The benefits of hyperbaric oxygen therapy (HBOT)

Hyperbaric oxygen therapy has been part of my own story. After a head injury in 2018, it was one of the therapies in my recovery, which Dr. Paul Anderson, NMD and I talk about on episode 42 of The Dr. Madeira Show. When I later had a chamber at my former Montana clinic, I saw firsthand how much interest there is in it, and how much confusion.

What HBOT is

Hyperbaric oxygen therapy uses a pressurized chamber to increase the amount of oxygen your blood can carry.¹ You breathe concentrated oxygen while the air pressure around you is raised above normal. Your tissues need oxygen to function and heal, and injured tissue needs even more.

Conventional, FDA-cleared uses

In hospitals and wound care centers, HBOT is a standard treatment for a specific list of conditions, including:¹

• Air or gas bubbles in the blood vessels (arterial gas embolism) and decompression sickness (“the bends”)
• Carbon monoxide poisoning
• Gas gangrene and serious soft tissue infections
• Non-healing bone infections (osteomyelitis) and wounds that haven’t healed with other treatment, such as diabetic foot ulcers
• Burns and frostbite, crush injuries, and skin grafts or flaps at risk
• Radiation injury

Off-label, adjunctive uses

Many other uses fall outside the scope of what the FDA has cleared. Even so, many clinics use HBOT as adjunctive care, alongside other treatment, for conditions such as:

• Concussion and traumatic brain injury
• Long COVID and chronic fatigue syndrome (ME/CFS)
• Migraine headaches
• Stroke recovery
• Parkinson’s disease, Alzheimer’s disease and multiple sclerosis
• Diabetic neuropathy and erectile dysfunction
• Fibromyalgia, complex regional pain syndrome and other chronic pain
• Osteoarthritis and rheumatoid arthritis
• Crohn’s disease and ulcerative colitis
• Chronic infections, such as Lyme disease, and mold illness
• Sports injuries and recovery after surgery
• Cancer care, as a complement to conventional treatment
• Autism spectrum disorder

For most of these, the research is early, small or mixed. HBOT isn’t a cure for any of them, and it shouldn’t replace the treatment your doctors recommend. Talk with your own medical team, including your oncologist for cancer care, before adding it.

What the research shows

The strongest evidence outside the cleared uses is for brain injury. A 2026 review of 8 randomized trials with 570 people with traumatic brain injury, mostly mild, found improvements in thinking speed, memory, executive function and sleep quality with HBOT. It didn’t find clear benefits for PTSD, emotional distress or overall neurobehavioral symptoms.³

For Long COVID, a review of 7 studies with 199 people found improvements in memory, attention, fatigue and pain, with minimal side effects, but the authors called for larger randomized trials before drawing firm conclusions.⁴

Protocols matter. Many of the studies with positive results used pressures of about 2.0 to 2.5 atmospheres and dozens of sessions, often 40 or more, rather than a handful.⁴ Shortened sessions and inconsistent schedules are one reason results vary from clinic to clinic.

Safety first

When it’s done properly, HBOT is generally well tolerated. The most common side effect is pressure in the ears, which may pop when you leave the chamber.¹ Some people shouldn’t have HBOT, or need medical clearance first, including people with:

• A pacemaker or other implanted device not approved for hyperbaric use
• Severe claustrophobia
• Lung conditions, or who can’t fly in an airplane without supplemental oxygen
• Severe incontinence

Fire is a rare but real risk. The FDA has warned providers about fires in hyperbaric chambers that caused serious injuries and deaths, and about the higher fire risk with concentrated oxygen. Follow the manufacturer’s instructions exactly, wear cotton clothing, and keep electronics and static-producing items out of the chamber.²

HBOT and telemedicine care

Apollo Health Clinic is 100% telemedicine, so I don’t offer HBOT sessions in an office. For telemedicine patients in Arizona, Montana and Washington who are good candidates, I can help you look into renting-to-own your own home mild hyperbaric (mHBOT) chamber, and talk through how it might fit into your overall plan and how to use it safely. Home chambers usually run at lower pressures than the hospital chambers used in most studies, so it’s worth understanding the difference before you invest.

Disclosure: Dr. Madeira may receive a commission on rent-to-own mHBOT chamber sales arranged through him. You’re never required to rent or buy a chamber, from him or anyone else, and your care doesn’t depend on it.

Curious whether HBOT could be part of your recovery? Let’s talk it through on a free discovery call.

This article is general education, not medical advice, and does not create a doctor–patient relationship. Talk with your own doctor before changing your diet, supplements or medications.

Sources

1. MedlinePlus Medical Encyclopedia (NIH): Hyperbaric oxygen therapy
2. U.S. Food and Drug Administration: Follow Instructions for Safe Use of Hyperbaric Oxygen Therapy Devices, letter to health care providers (August 2025)
3. Wang et al. (Complementary Therapies in Medicine, 2026): Effectiveness of hyperbaric oxygen in traumatic brain injury patients: a systematic review and meta-analysis (8 randomized trials, 570 participants)
4. Zamora et al. (Undersea & Hyperbaric Medicine, 2025): Hyperbaric oxygen treatment for long-COVID syndrome: a systematic review of current evidence on cognitive decline (7 studies, 199 participants)

Further reading

• Hyperbaric Experts: mild hyperbaric oxygen therapy (mHBOT) (an outside website run by Dr. Zayd Ratansi, ND; read more about mHBOT and its reported benefits)

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