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Took me a while to understand based on my own hearing loss that it's not about decreased sensitivity to sound. Hearing is about sound volumes that occur between two limits: The threshold of sensitivity (above which you discern that the sound exists), and the threshold of pain (above which the sound is painful). Between those limits lies hearing.

In age-related "hearing loss," the threshold of sensitivity rises while the threshold of pain stays the same or even decreases slightly. So the range of volumes you can comfortably discern becomes narrower. This explains why simply increasing the volume often does more harm than good. What's really needed to treat hearing loss is frequency-specific volume compression.




Of course prolonged exposure to loud sounds which are not explicitly painful can still cause hearing damage.




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