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Hyperbaric Oxygen 101: Benefits, Risks & Who It’s Really For

Written by Dr. Michael Ruscio, DC on May 25, 2025

Written by Dr. Michael Ruscio, DC on May 25, 2025 — Reviewed by Hannah Wright

• What Is HBOT?|
• Conditions Treated|
• Longevity|
• Chamber Types|
• Potential Risks|

I started experimenting with hyperbaric oxygen therapy (HBOT) to see if it could help optimize my brain function, exercise recovery, and performance. After diving into the research, interviewing experts on the podcast, and reaping benefits personally, I’ve gotten really excited about recommending this amazing tool for some of our clients in the clinic. 

HBOT is a remarkable therapy that can help reduce inflammation, preserve and optimize brain and mitochondrial function, and fight infections. But there are some risks and contraindications to understand before you sign up. 

Let’s dig into hyperbaric chamber benefits and risks, when you may want to consider using this therapy, and a possible at-home protocol.

What Is HBOT and How Does It Work?

Hyperbaric oxygen therapy is a medical treatment where you breathe 100% oxygen while sitting in a pressurized chamber. The pressure in the chamber is usually set at two times normal atmospheric pressure, aka the atmosphere absolute—or ATA 1. 

Why would you want to breathe 100% oxygen under pressure? Because, although oxygen is essential for our bodies, there’s a limit to how much we can absorb through normal breathing. 

Under regular conditions, the hemoglobin in red blood cells carries oxygen to the body’s tissues. But breathing oxygen in a pressurized chamber causes oxygen to dissolve directly into the liquid part of the blood (plasma), allowing more oxygen to reach the tissues. 

This means the tissues receive a higher oxygen concentration, triggering what’s called the hyperoxic-hypoxic paradox. In other words, even though you’re getting more oxygen, your body acts like it’s not getting enough—this can stimulate healing, growth, and regeneration processes 2. 

In short bursts (called dives), HBOT can help 1:

• Heal wounds
• Improve blood flow
• Reduce inflammation
• Stimulate the growth of new blood vessels (angiogenesis)
• Fight infections
• Reduce air or gas bubbles in the bloodstream (gas embolism)

Researchers aren’t exactly sure how it works, but the benefits of hyperbaric oxygen therapy may be due to its ability to: 

• Stifle tough infections 3
• Make antibiotics work better 4
• Boost cellular energy 5
• Activate the body’s natural repair systems 7

What Conditions Can HBOT Treat?

HBOT dates back to 1662, but it developed slowly because of early concerns about oxygen toxicity. It gained importance during World War II as a treatment for decompression sickness (common in scuba divers), and its use has expanded since 1. HBOT is still used to treat decompression sickness, and it’s a popular option for treating carbon monoxide poisoning (with or without cyanide poisoning) and chronic wounds. 

HBOT is also approved to treat these medical conditions 1:

• Embolism (a foreign substance, like a blood clot or air bubble, that has blocked a blood vessel)
• Serious burns
• Sudden vision loss due to blocked blood flow in the eye
• Gas gangrene (a dangerous bacterial infection)
• Failing skin grafts or tissue flaps
• Severe crush injuries and related trauma
• Bone or tissue damage from radiation injury
• Sudden unexplained hearing loss
• Brain abscesses (pus-filled infections)
• Flesh-eating infections (necrotizing soft tissue infections)
• Bone infections (osteomyelitis) that don’t respond to treatment
• Extremely low red blood cell levels (severe anemia)

In addition to these approved conditions, high-quality research shows HBOT may be a promising treatment for:

• Diabetic foot ulcers 8
• Diabetic peripheral neuropathy 9
• COVID-19 1
• Autism-related symptoms 10
• Parkinson’s disease symptoms 11
• Inflammatory bowel disease 12 13
• Erectile dysfunction 14
• Fibromyalgia 15
• Low sperm count and poor sperm motility 16

I have witnessed amazing results with HBOT treatment for a whole host of conditions and symptoms, and so have other providers. What excites me the most is that HBOT may be an effective option for people who have done the foundational work to overcome an illness or infection (improved their diet and lifestyle and healed their gut) but still struggle with lingering symptoms. 

Can HBOT Help With Longevity?

HBOT is a proven therapy for reducing inflammation, fighting infections, healing wounds, and more. Since it shows potential to support cellular rejuvenation and tissue repair, HBOT is also gaining attention from longevity and anti-aging experts. 

A couple studies have found that HBOT may boost longevity in people aged 65 and over. In each randomized controlled trial (gold-standard study), those who received 100% oxygen at two times atmospheric pressure for 90 minutes, 5 days a week for three months, had significantly better:

• Fitness 17
• Heart function 17
• Attention 18
• Processing speed 18
• Executive function 18

Although these are promising results, I want to point out that HBOT is not currently a proven longevity therapy. We still need more research to find out what it can do. 

