Retired musicians who use hearing instruments frequently stop performing, practicing, going to the concert hall, or even listening to music at home. Discriminating music lovers do the same, avoiding live performances and finding music unpleasant.

This pattern happens not only as a result of detuning of the auditory system, but also because amplified processing can cause music to sound unnatural and uncomfortable, with distortion of pitch and tone.

Long-term music training tunes how the brain temporally binds signals from multiple senses, resulting in specific and unique neuroplastic changes (Proc Natl Acad Sci U S A 2011;108[51]:E1441-E1450). As a result, audiovisual-tactile processing is different in musicians than in nonmusicians, with music memory and actuality more at odds.

As an amateur musician since childhood, I have learned to play some instruments, and, as an audiologist and specialist in acoustics, I understand why amplified music can sound so unnatural when listening to an orchestra with hearing aids.