HBOT Treatment: A Complete Guide to Hyperbaric Oxygen Therapy, Uses, and Benefits

BRMI Staff

Imagine a therapy that floods your body with oxygen at levels it could never achieve through normal breathing — one that can awaken dormant stem cells, rebuild damaged blood vessels, reduce neuroinflammation, and produce measurable improvements in brain function, chronic wound healing, PTSD, long COVID, traumatic brain injury, and more. That therapy exists, it has been in clinical use for decades, and it is now attracting serious new scientific attention. This is your complete guide to HBOT treatment.

What Is HBOT Treatment?

Hyperbaric Oxygen Therapy (HBOT) is a medical treatment in which a patient breathes 100% pure oxygen inside a pressurized chamber — typically at 1.5 to 3.0 times normal atmospheric pressure (measured in atmospheres absolute, or ATA). Under these conditions, the lungs absorb far more oxygen than is possible at normal atmospheric pressure, and that oxygen dissolves directly into the blood plasma, cerebrospinal fluid, and other bodily fluids. This allows it to reach tissues that may be oxygen-starved, damaged, or poorly perfused by red blood cells alone.

The underlying science is elegant: at sea level, oxygen is carried almost exclusively by hemoglobin. Under hyperbaric pressure, so much additional oxygen dissolves into the plasma itself that it can be delivered independently of hemoglobin — reaching inflamed, swollen, or compromised tissues that normal circulation cannot adequately serve.

A standard HBOT session lasts 60 to 90 minutes, and most therapeutic protocols recommend between 20 and 40 sessions depending on the condition being treated. The experience itself is straightforward — you lie or sit inside a chamber, breathe normally, and let the pressure and oxygen do their work.

A Brief History of HBOT

The use of pressurized air for therapeutic purposes dates back to the 17th century, but modern hyperbaric medicine took shape in the 1940s when the US military developed pressurized chambers to treat decompression sickness (the "bends") in divers and aviators. The discovery that elevated oxygen under pressure could prevent and reverse the nitrogen bubble formation responsible for decompression illness established the foundational principle of the therapy.

By the 1950s and 60s, researchers began exploring HBOT for a broader range of conditions — carbon monoxide poisoning, difficult wound healing, and gas gangrene infections. The US Food and Drug Administration (FDA) has since approved HBOT for 14 specific medical indications, and the field of hyperbaric medicine has grown into a recognized medical specialty with board certification, dedicated research institutions, and thousands of clinical facilities worldwide.

Today, the frontier of HBOT research has expanded dramatically — into neurology, aging, mental health, oncology, and regenerative medicine — making it one of the most rapidly evolving areas in integrative and conventional medicine alike.

How HBOT Works: The Physiology

Understanding the mechanisms behind HBOT helps explain its wide range of applications.

Hyperoxic–Hypoxic Paradox

One of the most important and counterintuitive discoveries in HBOT science is the so-called hyperoxic–hypoxic paradox. When the body is repeatedly exposed to elevated oxygen levels and then returns to normal atmospheric oxygen, the cells perceive this shift as relative hypoxia (oxygen deprivation). This paradox activates hypoxia-inducible factor (HIF), which in turn switches on genes involved in cellular repair, angiogenesis (new blood vessel formation), stem cell proliferation, and mitochondrial restoration (Hadanny & Efrati, 2020).

In other words, HBOT doesn't just flood tissues with oxygen — it triggers the body's own regenerative machinery.

Stem Cell Mobilization

HBOT has been shown to significantly increase the number of circulating stem cells — the body's master repair cells — in the bloodstream. A standard 40-session HBOT protocol has been found to more than double the number of circulating stem cells in some patients. These mobilized cells travel to sites of injury or disease and contribute to tissue repair and regeneration.

Anti-Inflammatory Action

Chronic inflammation underlies a remarkable number of modern diseases — from neurodegenerative disorders to autoimmune conditions to cardiovascular disease. HBOT reduces levels of pro-inflammatory cytokines, inhibits NF-κB pathways (a key driver of inflammatory signaling), and reduces expression of inflammatory enzymes. Multiple studies have confirmed measurable reductions in C-reactive protein (CRP) and other inflammatory biomarkers following HBOT protocols.

