Every day, we hear countless sounds—from the beep of a checkout scanner to the hiss of a coffee machine. Our brains process these sounds without us even noticing. But for some, everyday noises become overwhelming. Voices and alerts get lost in the mix, making it difficult to focus.

Sophie, a 25-year-old administration assistant from London, knows this struggle well. Friends and colleagues often say she zones out, doesn’t listen, or seems distracted. But the truth is more complex.

“I hear sounds, but I can’t always tell where they come from. I recognize voices, but I can’t process them fast enough,” she explained.

After normal hearing tests showed no issues, she turned to a private audiologist for answers. Eventually, she was diagnosed with Auditory Processing Disorder (APD). This neurological condition affects how the brain interprets sounds, making it hard to understand speech, especially in noisy environments.

Could Noise-Cancelling Headphones Be a Factor?

Sophie grew up on a quiet farm where sound processing was never a problem. But after moving to London for university, she started struggling to pinpoint where noises came from. Lectures became challenging. She relied on online recordings with subtitles to keep up with her studies.

“In lectures, words sounded like gibberish. I tried to listen, but I couldn’t make sense of them fast enough,” she said.

Social situations also became difficult. In busy restaurants and bars, background noise overwhelmed her. She often left early, exhausted by the effort to follow conversations.

Her audiologist suspects that her frequent use of noise-cancelling headphones—sometimes for up to five hours a day—may have played a role in her APD. Other specialists share this concern, calling for more research into the long-term effects of these devices.

Many audiology clinics in England report a rise in young people seeking help for sound-processing issues. Despite passing standard hearing tests, they struggle to focus on voices in noisy settings. APD is commonly linked to neurodiversity, brain injuries, or childhood ear infections. However, doctors are seeing more cases that don’t fit these categories, raising concerns about environmental factors, including prolonged headphone use.

The Difference Between Hearing and Listening

Renee Almeida, a clinical lead at Imperial College Healthcare NHS Trust, explains that the brain needs exposure to a variety of sounds to learn which ones matter.

“Hearing and listening are different skills. We are seeing more young people whose listening skills are getting weaker,” she said.

Noise-cancelling headphones can protect ears from loud or high-pitched sounds. However, different models offer varying levels of sound filtering. Some only provide passive noise cancellation by physically blocking outside noise, while others use transparency modes to let in selective sounds.

Lisa Barber, a technology editor at Which?, notes that these transparency modes vary in effectiveness, meaning some users may be blocking out more noise than they realize.

The Risk of a “False Reality”

Claire Benton, vice president of the British Academy of Audiology, warns that constant use of noise-cancelling headphones may alter the brain’s natural ability to filter sounds. This could explain why some users later struggle with noisy environments.

“Wearing these headphones creates a controlled world where you only hear what you choose. Your brain doesn’t practice filtering real-life sounds,” she said.

She also pointed out that the brain continues developing listening skills into the late teens. Using noise-cancelling headphones too much during this period may delay the ability to handle background noise effectively.

Despite the growing number of APD cases, NHS services for the condition are scarce. A 2024 survey by the British Academy of Audiology and ENT UK found that only 4% of audiologists felt well-informed about APD. In England, the Royal National ENT and Eastman Hospital is the only NHS provider offering full APD assessments for people over 16. The waiting list is currently nine months long.

Professor Doris-Eva Bamiou, a specialist at the hospital, explains that diagnosing APD is complex. “It’s not just a simple hearing test. The assessment takes up to two hours and involves multiple tests to understand how the brain processes sounds,” she said.

Changes in How We Listen

Since the pandemic, people’s listening habits have changed. Many now wear noise-cancelling headphones outdoors or watch videos with subtitles, even if they have normal hearing. A YouGov survey found that 61% of 18- to 24-year-olds prefer watching TV with subtitles.

Dr. Angela Alexander, founder of APD Support, believes more research is needed to understand the link between noise-cancelling headphones and APD.

“If we don’t study this, we might unknowingly be encouraging a condition that affects how people engage with sound,” she said. She worries that well-meaning parents and teachers may be over-relying on headphones as a solution for children who struggle with noise.

Dr. Amjad Mahmood, head of audiology at Great Ormond Street Hospital, has also seen a “significant increase” in demand for APD assessments, especially among school-aged children.

Can APD Be Treated?

The good news is that APD treatment can lead to major improvements, and in some cases, full recovery. One key approach is “word-in-noise” training. Mobile apps help users practice separating speech from background noise. Exercises also include auditory discrimination, which helps distinguish between similar-sounding words, like “seventy” and “seventeen.”

For some, special microphones or low-gain hearing aids can improve hearing in classrooms or offices. However, these are not covered by the NHS for adults outside of education settings.

Dr. Alexander explains the concept of auditory scene analysis—the brain’s ability to decide which sounds matter.

“Right now, I hear a fan running, but my brain knows it’s not important,” she said.

When the brain loses this ability, people may feel anxious because they can’t determine which sounds need attention. She suggests limiting headphone use, using transparency mode, and choosing open-ear models that don’t completely block outside noise.

The Need for Further Research

Wayne Wilson, an associate professor at the University of Queensland, agrees that more research is needed.

“This isn’t a simple question. The effects depend on many factors—what sounds people are exposed to, how long they use headphones, and even their age,” he said.

Sophie remains hopeful as she prepares to begin APD treatment. “My boyfriend and I sometimes leave bars early because of the noise. If treatment helps, I might finally enjoy socializing in busy places again.”

As more specialists push for research into the long-term effects of noise-cancelling headphones, the conversation around their impact on auditory health continues to grow.

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