁴, it remains the best means of optimizing hearing aid performance and has been shown to improve speech understanding over other manufacturer instant-fit methods².

Over-the-counter (OTC) hearing aids are also available, for those with a perceived mild-to-moderate hearing loss, and promise to offer similar benefits without the need to visit a doctor's office. HearAdvisor™, an independent hearing devices test lab, is working to verify such claims. While performance varies greatly between companies, it is clear that OTC hearing aids can benefit from similar fine-tuning as traditional devices.

Best Hearing Aids for Noise: Our Top Picks

After measuring background noise reduction in over 40 products in the HearAdvisor acoustic lab, we've identified the top performers on the market in 2023. Here we present the top 2 products—a winner and runner up—from three product categories: (1) prescription hearing aids, (2) OTC hearing aids, and (3) speech-enhancing earbuds.

This is not a comprehensive list by any means, so be sure to check out the full list of winners, which includes devices from ReSound, Starkey, Bose, and more.

A Few Key Differences

Here we compare the key noise-reducing features offered by each device:

How We Tested

A key part of HearAdvisor's hearing aid evaluation process involves testing devices in realistic spatial sound fields. These are generated using widely-favored ambisonic recordings and the statistical properties of an extensive variety of authentic spaces. This allows us to replicate the sound environments that users will encounter in their daily lives.

In order to offer a more thorough analysis, we perform tests across multiple talkers from a variety of spatial locations. This helps us understand how a hearing device might perform in a number of real-world environments.

For testing, all hearing aids were setup for a mild to moderate hearing loss. So all test results are strictly limited to mild to moderate hearing loss. We have not evaluated any device's performance for more severe hearing loss levels, yet. And remember, the OTC hearing aids and earbuds that we tested are not intended for those with greater than mild to moderate loss, so we'd expect them to score poorly for severe hearing loss.

We used the Hearing Aid Speech Perception Index v2 (HASPIv2) to quantify the expected improvement in speech intelligibility for each hearing aid. We chose this metric because it models the impaired auditory system and predicts intelligibility for a wide range of acoustic environments. For those looking to dive deeper, please check out our vetting process and HearAdvisor's whitepaper.

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Best Prescription Hearing Aid for Noise: Oticon Real

After testing over 40 modern hearing aids in the HearAdvisor acoustic lab, Oticon Real emerged as the top performing prescription device in background noise. Danish manufacturer Oticon claims to use Deep Neural Network (DNN) technology to help users "access the sounds" most important to them, and based on our testing, the technology seems to be working.

Real pairs with the Oticon On App, which provides the user with numerous ways to adjust the audio and noise handling. For example, you can adjust the "Sound Booster" to bring up soft speech sounds, and there's even a 3-band EQ for adjusting the tone of streaming Bluetooth audio.

Real can also pair with Oticon's ConnectClip remote microphone, allowing you to transmit audio directly to your ears from up to 20 meters away. Remote mics like ConnectClip can drastically improve the signal to noise ratio, making speech much much easier to understand.

In the lab, Real was a top-performer for speech in quiet, moderate, and loud noise when programmed for a common age-related hearing loss. When paired with the app and other wireless technologies it offers some of the greatest speech audibility available on the market today.

As it is a prescription hearing aid, a hearing professional is involved in the fitting process to guide you through any programming and or physical adjustments needed.

Oticon Real Pros

Oticon Real Cons

Runner-Up Prescription Device: Phonak Lumity

Phonak Audéo Lumity prescription hearing aids are a contending alternative offering similar features, app control, and wireless accessories. Both Lumity and Real performed similarly in the lab and both received a 2023 Expert Choice Award. One major difference between these hearing aids is the Fitness and Health tracking features Lumity offers. Those interested in Fitbit-like features may prefer this as an alternative to Real.

Best OTC for Noise: Sony CRE-E10

The Sony CRE-E10 is an over-the-counter self-fitting hearing aid with the look and feel of a typical earbud. The Sony's are designed for everyday use and adjust automatically per environment for comfort and speech enhancement. They also offer wireless control with the Hearing Control app, rechargeability, noise reduction, directional microphones, and audio streaming (currently only available for iOS).

Sony CRE-E10 was chosen due to its performance in the HearAdvisor™ lab, where it was found to offer greater speech-in-noise benefits than any other OTC devices tested to-date. It also received a SoundScore of 5.0, making it the top-performer of all devices based on their testing methods. The accompanying app also offers numerous adjustments to further tune CRE-E10 in difficult listening situations.

Sony CRE-E10 Pros

Sony CRE-E10 Cons

Runner-Up OTC: Lucid Engage

Lucid Engage is another OTC hearing aid offering speech benefits in noisy environments. While it does not perform as well as the CRE-E10, it is a receiver-in-canal device which many people will prefer due to the decreased “plugged” feeling in ear.

Best Speech-Enhancing Earbud for Noise: Sennheiser Conversation Clear Plus

Sennheiser’s Conversation Clear Plus are advanced earbuds designed to improve speech understanding in noisy environments. They offer many useful features such as automatic adjustments, speech enhancement, beamforming microphones, wireless app control, and Bluetooth™ streaming for most devices. They are also offer Active Noise Cancellation (ANC).

Since the Conversation Clear Plus (CCP) is not an FDA-registered hearing aid, Sennheiser needs to be very careful about the claims it makes about the product. Sennheiser can't legally call the CCP a hearing aid, and can't say anything about the product helping with hearing loss. However, the speech enhancement features are clearly intended to help people with hearing loss, and it's fair to assume that many people with hearing loss are using the CCP to accommodate for those lost decibels.

CCP is our top-pick in the earbud category as we found it to offer impressive noise reduction capabilities. It is the highest scoring PSAP to-date at HearAdvisor and even outperformed other prescription and OTC devices in loud noisy environments when programmed for a common age-related hearing loss. It also offers ANC which can further reduce the annoyance of lower-tone noises. While not related to noise performance, it is worth noting that CCP also offered excellent streamed audio quality. Listen here.

Conversation Clear Plus Pros

Conversation Clear Plus Cons

Runner-Up Earbud: Apple AirPods Pro 2

Those interested in an alternative to Clear Plus should consider Apple Airpods Pro 2. They offer a similar feature set and excellent streamed audio quality. They also allow you to take an on-ear hearing assessment or upload hearing data directly through the Health app. We did not find them to provide the same noise benefits but they are available for roughly $199, making them much more accessible. AirPods also pair better with iOS devices, unlocking other desirable health tracking and hearing features. 

All "Hearing Aids" Not Created Equal

Hearing aids continue to advance and offer better tools for solving the noise problem. However, it is not always clear which device is most appropriate for your individual hearing needs. There are many choices available and companies offer similar marketing claims. But beware—not all hearing aids are created equal.

To that second point, our experience shows that some of these claims are either unfounded or completely false. Take for example our deep dive on Amazon’s Top 4 Hearing Aids. All devices offered some claim of speech clarity yet we observed little to no speech intelligibility improvements—one device even made speech worse than normal listening.

There are fortunately numerous technologies that can improve hearing in background noise and hopefully this list offers some viable solutions for you. Speak with a hearing care provider for more specialized care, practice good communication strategies, and do not overlook the benefits of remote microphones if available for your hearing technology.