I work as an audio engineer, and my hearing is crucial to my livelihood. I've tried all sorts of active hearing protection and I have to say that these are the best, by far. I was dubious that they would give me the same kind of protection as my Peltor VIII, as I couldn't see how an in ear could offer the same kind of engineering. Boy was i wrong! These sound amazing, and at the indoor range I go to I was unphased by the guy next to me shooting 7.62 rounds unsuppressed. Even on the low setting I could hear my buddy in the next bay. On the high setting the conversation was almost natural, save for a SLIGHT tinniness to the vocalization, but I can live with that as there was no over modulation in my own voice in my ears (other companies fail in this aspect, in my less than humble opinion.) I bought these primarily for Skeet and Sporting Clays, but they are so comfortable I see using these indoors often.
The company that makes the OTTO is Etymotic. I have a set of wired in ear monitors that I use on set when working heavy noise days (NASCAR tracks, Armed Forces battle simulations, factories, etc) and have loved those, so I shouldn't be surprised how well these work.
One caveat: I have custom ear molds that I borrowed from my work set of "ears." I have not tried them except in the house with the flanged earpieces or the memory foam. The flanges are comfortable, but I have tiny ear holes so the memory foam was uncomfortable to me. I'm sure the fitted ear molds offer a bit better...
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