Types of Hyperbaric Oxygen Chambers

HBOT is most often done in a medical center with one of these chamber options 1:

• Monoplace chamber – Filled with oxygen for one person
• Multiplace chamber – Multiple people breathe oxygen through a mask or tube

In both chambers, you breathe 100% oxygen at 2–3 times normal air pressure (ATA) for 1:

• 1.5–2 hours per session
• 1–3 sessions per day
• 20–60 sessions total, depending on the condition you’re treating

Some chambers may use pressures as low as 1.5 ATA or as high as 6 ATA. Notably, no one can safely breathe pure oxygen above 2.8 ATA without other gases being added.

If you don’t have access to a healthcare provider with an HBOT chamber, you can still explore this therapy on your own, though we recommend doing it with the guidance of a healthcare provider and not by yourself. Several companies sell and rent home HBOT monoplace chambers.

We prefer Affordable Hyperbaric Solutions and recommend their OxyRevo Forward 90 model (about 1–2 hours to assemble) with the following protocol:

• 5–6 sessions per week for 60–90 minutes
• 1.3–1.5 ATA
• 40–60 sessions, then reassess progress

Note: We aren’t affiliated with this company and recommend it based only on positive experiences.

When looking for a home unit, built-in air conditioning is a plus—the model we recommend doesn’t have it. Additionally, some units (including the OxyRevo Forward 90) offer the option of sitting or lying down. 

Hyperbaric Chamber Risks

When used appropriately, HBOT is safe and has many benefits. But because there are potential side effects and contraindications, it’s important to go through an appropriate screening process before you jump in 1. 

Hyperbaric Chamber Side Effects

Although oxygen is necessary for us to live and function, it’s possible to get too much of this good thing. Oxygen levels that are too high (oxygen toxicity) can cause cell damage from too many free radicals (oxidative stress), DNA damage, seizures, and damage to nerves and lungs 1.

Other HBOT side effects may include 1:

• Claustrophobia – When being in a confined space causes anxiety or panic
• Barotrauma – Injury from pressure changes, especially in the ears, sinuses, lungs, or teeth
• Hyperbaric myopia – Temporary nearsightedness
• Worsened cataracts (rare)
• Harm to an unborn baby’s eyes if used during pregnancy (rare)

Ear Pressure and HBOT

Before getting into hyperbaric chamber contraindications, I want to share some information about ear pressure injury (barotrauma). 

Less than 5% of people will have ear pressure problems with HBOT. Nevertheless, it’s important to be aware of the potential and to get assessed to find out if equalizing your ear pressure may be a problem for you.  

Here’s a helpful video you may want to watch before starting hyperbaric oxygen therapy.

HBOT USA (a hyperbaric medicine education company) explains that your HBOT provider should use a questionnaire to better understand your risk for barotrauma. Questions may include:

• What do you do when your ears change pressure on an airplane? 
• What is your backup plan if that doesn’t work?

Your provider should also give you clear instructions on how to use equalization techniques, such as the:

• Valsalva method: Pinch your nostrils and blow slowly as though you’re blowing your nose. Let pressure build slowly until you feel crinkling or popping. If you don’t feel equalizing in both ears, try another method.
• Toynbee maneuver: Pinch your nostrils and blow slowly through your nose while swallowing. If you don’t feel equalizing in both ears, try another method.
• Frenzel maneuver: Pinch your nostrils and blow slowly through your nose while closing the back of your throat like you’re trying to lift a weight. Then make the sound of the letter “K”. 
• Other methods to look into are Voluntary Tubal Opening, the Lowry Technique, and the Edmonds Technique.

Who Shouldn’t Use a Hyperbaric Chamber?

Someone with a collapsed lung (pneumothorax) and people who can’t equalize their ear pressure should never get in a hyperbaric chamber. 

Other contraindications for (reasons not to use) HBOT include 1:

• Use of certain drugs like cisplatin or sulfamylon, which interfere with healing
• Having a pacemaker or other implantable devices
• Hereditary spherocytosis (risk of severe blood cell damage)
• Pregnancy (except if treating carbon monoxide poisoning)
• Low blood sugar (hypoglycemia) risk, especially in people with diabetes
• Chronic respiratory diseases like COPD, asthma, or infections due to a higher risk of lung injury
• High blood pressure or heart failure due to a risk of pulmonary edema and heart problems
• History of epilepsy, fever, hyperthyroidism, or use of drugs like penicillin or disulfiram, which can all increase seizure risk

The risks and contraindications may seem scary, but my intention isn’t to frighten you about HBOT. I want to reassure you that you can have a safe and healing experience when your provider carefully assesses you and applies the treatment appropriately. 

And if you’re doing it yourself, I strongly recommend consulting a healthcare provider first and reading as much as you can about how it works, who it’s for, and what the risks are before you take the hyperbaric plunge.

Hyperbaric Chamber Benefits Outweigh Risks

Hyperbaric oxygen therapy is gaining traction as a treatment for everything from wound healing and lowering inflammation to improving brain and immune system function.  

But hyperbaric oxygen treatment is not a universal cure—it comes with some risks and contraindications, and you should only use it with qualified professional guidance. 

I’ve witnessed some amazing results with HBOT as a complementary therapy. And I’m hopeful that future research will confirm its role in wellness, recovery, and even longevity. 

If you’ve created a solid foundation but still feel like you’re struggling with the healing process, contact our clinic. We’d be happy to help you decide if HBOT is a treatment option for you.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.