What Is an Audiogram? How to Read Your Hearing Test Results
If you have recently had a hearing test, you may have been given an audiogram showing a collection of lines, symbols and numbers.
At first glance, an audiogram can look confusing. You may see numbers ranging from negative values to 120, several different frequencies and separate markings for your left and right ears.
But what does it all mean?
An audiogram is essentially a visual map of your hearing. It shows the quietest sounds you were able to hear at different pitches during a hearing assessment.
Understanding your audiogram can help you understand whether your hearing falls within the expected range, whether you have hearing loss and which frequencies may be affected.
This guide explains how to read an audiogram and what your hearing test results may mean.
What Is an Audiogram?
An audiogram is a graph used to record the results of a hearing test.
During a standard hearing assessment, you listen to sounds at different frequencies and volumes.
You indicate when you can hear each sound.
The results are then plotted on the audiogram.
The graph normally shows:
Frequency along the horizontal axis
Hearing level along the vertical axis
Separate results for each ear
Symbols representing the responses from each ear
The resulting pattern gives your hearing professional information about how well you hear different pitches.
What Does the Horizontal Axis Show?
The horizontal axis of an audiogram represents frequency.
Frequency is measured in Hertz (Hz).
Lower frequencies represent deeper sounds, while higher frequencies represent higher-pitched sounds.
You may see frequencies such as:
250 Hz
500 Hz
1,000 Hz
2,000 Hz
4,000 Hz
8,000 Hz
A lower frequency is similar to a deep bass sound.
A higher frequency is more like a high-pitched sound.
Speech contains a wide range of frequencies, which is why hearing different parts of the frequency range can affect communication in different ways.
What Does the Vertical Axis Show?
The vertical axis represents the hearing level, usually measured in decibels hearing level, written as dB HL.
The numbers generally become larger as you move down the graph.
For example, the top of the graph may show:
0 dB HL
while lower sections may show:
20, 40, 60, 80, 100 dB HL
This does not mean that 0 dB is complete silence.
Instead, the scale is based on standardised hearing thresholds.
Generally, the further down the graph your hearing thresholds appear, the louder a sound needs to be before you can detect it.
What Does 0 dB Mean on an Audiogram?
A common misunderstanding is that 0 dB means no sound.
It does not.
On an audiogram, 0 dB HL represents a reference level based on the typical hearing thresholds of people with normal hearing.
Someone with a threshold around 0 dB HL can hear relatively quiet sounds.
This is very different from saying that the person cannot hear anything.
What Do the Symbols on an Audiogram Mean?
Audiograms use different symbols to represent the results from each ear.
The exact symbols can vary depending on the test and the hearing professional, but traditionally:
A red circle represents the right ear
A blue X represents the left ear
Other symbols may be used for bone-conduction testing, masked results and other measurements.
Your audiologist or hearing professional should explain the symbols on your individual audiogram.
Why Are the Left and Right Ears Tested Separately?
Your ears do not necessarily hear equally.
One ear may have better hearing sensitivity than the other.
Testing each ear separately allows your hearing professional to identify differences between them.
For example, your audiogram might show relatively similar thresholds in both ears.
Alternatively, one ear might show greater hearing loss.
The pattern can provide useful information about your hearing.
What Is Normal Hearing on an Audiogram?
The definition of normal hearing can vary slightly between clinical guidelines, but hearing thresholds within approximately 0 to 20 dB HL are commonly considered within the normal range for many adults.
Some classifications use a slightly different upper limit.
This is one reason why it is better to discuss your individual results with your hearing professional rather than focusing on one number alone.
Your overall hearing ability also involves more than simply whether a threshold falls within a particular range.
What Does Mild Hearing Loss Look Like?
Mild hearing loss generally means that sounds need to be somewhat louder before you can hear them compared with someone with typical hearing sensitivity.
Depending on the classification system used, mild hearing loss may fall approximately within the 20 or 25 to 40 dB HL range.
Someone with mild hearing loss may still hear most everyday sounds.
However, they may have difficulty understanding speech when:
There is background noise
Someone speaks quietly
Several people are talking
The speaker is far away
The person cannot see the speaker’s face
Mild hearing loss can therefore have a noticeable impact on communication even when everyday sounds remain audible.
What Does Moderate Hearing Loss Look Like?
Moderate hearing loss generally means that speech and other sounds need to be considerably louder before they are heard clearly.
Depending on the classification system, moderate hearing loss may fall approximately between 41 and 55 or 60 dB HL.