Neuroplasticity and Brain Repair

HBOT produces clinically significant neuroplasticity effects — changes in brain structure and function. These include reduced neuroinflammation, restoration of mitochondrial function in neurons, increased cerebral blood flow through angiogenesis, and the proliferation and migration of neural stem cells. Brain imaging studies using perfusion MRI and diffusion tensor imaging (DTI) have confirmed these changes at the structural level following HBOT protocols (Hadanny et al., 2022).

Wound Healing and Angiogenesis

In damaged or ischemic tissue, HBOT stimulates the formation of new capillaries and blood vessels, a process critical for wound healing, post-radiation recovery, and tissue grafts. The high-oxygen environment also directly kills anaerobic bacteria — organisms that thrive in low-oxygen environments and cause some of the most treatment-resistant infections.

Collagen Synthesis and Cellular Repair

HBOT promotes the production of collagen — the structural protein essential for wound closure, skin integrity, bone repair, and connective tissue health. It also upregulates antioxidant defenses, helping cells manage oxidative stress during and after intensive treatment or injury.

The FDA-Approved Indications for HBOT

The FDA has formally approved HBOT as a standard treatment for the following 14 conditions:

1. Decompression sickness (the bends)

2. Carbon monoxide poisoning

3. Gas gangrene (clostridial myonecrosis)

4. Air or gas embolism

5. Diabetic wounds of the lower extremities (Wagner Grade III and above)

6. Radiation injury (osteoradionecrosis and soft tissue radionecrosis)

7. Osteomyelitis (chronic refractory)

8. Compromised skin grafts and flaps

9. Crush injuries and acute traumatic ischemia

10. Severe anemia (when blood transfusion is unavailable)

11. Actinomycosis (refractory to antibiotics)

12. Necrotizing soft tissue infections

13. Intracranial abscess

14. Exceptional blood loss anemia

Medicare, Medicaid, and most private insurers cover HBOT for these approved indications, typically with standard co-pays and deductibles.

The Expanding Research: Off-Label Uses and Emerging Evidence

Beyond its FDA-approved uses, HBOT is the subject of an extraordinarily active research program. The following areas represent some of the most exciting and best-supported emerging applications.

Traumatic Brain Injury (TBI) and Post-Concussion Syndrome

TBI and post-concussion syndrome are among the most intensely studied off-label applications for HBOT. A February 2025 double-blind randomized controlled trial published in Scientific Reports found that adults with persistent TBI symptoms who received HBOT experienced an average 10.6-point improvement on a standardized symptom inventory, compared to just 3.6 points in the control group — with improvements in anxiety, sleep quality, and vestibular symptoms persisting at one-year follow-up. Research from Frontiers in Neurology found that patients experiencing cognitive difficulties from brain injuries showed statistically significant improvements across multiple domains — including memory, executive function, attention, and information processing — following 40 HBOT sessions.

A 2025 information paper from the US Department of Defense reviewed multiple military studies on HBOT for TBI and post-concussion symptoms, including a sham-controlled RCT in 56 male veterans that found HBOT produced a significant decrease in PTSD symptom scores while the sham group showed an increase (Doenyas-Barak et al., 2024).

PTSD

Emerging evidence suggests that HBOT promotes neuroplasticity and may offer meaningful relief for treatment-resistant PTSD. A 2025 study in Brain and Behavior reanalyzed the end-of-treatment and 3-month follow-up data from a randomized controlled trial in 56 veterans with treatment-resistant PTSD, finding evidence of a threshold effect — sufficient sessions of HBOT led to sustained symptom improvement, while insufficient treatment resulted in diminishing returns. This suggests that HBOT may need to be dosed with precision to achieve durable neurological change in PTSD patients (Danan et al., 2025).

Long COVID

Long COVID — the constellation of persistent symptoms following SARS-CoV-2 infection, including brain fog, fatigue, sleep disturbance, cognitive impairment, and chronic pain — has become one of the most urgent applications for HBOT research. Results have been striking.

