Hearing Loss and Cognitive Overload - What is the Connection?

by Envoy Medical Staff Member, on January 30, 2021

Consider the last time you were in an environment that made it more challenging to hear. It could have been a phone call with a bad connection, a time when you were focused on something intently and  didn’t realize someone was talking to you, or a situation where background noise made it harder for you to understand.  Do you remember having to focus and concentrate on hearing? Perhaps making sure you are looking at the speaker, using facial expressions to determine if a question was being asked, and absent-mindedly filling in the blanks? Perhaps you realized it must be your turn to order or used a word clue like “Friday” to determine the date mentioned that you missed.

For many of us with hearing loss, we actively listen and we do it as a sole activity. We don’t listen and do something else as our attention needs to be focused on the speaker. It turns out this filling in the blanks requires some cognitive acrobatics and there is a name for it – Cognitive overload.


Recent studies which discuss the impact of hearing loss on the brain tell us something we already know - When you have hearing loss it can be exhausting to participate. While our ears perceive sound the processing of sound or making sense of the pieces we are hearing happens in the brain. One theory is that this cognitive overload could overtax our brains.

I prefer to think of these skills as dynamic. I am an attentive listener and a good friend I can multi-task and use many portions of my brain to succeed. I also have great eye contact and am engaged when in conversation.

Cognitive overload is a broad term describing a situation in which the demands placed on a person by mental work (the cognitive load) are greater than the person’s mental abilities can cope.

In one study Jonathan Peale and his team at Washington University used functional MRI images comparing brain patterns in people with poor hearing and people with good hearing.  While the images showed people with poor hearing having reduced activation of areas of the brain used for sound processing,  the same people showed increased language drive activity in critical areas. The theory is that the brain may be recruiting other areas to help with the sound processing deficits. While these facts may be interesting and studies will continue in hopes of pinpointing an irrefutable fact, we can use our common sense and our understanding when we experience some exhaustion after actively hearing.

So how can we reduce the energy we are spending going about our activities of daily life?

My friend Sarah keeps the captions on when she watches television. She doesn’t need them to watch but finds television and movies to be more relaxing to have them there to fall back on.

Activities where there is one focus, can be helpful as well. We spend so much time multi-tasking to hear why not simply listen to music or an audiobook and relax?

Have you ever meditated? Even if you haven’t or don’t want to, it relaxing to listen to soothing sounds to relax and unplug you can listen to the rain, or the ocean whatever your choose.

In loud environments prepare to focus and try to place yourself well in the room. For example, having your back to a wall or towards the edge of the room will help reduce background noise. If sitting outside is an option, they can be helpful as well.

Ask a friend to assist you in hearing your order and focus just on the conversation and don’t apologize to ask your neighbor to repeat.  

If you are an Esteem user, switching to a background profile and turning the volume down can also be helpful.

Perhaps in the future, we will see some studies which cover the dynamic use of the brains of those of us treating and managing our hearing loss. In the meantime, we need to be a bit like a superhero, and rest to recharge.

Self and Shared Advocacy

Living with hearing loss is often called a journey.  While that can sound corny, it does help one to recognize that things can be fine, and then not fine either moment to moment or sometimes with long periods, even years in between.  Sometimes we feel motivated and confident, sometimes we don't.  If you, a loved one or someone you know is in the throes of hearing loss something like InnoCaption might be a really helpful tool.

InnoCaption is a mobile app that offers real times captioning of phone calls.  You download the app on your smartphone, register an account, and then dial the person you'd like to talk to through the app.  It can also be streamed through a desktop for conference calls or just to see better on a larger screen.  The great thing about it is there is no cost to users if they have hearing loss because they are certified by the FCC.  This means they receive compensation from the total relay service (TRS) fund.  

Click here to check it out!


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