Here's a crazy idea. I personally prefer the fidelity of an active ambient in-ear monitor (IEM), as used by musicians on stage over the best hearing aids. Once a year, I do a monthly trial with the latest hearing aid models and IMO the fidelity (especially low-end) and the comfort just is not there compared with the best active ambient IEMs. The difference between hearing aids and IEMs is blurring, but they are not yet fully interchangeable.

Standard IEMs isolate you from the world, which is the opposite of what a hearing aid does. However, a specific category called "Active Ambient" IEMs bridges this gap. These are IEMs with embedded high-fidelity microphones on the outer shell. They pick up the sound of the room (bandmates, crowd, conductor), amplify it, and blend it with your monitor mix. The accompanying bodypack or app often includes a multi-band EQ and Limiter. You can boost specific frequencies where you have hearing loss (e.g., boosting highs to hear cymbals or speech clearly) and set a volume ceiling to protect your remaining hearing. I have no ownership/sponsorship in the product, but I personally LOVE the ASI Audio 3DME (powered by Sensaphonics), which is the industry standard for this. [1] It allows you to use an app to shape the ambient sound to your hearing needs.

The Pros: It provides hearing protection + monitoring + hearing enhancement in one device.

The Cons (Why they aren't daily hearing aids):

1) Form Factor: You are tethered to a belt pack. You likely won't wear a wired bodypack to a grocery store or dinner party.

2) Social Barrier: Wearing full-shell custom IEMs creates a "do not disturb" look that discourages conversation in social settings. This can be more socially alienating than a comparatively inconspicuous hearing aid.

3) Battery Life: IEM systems typically last 6–8 hours, whereas hearing aid batteries can last days or weeks.

[1] https://www.sensaphonics.com/products/3dme-custom-tour-gen2-...

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thfuran 11 hours ago | parent | next [-]

They only get a couple hours better life even with a belt pack to fit more battery?

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chha 19 minutes ago | parent | next [-]

The belt packs typically do a lot more than to amplify ambient noise, they also handle RF, depending on the model decryption of the audio signal, EQ as well as other stuff. All while typically running on 2x1,5V AA batteries.

Audio gear isn't made to last long on batteries, it's made to be reliable for the hours a show typically lasts. I worked part-time as a sound tech (paid hobby) for 15+ years, and I never started a show without fresh batteries, regardless of what the indicators on the transmitters/receivers told me.

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stevenjgarner 2 hours ago | parent | prev | next [-]

Power requirements, moving mass and audio sampling and processing.

Hearing aids run on tiny voltages (typically ~1.4 Volts). They are designed to amplify speech (a small frequency range) at moderate volumes. An IEM is designed to handle the massive energy of a live drum kit without distortion. To do this, the internal amplifier needs Headroom. It likely steps up the battery voltage significantly (internally converting to higher voltage rails) to ensure that when a snare drum hits 120dB, the amplifier has enough electrical height to reproduce that spike without clipping.

Hearing aids use microscopic balanced armature receivers that require almost zero power to move because they are only moving a tiny amount of air near your eardrum. IEMs use dual-driver miniature subwoofers and tweeters that are physically larger and heavier. It takes significantly more electrical current to push these drivers back and forth.

Hearing aids often use aggressive battery-saving tricks, such as lowering the sampling rate or "sleeping" processes when silence is detected. The processor of an IEM is running wide open 100% of the time. It is constantly digitizing the world at a high sampling rate to ensure zero latency. If it tried to save battery by "sleeping" between notes, you would hear a delay (latency), which would make it impossible to play in time.

	▲	amluto an hour ago \| parent [-]
		Let’s try some actual numbers. A fancy passive IEM quotes: > Sensitivity: 114 dB-SPL (@ 0.1V) That’s on the high side for an IEM. Let’s be conservative and say it’s actually 100dB SPL at 1mW (which is on the low side) and that the user has hearing loss and the IEM is actually outputting 90dB continuously (I’m not an expert but this seems high. Certainly I would not set an active IEM anywhere near that loud, even at a concert). That’s 0.1mW of electrical power to each IEM, for 0.2mW total. This part could run for days on a small battery pack. A modern amplifier might as well be 100% efficient, although that body pack could easily be some wildly efficient Class A design. Let’s suppose the DSP is processing 96kSPS (might as well minimize latency and the need for a complex antialiasing setup and let’s assume it’s using a duper-high-fidelity FIR filter that’s a whole 100ms long, i.e. 9600 taps, and that the FIR implementation is pure brute force, so there are 9600 times 96k FMAs per second. That’s about 2 billion FMAs per second for both ears. (Again, this is a ridiculous way to do this.) The fancy nonlinear compression stuff will be negligible in comparison. From some quick Googling, you could easily spend a whole watt on the DSP. And there’s where all that battery charge goes :) I bet that someone who really cared about optimizing this could put some software engineering into getting DSP power down below 50mW. Either use an FFT to optimize the filter or use a much lower complexity filter bank.

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mapt 4 hours ago | parent | prev [-]

A belt pack can fit a battery literally ~1000x as large as a hearing aid battery.

Is there a little computer doing DAW work inside the earpiece?

	▲	InitialLastName 2 hours ago \| parent [-]
		> Is there a little computer doing DAW work inside the earpiece? Yes, and likely always running all filters at high fidelity rather than power-saving whenever there isn't something to amplify.

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EionRobb 11 hours ago | parent | prev | next [-]

Does that setup work ok outside in windy environments? A lot of the 'active' audio systems I've found really focus on the wind noise while hearing aids will try to filter that out

	▲	stevenjgarner 5 hours ago \| parent [-]
		You definitely have a point there. The 3DME uses small MEMS microphones embedded in the faceplate of the earphone and has no physical windscreen or noise suppression like digital hearing aids and consumer buds which use aggressive software algorithms to detect wind and instantly cut the low frequencies to stop the rumble. As a workaround, some artists performing outside wear a thin, acoustically transparent beanie or headband over the ears effectively acting as a pop-filter/windscreen. This breaks the wind before it hits the mic while still letting mid-to-high frequency sound (speech/music) pass through. Not exactly a hearing aid alternative.

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madeofpalk 4 hours ago | parent | prev [-]

This sounds essentially like a higher end/specialised version of what Apple Airpods do.