Relationship Between Daily Device Usage and Listening-Related Fatigue in Adults and Children With Cochlear Implants

OBJECTIVES: Cochlear implants (CIs) enable people with moderate-to-profound sensorineural hearing loss to perceive sounds, but perceptual outcomes with a CI remain highly variable from person to person. Individuals who wear their CI consistently tend to exhibit better auditory outcomes than those who do not wear their CI as often. However, even the best-performing CI users typically exert more effort to understand speech than their peers with normal hearing, which can lead to listening-related fatigue. In this study, we aimed to understand whether the amount of time an individual wears a CI each day influences his or her listening-related fatigue and subjective hearing abilities. We hypothesized that individuals who wear their CI consistently will experience less listening-related fatigue and better subjective hearing abilities than those who do not wear their CI as often. DESIGN: We surveyed 71 CI listeners, including 40 adults (age 18 to 79 years) and 31 children (age 7 to 16 years). Listening-related fatigue was estimated via the adult, pediatric, and parent versions of the Vanderbilt Fatigue Scale. Subjective hearing abilities were estimated using the adult, pediatric, and parent versions of the Speech, Spatial, and Qualities of Hearing Scale. CI daily wear time was estimated using self-report measures and data from the participants' mobile phone applications. RESULTS: Adults who wore their devices less often during the day experienced significantly more listening-related fatigue and more physical exhaustion than those who wore their devices more consistently. Higher levels of listening-related fatigue were associated with poorer subjective hearing abilities in the adults with CIs. On the other hand, children with CIs and their parents did not report high levels of listening-related fatigue overall (i.e., their responses fell within the normative range of scores on the child and parent versions of the Vanderbilt Fatigue Scale, respectively). Daily device wear time did not predict either parent-reported or child-reported listening-related fatigue. However, higher mental fatigue was associated with poorer subjective hearing abilities in children with CIs, as reported by their parents. There were no significant relationships between child-reported listening-related fatigue and subjective hearing abilities. CONCLUSIONS: Adult CI users who consistently wear their device experience less listening-related fatigue and physical exhaustion than those who wear their device less often. This information can guide clinicians in counseling their adult patients to wear their devices consistently, potentially leading to improved quality of life. We did not observe relationships between device usage and listening-related fatigue in the children with CIs, likely because our pediatric participants reported relatively low levels of listening-related fatigue overall. There is a need to explore factors that contribute to listening-related fatigue in children with CIs who experience a broad range of hearing histories and fatigue symptoms.