A landmark randomized, sham-controlled, double-blind trial found that 40 daily HBOT sessions produced significant improvements in global cognitive function, attention, executive function, energy, sleep, and pain in long COVID patients. Brain imaging confirmed the improvements — showing increased cerebral blood flow and improved white matter integrity in regions associated with cognition and mood (Hadanny et al., 2022). A follow-up longitudinal study published in Scientific Reports (2024) found that these improvements persisted at one-year follow-up — a remarkable finding suggesting HBOT may produce durable neurological repair, not merely temporary relief (Hadanny et al., 2024).

A large prospective registry study conducted across nine Dutch hyperbaric centers (2023–2024), published in Scientific Reports (2025), enrolled 232 long COVID patients and confirmed significant improvements in quality of life across multiple domains following 40 HBOT sessions.

Aging and Cognitive Enhancement

One of the most provocative areas of HBOT research involves healthy aging. A randomized controlled trial conducted at Tel Aviv University found that a protocol of 60 HBOT sessions in healthy adults over 64 years of age produced measurable lengthening of telomeres (the protective caps on chromosomes that shorten with age) and a reduction in senescent cells — both established biomarkers of cellular aging. This was the first time a non-pharmacological intervention had demonstrated such effects, and it generated significant scientific attention.

Cognitive performance improvements — including memory, attention, and information processing — were also documented in healthy older adults following HBOT protocols, pointing toward potential applications in age-related cognitive decline prevention.

Neurological Conditions: Stroke Recovery and Post-Stroke Rehabilitation

A growing body of evidence supports HBOT as an adjunct therapy in post-stroke rehabilitation. By promoting angiogenesis, reducing neuroinflammation, and activating neuroplasticity mechanisms in brain tissue that is alive but dysfunctional (the "ischemic penumbra"), HBOT may help restore function in stroke survivors long after the conventional rehabilitation window has passed. Retrospective analyses have shown improvements in motor function, cognitive performance, and quality of life in post-stroke patients treated months to years after their initial event.

Diabetic Wound Healing

This is one of HBOT's most established and insurance-covered applications beyond emergency medicine. Diabetic foot ulcers are a leading cause of limb amputation and represent an enormous burden on healthcare systems. HBOT accelerates wound closure through multiple mechanisms — enhanced angiogenesis, direct bactericidal effects, increased collagen synthesis, and improved leukocyte function. Multiple randomized controlled trials have confirmed that HBOT significantly improves wound healing rates and reduces amputation risk in diabetic lower extremity wounds that have failed standard wound care.

Radiation Injuries and Cancer Treatment Side Effects

Radiation therapy for cancer often damages surrounding healthy tissue, causing osteoradionecrosis (bone death), soft tissue necrosis, radiation cystitis, and radiation proctitis — conditions that can be severely debilitating and difficult to treat. HBOT is one of the most effective treatments available for radiation-induced tissue damage, both as an FDA-approved indication and for broader radiation injury management.

A 2025 safety evaluation published in Medicina examined HBOT in patients with active or previously treated solid cancers, finding it to be well-tolerated with no evidence of accelerating tumor growth or recurrence — an important reassurance given the historical (and largely unfounded) concern that extra oxygen might fuel cancer growth.

Emerging oncology research is also exploring HBOT as a cancer treatment adjunct. A 2024 study in Cell Stem Cell found that HBOT downregulates markers on cancer stem cells, increasing their uptake of chemotherapy drugs while reducing metastatic potential. HBOT has also been shown to inhibit HIF-1α — a driver of tumor angiogenesis and metabolic adaptation — potentially making cancers more susceptible to conventional treatment.

Athletic Recovery and Performance

Elite athletes have begun integrating HBOT into their recovery protocols, and the science supports this application. A 2024 study of elite football players found faster recovery from injuries in those who used HBOT after matches. The therapy reduces exercise-induced oxidative stress and inflammation, accelerates muscle repair, and may improve VO₂ max and aerobic efficiency through enhanced oxygen delivery. Major sports teams and high-performance training facilities across the US, Europe, and beyond now include HBOT as part of their standard recovery infrastructure.

Autism Spectrum Disorder (ASD)

HBOT has been used off-label for autism spectrum disorder, with some small studies and many anecdotal reports suggesting improvements in language, social interaction, and behavior. However, the evidence base remains preliminary and inconsistent, and larger, well-controlled trials are still needed. Families and clinicians exploring this application should approach it with appropriate expectations and work within a comprehensive therapeutic framework.