People with moderate hearing loss may frequently ask others to repeat themselves.
They may turn the television volume up or struggle to follow conversations in restaurants and other noisy environments.
Hearing aids may be recommended depending on the individual’s hearing results, communication needs and preferences.
What Does Severe Hearing Loss Look Like?
Severe hearing loss means that sounds generally need to be significantly louder before they can be detected.
The exact classification varies, but severe hearing loss often falls approximately within the 71 to 90 dB HL range.
People with severe hearing loss may struggle to understand ordinary speech without amplification.
Hearing technology and communication strategies can be particularly important for maintaining communication and independence.
What Does Profound Hearing Loss Look Like?
Profound hearing loss is at the most significant end of the hearing-loss range.
Sounds may need to be extremely loud before they can be detected.
The management of profound hearing loss depends on the individual and may involve specialised hearing technology and, in some cases, discussion of other hearing solutions.
A hearing professional can explain the options based on the person’s hearing results and communication needs.
What Is a Flat Audiogram?
A relatively flat audiogram means that hearing thresholds are fairly similar across the frequencies tested.
For example, someone might have similar levels of hearing loss at low, middle and high frequencies.
A flat pattern can occur with different types of hearing loss.
The shape of the audiogram is therefore important when understanding the overall picture.
What Is a Sloping Audiogram?
A sloping audiogram means that hearing thresholds become poorer as frequency increases.
In other words, lower-pitched sounds may be easier to hear than higher-pitched sounds.
This pattern is common in certain types of age-related and noise-related hearing loss.
People with a high-frequency hearing loss may report that they can hear someone speaking but struggle to understand what the person is saying.
This can happen because many speech sounds that help distinguish words occur in the higher-frequency range.
What Is a Rising Audiogram?
A rising audiogram occurs when hearing is poorer at lower frequencies but improves at higher frequencies.
This is less common than a high-frequency sloping pattern but can occur with certain types of hearing conditions.
The underlying cause and significance depend on the individual’s complete hearing assessment.
Why Can I Hear Someone Speaking but Not Understand Their Words?
This is a very common hearing complaint.
You may be able to hear that someone is speaking while struggling to understand exactly what they are saying.
This can happen when hearing loss affects frequencies that are particularly important for distinguishing speech sounds.
It can become especially noticeable in noisy environments.
For example, you might hear:
“I can hear them, but I can’t understand them.”
This is an important symptom to mention during a hearing assessment.
What Does the Speech Banana Mean?
If you have looked at an audiogram before, you may have seen a shaded area shaped somewhat like a banana.
This is commonly called the speech banana.
It represents approximately where many speech sounds occur in terms of frequency and loudness.
Different speech sounds occur at different frequencies and intensities.
For example, some high-frequency consonant sounds occur towards the upper-frequency area, while lower-frequency vowel sounds appear lower on the graph.
The speech banana can help illustrate how hearing loss may affect speech understanding.
Can an Audiogram Tell You What Type of Hearing Loss You Have?
An audiogram provides important information, but a complete diagnosis may require additional assessment.
Hearing loss is often broadly classified as:
Conductive hearing loss
Sensorineural hearing loss
Mixed hearing loss
Conductive hearing loss involves problems affecting the outer or middle ear.
Sensorineural hearing loss involves the inner ear or auditory nerve pathways.
Mixed hearing loss contains elements of both.
Additional tests, including bone-conduction testing and other assessments, can help determine the type of hearing loss.
What Is Bone-Conduction Testing?
Bone-conduction testing is another part of some hearing assessments.
Instead of sending sound through the ear canal using headphones or insert earphones, a small device is placed against the bone behind the ear.
The device sends vibrations through the skull to stimulate the inner ear.
Comparing air-conduction and bone-conduction results can help your hearing professional determine whether hearing loss is related to the outer or middle ear, the inner ear or a combination of factors.
Why Are Some Audiogram Lines Different Colours?
Many audiograms use colour to make the results easier to understand.
Traditionally, red is used for the right ear and blue for the left ear.
This colour convention helps distinguish the ears when reviewing the graph.
However, the exact presentation can vary between clinics and testing systems.
Always use the labels and explanation provided with your own audiogram.
What If One Ear Has Worse Hearing Than the Other?
Different levels of hearing between the two ears are relatively common.
However, the reason for the difference can vary.
