I have a Creative cordless headset that I sometimes forgetfully leave on the charger when I enter DDO.
Unfortunately DDO apparently does not sense new USB devices coming online after initialization of the game, requiring me to /quit and restart to gain access to my headset while playing. When this happens after I have entered a quest (the usual case I am afraid) I suspect I encounter an HP penalty by quitting and restarting, then re-entering the quest.
Given that I am on Win7, with Plug and Play dynamic device recognition, I assume DDO has access to the appropriate interrupt info concerning newly attached devices. It would be a great help to forgetful types like myself if you could update your audio device selection list when new devices come online.