Chronic Inflammatory Conditions and Fibromyalgia

A growing number of clinicians are using HBOT for fibromyalgia, Lyme disease, chronic fatigue syndrome (ME/CFS), and chronic inflammatory response syndrome (CIRS). A 2025 case study published in Frontiers in Immunology documented complete resolution of all 22 reported CIRS symptoms and normalization of inflammatory biomarkers following 40 low-pressure HBOT sessions — a compelling finding, though it requires validation in larger controlled trials.

Types of HBOT: Hard Shell vs. Soft Shell Chambers

Not all hyperbaric chambers are equal, and this distinction matters considerably to outcomes.

Hard Shell (Medical-Grade) Chambers

Hard shell chambers are constructed from steel or medical-grade acrylic and are capable of pressures of 2.0 ATA and above, delivering 100% pure oxygen. They are the standard in hospitals, wound care centers, and dedicated HBOT clinics. All 14 FDA-approved indications for HBOT are based on studies conducted in hard shell chambers at pressures of 2.0 ATA or higher. These are the chambers used in virtually all peer-reviewed clinical research and are required for conditions with the highest level of evidence. They come in two configurations: monoplace (single-patient) and multiplace (multiple patients treated simultaneously in a room-sized chamber). Hard shell chambers require certified hyperbaric technicians and strict facility safety standards.

Soft Shell (Mild Hyperbaric) Chambers

Soft shell chambers are inflatable, portable, and significantly less expensive than hard shell units. They typically reach a maximum pressure of 1.3 ATA and deliver enriched air (not 100% pure oxygen) via a mask or concentrator — reaching oxygen concentrations of around 24 to 31%, compared to the 100% oxygen of a hard shell chamber. They are marketed for home use and wellness applications.

The key clinical caveat: the scientific evidence base for HBOT was built on hard shell, high-pressure, 100% oxygen protocols. Soft shell chambers operate below the pressure thresholds used in virtually all clinical trials. Some mild effects — reduced inflammation, modest recovery support — may still be achievable, but soft shell chambers cannot replicate the neuroplasticity, angiogenesis, and stem cell mobilization effects documented in clinical research. For wellness and general recovery, they may offer some value. For treating serious medical conditions, a hard shell clinical chamber is the appropriate choice.

HBOT vs. Normobaric Oxygen Therapy

Normobaric oxygen therapy (NBOT) delivers supplemental oxygen at normal atmospheric pressure — through a nasal cannula, mask, or oxygen concentrator at home. While useful for conditions requiring supplemental oxygen (COPD, acute hypoxia), it does not achieve the plasma oxygen dissolution that defines HBOT's unique mechanism. NBOT cannot replicate the stem cell mobilization, angiogenesis, or neuroplasticity effects of pressurized HBOT. The pressure is not incidental to the therapy — it is the therapy.

Contraindications and Safety

HBOT has an excellent safety profile when properly administered, but it is not appropriate for everyone.

Absolute Contraindication

• Untreated pneumothorax — The only absolute contraindication. Pressure changes in a hyperbaric chamber can convert a simple pneumothorax into a life-threatening tension pneumothorax. This must be treated before any HBOT.

Strong Contraindications (Require Medical Clearance)

• Concurrent use of certain medications: Doxorubicin (Adriamycin), cisplatin, and disulfiram (Antabuse) interact dangerously with high-pressure oxygen. Always disclose all medications before treatment.

• Premature infants (under 37 weeks gestation): Risk of retrolental fibroplasia.

• Intraocular gas (following certain eye surgeries): Can cause permanent vision loss unless life-saving treatment is required.

Relative Contraindications (Require Individual Assessment)

• Untreated or severe COPD or emphysema: Risk of pulmonary barotrauma; patients with air trapping are at elevated risk.

• History of chest surgery or spontaneous pneumothorax: Requires imaging and physician clearance.

• Uncontrolled high fever: Elevated temperature increases the risk of oxygen toxicity seizures.

• Seizure disorders: High-pressure oxygen can lower the seizure threshold; history of seizures warrants careful risk-benefit analysis.

