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I ended up buying a Yamaha V685 receiver for £400. It has a dialogue boost that you can set from 0 to 3 and a night listening feature that slightly reduces the volume of background music and sound effects. Using the 'sport' DPS preset helps as well but I avoid it unless necessary.
With my Monitor Audio speakers it gives quite a detailed sound and dialogue is better than using the TV's speakers with all the TV's dialogue-enhancing features enabled, and better than it was with my Marantz Amp. It's far from perfect but it is an improvement.
The downside is that music sounds worse with the AV receiver than with the stereo amp, but I imagine that will always be the case with receivers. Music from the receiver just feels less emotive and rounded than music from the amp, but the Yamaha is still nice to listen to and the combination sounds better than wireless Sonos etc.
Also, at lower volumes dialogue is still difficult to distinguish, but if I'm watching the TV late at night I just use headphones anyway.
I went to 4 stores and several people cautioned against buying Denon or Pioneer receivers if dialogue clarity is a priority. I was also recommended the Onkyo 686 but didn't get the opportunity to test it. I considered the Sony 1080 but it seems to be less reliable.
My next step is to try an additional centre speaker, probably a Monitor Audio bronze or radius 200. I expect adding a centre speaker will be another small improvement.
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But the main problem is that sound recording & editing of modern films and high-end tv dramas prioritises realism too much. So you get lots of mumbling, heavy accents, and overly noisy background music & sound effects. It seems like there's already a backlash against it and BBC, HBO etc. are moving back towards crisper dialogue.
Has anyone successfully improved the dialogue clarity from their TV? Would love to know what kit you're using. At the moment I'm using Monitor Audio Bronze 2 speakers with a Marantz stereo amp for TV audio and music, but I'm having to use subtitles a lot because the dialogue is difficult to distinguish over background noise. I'm looking at buying a different amp, or more likely a dedicated AV receiver, and would swap speakers too if it helped.