Why can’t active noise cancelling headphones be used as hearing aids?

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As I understand it, active noise cancelling headphones use microphones to pick up the sound around you, and cancel it out. So why can’t the same hardware be used to pick up the sounds around you and amplify them?

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Lots of them do use the same technology to simply repeat ambient noises louder, but the trick is that hearing loss isn’t always just a volume problem. Some people have problems with specific frequencies or ranges of frequencies, and a good hearing aid will target *just those problem areas* for the patient.

The quality of cheap hearing aids (that rely on the same tech as noise-cancelling headphones) has risen significantly in the last 5-10 years.

I wear hearing aids and from my experience I’d say there are a few things:
1) my hearing aids are calibrated for my specific hearing loss, to amplify certain frequency regions more than others
2) hearing aids set the speakers pretty far into your ears, mine have silicone “cones” to help center them and hold them in place so the sound is going as straight into the ear as possible.
3) they have advanced programming to aid in hearing beyond what I’ve mentioned in #1
4) hearing aids have to be prescribed

You just described hearing aids. That’s exactly what they do, only they are calibrated to certain frequencies depending on the hearing loss in the individual. But in essence they are like a personalized noise cancelling/sound amplifying headphone.

I have a pair of shooting earmuffs that do exactly that; they pick up and play the audio around you back to you, but if they detect a sound over a certain decibel level (like a gunshot) they shut off. You can turn them up higher than normal hearing would allow, so you can have enhanced hearing for hunting.