• Pregnancy: Considered a relative contraindication due to unknown fetal effects; HBOT is used in pregnancy only in life-threatening circumstances.

• Claustrophobia: A monoplace chamber may feel confining; some patients manage with medication or by using a multiplace chamber. Many facilities offer anxiolytic support.

• Optic neuritis: High-pressure oxygen may worsen inflammation in acute optic neuritis.

• Recent ear or sinus surgery: Pressure equalization may be compromised; discuss timing with your physician.

• Implanted devices: Pacemakers, cochlear implants, and pain pumps must be evaluated for pressure tolerance; confirm with the device manufacturer.

• Active viral infections: Some facilities defer treatment during active viral illness.

• Blood-thinning medications (anticoagulants): Not an absolute contraindication but warrants monitoring and discussion.

Common Side Effects

Most side effects of HBOT are mild and temporary:

• Ear and sinus pressure or discomfort — The most common complaint, analogous to the pressure felt when descending in an airplane. Patients are taught to equalize pressure by yawning, swallowing, or performing the Valsalva maneuver. Ear barotrauma can occur if equalization is poor.

• Temporary myopia (nearsightedness) — Changes in the lens of the eye are common with extended courses of HBOT and typically resolve within 6 to 8 weeks after treatment ends.

• Cataracts — Associated with very long treatment courses (over 100 sessions); a 2024 literature review found approximately 2% incidence with 20–40 sessions.

• Oxygen toxicity seizures — Extremely rare at standard therapeutic pressures (below 3.0 ATA); essentially unheard of in properly managed clinical settings.

• Lightheadedness or fatigue — Common immediately after sessions, typically brief.

• Hypoglycemia in diabetic patients — HBOT can lower blood glucose; diabetic patients should monitor blood sugar before and after sessions.

Cost and Accessibility

How Much Does HBOT Treatment Cost?

HBOT costs vary considerably depending on the type of facility, chamber type, geographic location, and whether the condition is covered by insurance.

For FDA-approved indications: Medicare Part B covers HBOT for approved conditions (diabetic lower extremity wounds, osteoradionecrosis, osteomyelitis, and others) with standard co-pays and deductibles. Most private insurers follow similar coverage frameworks. Hospital-based HBOT programs often carry higher out-of-pocket costs due to facility fees, despite accepting more insurance plans.

For off-label indications (out-of-pocket): Independent HBOT clinics typically charge between $150 and $650 per session, with the most common pricing falling in the $250 to $350 range. Package pricing — purchasing 10, 20, or 40 sessions upfront — typically offers discounts of 20 to 30%. Some wellness-oriented centers offer membership plans bringing per-session costs to $75–$150 for high-frequency users (BestDosage, 2026).

Total treatment course costs: Given that most therapeutic protocols require 20 to 40 sessions, full-course out-of-pocket costs can range from approximately $3,000 to $26,000 depending on pricing and session count. For severe or chronic conditions requiring extended protocols, costs can be higher.

Home chambers: Soft-shell home hyperbaric chambers are available for purchase between $5,000 and $15,000. For those committed to 100 or more sessions, this may represent a lower per-session cost — but as discussed above, soft-shell chambers do not replicate the therapeutic pressure or oxygen levels of clinical hard-shell units.

Practical Cost-Saving Strategies

• Verify insurance coverage first: Call your insurer with your specific diagnosis codes and ask whether HBOT is covered, what pre-authorizations are needed, and which providers are in-network.

• Check Medicare coverage: If your condition is on the Medicare-approved list, Part B coverage may significantly reduce your costs.

• Ask about package pricing: Most clinics offer meaningful discounts for multi-session packages.

• Use HSA or FSA funds: HBOT is an eligible expense for health savings accounts and flexible spending accounts regardless of insurance coverage.

• Check ClinicalTrials.gov: HBOT is an active area of clinical research; trials recruiting participants often provide treatment at no cost.

• Compare facilities: Hospital-based programs often have higher facility fees; independent clinics may offer competitive pricing for the same hard-shell equipment.

