I use CEP's which are in-ear plugs that can be fitted to your existing headset. I fly about 600 hours a year in heavy twin engined helicopters, upto 8 hours a day. Yes they take some getting used to, yes there might be issues if you are susceptable to ear infections. Quite simply they provide excellent noise attenuation and superb clarity. They also mean you can still have your existing headset, which still functions as such even if you don't plug in the CEPs. I am not in a position to say whether they are better than ANR, but they certainly are much cheaper to buy and run.