The Effects of Daily Life Auditory Demands on Listening Effort, Affect, and Fatigue as a Function of Hearing Loss

Previous research has highlighted challenges for individuals with hearing loss, including increased listening effort and fatigue. This study aimed to: (a) examine the relationship between auditory demand and listening effort, affect, and fatigue, focusing on the moderating role of hearing loss; and (b) assess whether listening effort and affect mediate the effect of auditory demand on fatigue. A total of 130 participants, with and without hearing loss, participated in EMA over 5.5 days, answering questions on listening effort, fatigue, and listening environment attributes. Auditory demand was defined by contextual and subjective components derived from EMA responses. LME models analyzed the effect of auditory demand on listening effort, affect, fatigue and the moderating role of hearing loss. Additional models tested mediation by listening effort and affect. Results: highlighted that both contextual and subjective auditory demand significantly increased listening effort with stronger effects in those with more hearing loss. No effects of contextual auditory demand on affective state were observed, nor was there a moderation effect of hearing loss. An effect of subjective auditory demand on affect was observed, but no moderation of hearing loss was present. Contextual and subjective auditory demand predicted fatigue (β = 0.07-0.14, p < .01-p < .001) with amplified effects present in those with more hearing loss (p_interaction < .01) for contextual demand. Mediation analyses highlighted that listening effort contributed to the demand-fatigue relationship, though patterns differed by demand type. The results indicate that increased listening effort, rather than negative affect, may underlie the association between auditory demand and fatigue.