Where to Find HBOT Providers

Finding a Reputable Clinic

Undersea and Hyperbaric Medical Society (UHMS) — uhms.org The primary professional and accrediting body for hyperbaric medicine in the US. The UHMS accredits hyperbaric facilities to rigorous safety and clinical standards. Their website includes a directory of accredited hyperbaric facilities and is the best starting point for finding credentialed providers. UHMS-accredited centers employ physicians with recognized training in hyperbaric medicine.

American Board of Preventive Medicine — Hyperbaric Medicine Subspecialty — abpm.org Board certification in hyperbaric medicine is offered through the American Board of Preventive Medicine. Look for physicians with this credential when seeking HBOT for complex or off-label conditions.

Wound Care Centers and Hospital-Based Programs For FDA-approved wound-healing and radiation injury indications, hospital-affiliated wound care centers and hyperbaric programs are the most appropriate setting. These are found in most major medical centers across the US and are generally covered by insurance for approved conditions.

Independent Hyperbaric Clinics For off-label applications — including TBI, long COVID, PTSD, and cognitive enhancement — independent HBOT clinics are typically more accessible and may offer more flexible scheduling and protocols. When evaluating a clinic, ask:

• What type of chamber do you use (hard shell or soft shell)?

• What pressure protocols do you follow?

• Do you have a physician oversight arrangement?

• Is your facility UHMS-accredited?

• What is your intake and screening process?

Neurologic Wellness Institute — neurological applications, TBI, and long COVID Aviv Clinics — longevity and cognitive enhancement HBOT protocols Hyperbaric Medical Solutions (HMS) — multi-location provider accepting major insurance

Digital Resources and Directories

• ClinicalTrials.gov — Search "hyperbaric oxygen" to find current research trials, many of which provide free treatment

• UHMS Facility Locator — uhms.org/find-a-doctor

• Medicare Provider Finder — medicare.gov — find Medicare-approved HBOT providers

HBOT vs. Other Oxygen-Based Therapies: A Comparison

Feature	HBOT (Hard Shell)	Mild HBOT (Soft Shell)	Normobaric Oxygen (NBOT)	Ozone Therapy
Pressure	2.0–3.0 ATA	1.2–1.3 ATA	1.0 ATA (normal)	1.0 ATA
Oxygen %	100%	~24–31%	24–100% (via mask)	Not oxygen therapy
Plasma dissolution	High	Minimal	None	N/A
Clinical evidence base	Extensive (14 FDA approvals + robust RCTs)	Limited	Established for hypoxia	Limited, unregulated
Stem cell mobilization	Documented	Not demonstrated	Not demonstrated	Not demonstrated
Neuroplasticity effects	Documented	Not demonstrated	Not demonstrated	Not demonstrated
Insurance coverage	Yes (for approved indications)	No	Yes (for COPD, hypoxia)	No
Setting	Hospital/clinic	Home/wellness	Home/clinic	Alternative clinics
Best suited for	Medical conditions, TBI, wound healing, post-radiation	Mild wellness, recovery	Supplemental O₂ needs	Unproven uses

The table above illustrates why hard-shell clinical HBOT represents a categorically different therapy from mild home chambers or supplemental oxygen — not merely a more intense version, but a physiologically distinct intervention producing mechanisms that lower-pressure alternatives cannot replicate.

FAQs

Q: What does an HBOT session feel like? You enter a clear acrylic or metal chamber (monoplace) or a larger room-like space (multiplace) and are gently pressurized over 10 to 15 minutes — you will feel pressure in your ears similar to descending in an airplane and will be taught how to equalize. Once at pressure, you breathe normally. Most patients find sessions relaxing and use the time to rest, listen to music, or watch a screen. Depressurization at the end takes another 10 to 15 minutes.

Q: How many sessions will I need? This depends entirely on the condition being treated. For emergency indications like carbon monoxide poisoning, one to three sessions may suffice. For chronic wound healing, 20 to 40 sessions are typical. For neurological applications (TBI, long COVID, post-stroke), most research protocols use 40 to 60 sessions. Your treating physician will recommend a protocol based on your specific diagnosis and response.

