Apple will introduce a new “hearing aid mode” with the release of iOS 18 in September, according to Bloomberg’s Mark Gurman, a technology expert and reliable reporter on the company’s product development. Writing in his Power On newsletter, Gurman says Apple AirPods Pro won’t showcase any new hardware change this year, but the “big news will be a major new hearing aid mode, coming alongside iOS 18.”

If this comes to pass, it may represent the "next wave" of hearing devices: less expensive, mass-marketed hearables that have been re-engineered for the OTC hearing aid market. Apple is not yet listed in the full list of OTC hearing aids that have been cleared by the FDA to treat mild to moderate hearing loss in adults. However, products are being continuously added to this list to serve the unmet needs of millions of people with hearing loss or who have trouble hearing in noise.

Over a year ago, in an article titled “Will Apple Make an OTC Hearing Aid?”, I wrote that “it’s almost guaranteed Apple will be [in the OTC hearing aid market]—stated or unstated—every step of the way.” That’s because, for all intents and purposes, the Apple AirPods Pro is an OTC hearing aid.

The AirPods Pro app menu should, but doesn't, include a button that switches them into Hearing Aid Mode because the devices are not FDA-approved to compensate for hearing loss. But the Airpods Pro earbuds can hold their ground against most OTC hearing aids once you take a short online hearing test like Mimi (or enter numbers from an existing audiogram) and configure the devices to compensate for your unique hearing loss profile. Although they’re currently good for only about 4 hours of use in full transparency mode, the AirPods Pro’s Headphone Accommodations have been shown to be effective in amplifying sound for people with mild to moderate hearing loss—the target audience for OTC hearing aids.

In this video, HearingTracker Audiologist Matthew Allsop explains how to set up your Apple Airpods Pro as hearing aids. Closed captions are available on this video. If you are using a mobile phone, please enable captions clicking on the gear icon.

For example, a research group from the esteemed National Acoustic Laboratories (NAL) in Australia showed that the Conversation Boost and Ambient Noise Reduction features of AirPods Pro can improve hearing in background noise up to about 7 decibels (dB)—a large margin in terms of signal in noise benefit. A follow-up study this year by the same group also showed the AirPod Pro’s Active Noise Cancellation (ANC) system can reduce ambient noise levels by an average of 27 dB across frequencies—so you can add moderate hearing protection as one more important benefit for the devices.

Disrupting the Disrupters?

The OTC hearing aid market is less than a year and a half old, as the FDA’s regulations for this new class of hearing aids went into effect in mid-October 2022. Although some of the established online OTC hearing aid companies (e.g., Lexie, Jabra Enhance, etc.) have seen their hearing aid sales increase substantially, the growth of the overall OTC market has been mostly underwhelming.

An assortment of currently available OTC hearing aid devices.
An assortment of currently available OTC hearing aid devices.

This may be due to many OTC hearing aids being essentially re-engineered from traditional hearing aids and then sold for around $1000 or more. With Costco, Sam’s Club, and private practice offices selling professionally fit hearing aids starting at around $1400 per pair, there may not be enough enticement for consumers to ditch prescription hearing aids for OTC aids.

Ironically, the OTC hearing aid market, which was created to disrupt traditional hearing aids, could find itself disrupted by the evolving class of hearable earbuds embodied by products like Apple AirPods Pro and Samsung Galaxy Buds Pro. These more widely sold hearables incorporate hearing-aid-like functions similar to, but at half or one-third the price of, most OTC hearing aids.

Although Apple’s technology development is legendary, the company is not known for trail-blazing new markets; rather, its strength lies in party-crashing more established markets with innovative products and features that give it a big edge. Several tech giants have already thrown their hats into the OTC hearing aid ring, including SonyHPJabra, Bose, and JVC. JLabs has confirmed to HearingTracker that it expects to introduce a $99 OTC hearing aid in April 2024. More products are sure to come.

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There is also an emerging class of smart glasses and live-captioning glasses that allow you to read a transcript of the conversation in real-time right before your eyes. Vision care giant Essilor-Luxottica is entering the OTC hearing aid market in late 2024 with amplified glasses developed by Nuance Hearing that help boost conversations in the most difficult listening situations. It has also been reported Apple is exploring the use of putting low-resolution cameras on Airpods and combining this information with AI to make them smarter.

The hearing aid market is large, growing, and becoming dominated by Baby Boomers. But people of all ages can benefit from hearing enhancement devices. By some estimates, there are 38 million people with hearing loss in the United States and another 26 million with normal hearing but who still have trouble hearing in certain situations like noisy workplaces, airports, and restaurants. That’s a lot of people who can benefit from customized amplification, and a market worth exploring for any consumer electronics giant like Apple.

The above graphic demonstrates that hearing aid market penetration rates increase with the severity of hearing problems. OTC hearing aids are designed for those with mild-to-moderate hearing loss (the bottom two-thirds of the pyramid), as well as those who fall outside this diagram—people who do not have an “audiometric hearing loss” but could still benefit from situational help in noisy places. Adapted from Niels Granholm-Leth of Carnegie Investment Bank, WHO, and Sonova.
The above graphic demonstrates that hearing aid market penetration rates increase with the severity of hearing problems. OTC hearing aids are designed for those with mild-to-moderate hearing loss (the bottom two-thirds of the pyramid), as well as those who fall outside this diagram—people who do not have an “audiometric hearing loss” but could still benefit from situational help in noisy places. Adapted from Niels Granholm-Leth of Carnegie Investment Bank, WHO, and Sonova.

Although Apple AirPods are exceptional audio devices, there is room for improvement if they're to be used as OTC hearing aids. The HearAdvisor lab gave them a SoundScore of 2.9 (out of 5), which isn't bad, but they lag significantly behind the top OTC hearing aids in speech-in-quiet and speech-in-noise scores. Another major improvement would be to incorporate a customized hearing test, like those of Mimi or SonicCloud, to more easily tune the device for users' individual hearing losses. This wouldn't be completely unexpected: in 2018 at WWDC18, an Apple engineer explained how the company’s ResearchKit for software developers uses the Hughson-Westlake pure-tone threshold method, as well as an assessment of the noise level in the test environment. Finally, they could greatly extend battery life beyond 4-5 hours in transparency mode; most hearing aids offer at least 12 hours of service when fully charged.

Apple wouldn't necessarily need to do any of these things. Just having a switch to activate the Hearing Aid Mode could be a game-changer; it would alert millions of users that this useful function exists.

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It remains to be seen if Apple will announce a new Hearing Aid Mode in its AirPods and iOS 18 in mid-September. But, if not then, it’s hard to believe it won’t at some date in the near future.