Your hearing professional will consider:
The degree of difference
The shape of the audiogram
Your symptoms
How quickly the difference developed
Your medical and ear history
Other test results
If you experience a sudden change in hearing in one ear, seek prompt medical assessment rather than waiting for a routine hearing appointment.
Can an Audiogram Show Tinnitus?
An audiogram does not directly measure tinnitus.
Tinnitus is the perception of sound without an external sound source.
However, hearing tests are often performed when someone experiences tinnitus because tinnitus can occur alongside hearing loss.
Your hearing professional can assess your hearing and discuss the tinnitus symptoms you are experiencing.
Can Earwax Affect an Audiogram?
Yes.
Significant earwax can block the ear canal and reduce the amount of sound reaching the eardrum.
This can affect hearing and potentially influence hearing test results.
For this reason, your ears may be checked before a hearing assessment.
If significant wax is present, it may need to be dealt with before certain hearing measurements can be interpreted accurately.
Can Your Audiogram Change Over Time?
Yes.
Hearing can change over the course of your life.
Possible factors include:
Age
Noise exposure
Ear conditions
Ear infections
Certain medications
Head injuries
Other medical conditions
This is why comparing hearing tests over time can be useful.
If your hearing professional has previous audiograms, they can sometimes compare the results to identify changes.
How Often Should You Have a Hearing Test?
The appropriate frequency depends on your age, hearing history, symptoms and risk factors.
People who already have hearing loss or hearing aids may require more regular monitoring.
If you work around loud noise or frequently experience tinnitus, your hearing professional may also recommend regular assessments.
If you notice a change in your hearing, you should arrange a hearing assessment rather than waiting for your next routine test.
What Happens After an Audiogram?
Your hearing professional will discuss your results with you.
If your hearing falls within the expected range, they may simply recommend monitoring it periodically.
If hearing loss is identified, they can explain the severity, pattern and possible implications for communication.
Depending on your results and needs, you may discuss:
Hearing protection
Communication strategies
Hearing aids
Follow-up hearing tests
Further medical assessment
Management of tinnitus
Earwax management
A hearing test is not simply about giving you a pass or fail result.
It provides information that can help you make informed decisions about your hearing.
Can You Read Your Own Audiogram?
You can learn the basics of reading an audiogram, but your hearing professional is best placed to interpret the complete results.
The graph shows your hearing thresholds, but the meaning of those results depends on the complete assessment.
For example, two people can have similar audiograms but experience very different communication difficulties.
Your lifestyle, listening environments, speech understanding and other symptoms all matter.
Frequently Asked Questions
What is an audiogram?
An audiogram is a graph showing the results of a hearing test. It records the quietest sounds you were able to hear at different frequencies.
What do the numbers on an audiogram mean?
The horizontal numbers represent frequency in Hertz, while the vertical numbers represent hearing level in decibels hearing level. Together, they show how loudly different pitches need to be before you can hear them.
What does a normal audiogram look like?
A typical adult audiogram with hearing thresholds around 0 to 20 dB HL across the tested frequencies is generally considered within the normal range, although classifications can vary.
What does a sloping audiogram mean?
A sloping audiogram means that hearing thresholds become poorer at higher frequencies. This pattern is common with some forms of age-related hearing loss.
Can an audiogram show hearing loss in one ear?
Yes. Each ear is tested separately, allowing the hearing professional to identify differences between the ears.
What does the speech banana mean?
The speech banana is a visual area on some audiograms showing approximately where many speech sounds occur in terms of frequency and loudness.
Can earwax affect an audiogram?
Yes. Significant earwax can block the ear canal and affect hearing. Your ears may be checked before testing.
Does an audiogram show tinnitus?
No. An audiogram measures hearing sensitivity rather than directly measuring tinnitus. However, a hearing assessment can help determine whether tinnitus is occurring alongside hearing loss.
The Bottom Line
An audiogram is one of the most useful tools for understanding your hearing.
The horizontal axis shows the frequency or pitch of sounds, while the vertical axis shows how loud those sounds needed to be before you could hear them.
The shape and position of your results can provide information about the degree and pattern of hearing loss.
However, an audiogram is only one part of understanding your hearing. Your everyday communication difficulties, tinnitus, medical history and listening environment are also important.
If you have recently received a hearing test, ask your hearing professional to explain your audiogram. Understanding your results can help you make informed decisions about hearing protection, monitoring, hearing aids and other forms of hearing support.
If you have noticed that conversations are becoming more difficult, you frequently ask people to repeat themselves or you struggle to hear in noisy environments, a hearing test can be an important first step.