From the beeping of a checkout scanner to the hum of a coffee machine, our brains process many sounds at once. But for some, these background noises become too much, making it hard to hear voices or alarms.
This is the reality for Sophie, a 25-year-old administrative assistant from London. Friends and coworkers often say she zones out or does not pay attention.
“I hear the noises around me, but I can’t figure out where they come from. I recognize voices but can’t process them fast enough,” she said.
A standard hearing test showed no issues. She then visited a private audiologist and was diagnosed with auditory processing disorder (APD). This condition affects how the brain interprets sound, even when hearing itself is normal.
Now, her audiologist and other experts in England are asking if long-term use of noise-cancelling headphones plays a role in the rising cases of APD.
The Struggle to Separate Sounds
Sophie grew up on a quiet farm. She only noticed her hearing difficulties when she moved to London for university. City life was full of noise, making it hard for her to focus on specific sounds.
Instead of attending in-person lectures, she preferred watching them online with subtitles.
“During lectures, everything sounded like gibberish. I struggled to process what was being said,” she explained.
Social gatherings were also difficult. She often left bars and restaurants early because of the overwhelming noise.
Her audiologist suspects her extensive use of noise-cancelling headphones—up to five hours a day—might have contributed to her condition. Other specialists share this concern and call for more research on the effects of long-term headphone use.
Several NHS audiology departments told the BBC they had seen more young patients with hearing concerns. But most had normal hearing tests, suggesting their issue was with processing sound, not hearing loss.
APD is more common in people with neurodivergent conditions, brain injuries, or a history of ear infections. However, more patients outside these categories are now being diagnosed. Experts are investigating whether external factors—such as noise-cancelling headphones—play a role.
Hearing vs. Listening
Renee Almeida, an audiology expert at Imperial College Healthcare NHS Trust, says people need exposure to a variety of sounds to develop proper listening skills.
Her team has seen an increase in young people seeking hearing assessments. “There’s a difference between hearing and listening. We’re seeing a decline in listening skills,” she noted.
Noise-cancelling headphones do have benefits. They block loud, high-frequency sounds, which can protect ear health over time.
Lisa Barber, a technology expert at Which?, says these headphones have become very popular. However, she points out that different models filter sound differently. Some block all external noise, while others let in some ambient sounds.
Are Headphones Changing How We Process Sound?
Claire Benton, vice president of the British Academy of Audiology, warns that blocking everyday sounds—like traffic—could weaken the brain’s ability to filter noise.
“With noise-cancelling headphones, you only hear what you choose to hear. Your brain isn’t being challenged,” she said.
Listening skills continue developing until the late teens. If young people rely too much on noise-cancelling headphones, they might struggle to process speech and background noise later in life.
For those in England with APD, NHS support is limited. A 2024 survey found that only 4% of audiologists felt well-informed about the condition.
The Royal National ENT and Eastman Hospital is the only NHS provider offering full APD assessments for those over 16. However, there is a nine-month waitlist, making diagnosis and treatment hard to access.
Professor Doris-Eva Bamiou, who leads these assessments, says diagnosing APD is complex. “It’s not just an audiogram. Testing takes up to two hours and includes cognitive assessments. Children may also need input from an educational psychologist.”
How Technology Is Changing Listening Habits
Since the pandemic, people’s listening habits have changed. Many rely on subtitles, and some feel anxious in noisy places after long periods of quiet.
It’s common to see people wearing noise-cancelling headphones while watching videos with subtitles. A YouGov survey found that 61% of 18- to 24-year-olds prefer watching TV with subtitles, even if they can hear the audio.
Dr. Angela Alexander, an audiologist at APD Support, calls for research into how these headphones affect auditory processing, especially in children.
“If we don’t study this now, what will the future look like? Many parents and teachers think noise-cancelling headphones help with noise sensitivity. But could they be making it worse?”
Dr. Amjad Mahmood, head of audiology at Great Ormond Street Hospital, agrees that more research is needed. He has seen a big rise in requests for APD assessments, especially from school-aged children.
APD treatment can help, sometimes leading to full recovery. Mobile apps that offer “word-in-noise” training can improve speech recognition in loud settings. Other exercises teach users to tell apart similar sounds, like “seventy” and “seventeen.”
Microphones and low-gain hearing aids can help people hear better in meetings or classrooms. But these tools are not available on the NHS for adults outside education.
Dr. Alexander explains auditory scene analysis—the process of focusing on important sounds. “Right now, I hear a fan above my head, but my brain knows it’s not important.”
Without regular exposure to background noise, the brain might struggle to prioritize sounds, leading to more anxiety. To improve listening skills, she suggests reducing headphone use, enabling transparency mode, and choosing models that don’t block all external sound.
More Research Needed
Wayne Wilson, a researcher at The University of Queensland, agrees that further studies are needed. But he acknowledges the difficulty in controlling all the factors that could affect results.
“The answer likely depends on multiple factors: the type of sounds, noise levels, duration of noise cancellation, and the listener’s age.”
Despite these questions, Sophie is hopeful as she begins treatment for APD.
“When my boyfriend and I go out, we often leave early because of the noise. Hopefully, with treatment, I’ll be able to enjoy busier places and manage sound better.”
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