Hyperbaric Oxygen Therapy

Medical hyperbaric oxygen therapy, or HBOT, involves breathing 100 percent oxygen inside a sealed chamber at pressures higher than normal air pressure, typically 2.0 to 3.0 atmospheres absolute. It is a regulated medical procedure and is distinct from the softer, lower-pressure sessions marketed for wellness.

A physician prescribes it, and a trained technician monitors you throughout. You lie or sit in a chamber while the pressure rises, which can make your ears feel full, much like on an airplane. You then breathe oxygen for a set period, and sessions usually last one to two hours. The number of sessions depends on the condition.

HBOT is used in hospitals and specialist clinics for decompression illness, carbon monoxide poisoning, gas embolism, certain diabetic foot wounds, radiation injury, and chronic bone infection. It is generally used alongside other medical care.

For these established indications, the evidence is strong, including Cochrane reviews supporting its use for diabetic foot ulcers and decompression sickness. For uses outside approved indications, such as brain injury, autism, stroke recovery, or anti-aging, the evidence ranges from preliminary and mixed to absent.

HBOT carries real risks, including ear and sinus pressure injury, temporary changes in vision, and, rarely, oxygen toxicity seizures, and pure oxygen creates a fire risk that requires strict safety protocols. Choose a certified facility with physician oversight, be cautious of clinics that promote it for unapproved conditions, and tell your doctor about lung disease, ear problems, or any medicines you take.

Hyperbaric medicine began in 1662, when the English clergyman Henshaw built a sealed chamber in which air pressure could be adjusted. Because oxygen was not isolated until the 1770s, hyperbaric oxygen is a much later development. Compressed air was used in tunnel and bridge work in the 19th century, and the study of decompression sickness among caisson workers and divers laid the groundwork for modern practice.

In the 1950s, Ite Boerema in Amsterdam studied surgery under high-pressure oxygen, and in Britain Churchill-Davidson explored its use alongside radiotherapy. Diving medicine and the U.S. Navy then drove further work, and U.S. Navy medical officers founded the Undersea Medical Society in 1967, which was renamed the Undersea and Hyperbaric Medical Society (UHMS) in 1986.

The society maintains a list of accepted indications, and the FDA clears hyperbaric chambers as medical devices for specified uses. Hospital therapy is prescribed by physicians and delivered by trained staff in rigid chambers, typically at 2.0 to 3.0 atmospheres absolute, well above the pressures used in wellness settings. Marketing for uses outside the accepted indications remains disputed, and anyone considering it is usually advised to confirm the indication with a physician. Hospital-based hyperbaric units operate in many countries.