Q: Is HBOT safe to combine with other treatments? For most standard medical treatments, yes. However, certain chemotherapy drugs (doxorubicin, cisplatin) and disulfiram (Antabuse) are absolute contraindications. Always provide your full medication list to the hyperbaric physician before beginning treatment, and inform both your oncologist and your HBOT physician if you are receiving cancer therapy.

Q: Can HBOT help with anti-aging and longevity? The Tel Aviv University research on telomere lengthening and senescent cell reduction is genuinely exciting and scientifically credible. However, it is preliminary — based on one study in a specific older adult population. While the findings warrant continued research, it is premature to position HBOT as a proven anti-aging treatment. What can be said is that its effects on inflammation, cellular repair, and cognitive function may contribute meaningfully to healthspan. Many longevity-focused clinics now offer HBOT as part of comprehensive protocols.

Q: Will HBOT make cancer grow faster? This is one of the most common fears associated with HBOT in cancer patients, and the evidence strongly suggests it is unfounded. Multiple studies have found no evidence that HBOT promotes tumor growth, and indeed some evidence suggests it may impair cancer stem cell function and enhance the efficacy of conventional treatments. The 2025 Medicina safety evaluation found no cancer recurrence or progression attributable to HBOT across a mixed population of active and previously treated cancer patients.

Q: Can I do HBOT if I am claustrophobic? Many claustrophobic patients successfully complete HBOT. Monoplace chambers are clear acrylic, allowing patients to see out and communicate with technicians at all times. Multiplace chambers are much larger and room-like. Most facilities can provide mild anxiolytic medication if needed. It is worth discussing your concerns with the facility before your first session — many patients who expect the worst find the experience manageable.

Q: Is HBOT FDA-approved for long COVID or TBI? Not currently. Both applications are considered off-label. However, the evidence base for both is growing rapidly, and several large clinical trials are underway. Off-label use of approved medical treatments is common and entirely legal — and for TBI and long COVID in particular, the existing randomized controlled trial evidence is among the strongest in the off-label HBOT literature.

A Final Word: Oxygen as Medicine

There is something almost paradoxical about hyperbaric oxygen therapy — the idea that one of the most basic elements of life, oxygen, can be transformed into a powerful medical intervention simply by changing the conditions under which it is delivered. Yet the research leaves little doubt: pressure changes everything.

From healing wounds that have resisted treatment for years, to repairing neurological function in veterans with PTSD, to producing measurable improvements in brain structure and cognitive performance in long COVID patients, HBOT treatment is demonstrating a therapeutic range that few interventions can match. It is not a cure-all — the evidence is clearer for some conditions than others, and the field still has important research questions to answer. But as a complement to conventional medicine, it is one of the most compelling tools in the modern integrative health arsenal.

If you are considering HBOT, the most important first step is a thorough consultation with a qualified hyperbaric physician — one who can assess your specific condition, recommend an evidence-based protocol, and ensure you receive treatment in a properly accredited facility. The oxygen is waiting. The question is whether it is right for you.

References

1. Hadanny, A., Zilberman-Itskovich, S., Catalogna, M., et al. (2024). Long term outcomes of hyperbaric oxygen therapy in post COVID condition: longitudinal follow-up of a randomized controlled trial. Scientific Reports, 14, 3604. https://doi.org/10.1038/s41598-024-53091-3

2. Hadanny, A., Zilberman-Itskovich, S., Catalogna, M., et al. (2022). Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial. Scientific Reports. https://doi.org/10.1038/s41598-022-15565-0

3. Danan, D., Grosskopf, Y., Mayo, A., et al. (2025). Hyperbaric oxygen therapy for PTSD: threshold effect for sustained symptom improvement in a biologically based treatment. Brain and Behavior, 15(8), e70757. https://doi.org/10.1002/brb3.70757

4. Doenyas-Barak, K., Catalogna, M., Kutz, I., et al. (2024). Hyperbaric oxygen therapy for veterans with treatment-resistant PTSD: a randomized controlled trial. Scientific Reports.

5. Kjellberg, A., Abdel-Halim, L., Hassler, A., et al. (2025). Ten sessions of hyperbaric oxygen versus sham treatment in patients with long COVID (HOT-LoCO): a randomised, placebo-controlled, double-blind, phase II trial. BMJ Open, 15(4), e094386.

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