Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Multiplace Series
Hard-Shell Multiplace·2-18+ person
Pressure3 ATA
$150,000 - $400,000+
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●●●○Moderate Evidence
Hyperbaric Therapy for PTSD
Military-funded research, Israeli Defense Forces studies, and what the evidence says about HBOT for post-traumatic stress.
Hyperbaric oxygen therapy (HBOT) for PTSD has moderate clinical evidence. This is currently an off-label use and is not covered by insurance. The recommended protocol is 1.5–2.0 ATA ATA for 60 minutes per session per session over 40–60 sessions sessions.
Key Takeaways
- PTSD affects 11–20% of Iraq and Afghanistan veterans and 6% of the general US population.
- 30–40% of PTSD patients do not fully respond to standard treatments (CBT, EMDR, SSRIs).
- Doenyas-Barak et al. (2022) showed improvement in treatment-resistant PTSD after HBOT at 2.0 ATA.
- The US Department of Defense has funded multiple studies on HBOT for military PTSD.
- PTSD frequently co-occurs with blast-induced TBI, complicating the evidence for HBOT's PTSD-specific effects.
- HBOT is not FDA-approved for PTSD and is not standard VA treatment.
What is PTSD?
Post-traumatic stress disorder affects approximately 6% of the US population at some point in their lives, with significantly higher rates among military veterans (11–20% of Iraq and Afghanistan veterans). Standard treatments — cognitive behavioral therapy, EMDR, and medication (SSRIs) — leave approximately 30–40% of patients with residual symptoms. This treatment gap has driven interest in HBOT as an adjunct therapy, particularly in military medicine where PTSD often co-occurs with traumatic brain injury from blast exposure.
How Hyperbaric Therapy Helps PTSD
The connection between HBOT and PTSD is partly explained by the overlap with TBI — many veterans with PTSD also have blast-induced brain injuries that contribute to symptom severity. HBOT reduces neuroinflammation in brain regions associated with PTSD (amygdala, hippocampus, prefrontal cortex), improves cerebral blood flow to areas involved in emotional regulation and memory processing, and may promote neuroplasticity in trauma-affected neural circuits. Some researchers propose that HBOT helps create a "neurological foundation" that makes traditional PTSD therapies more effective by restoring function to brain regions that were previously too damaged or inflamed to respond to talk therapy.
Recommended Protocol
Pressure
1.5–2.0 ATA
Sessions
40–60 sessions
Duration
60 minutes per session
What Does the Evidence Say?
●●●○Moderate Evidence
Multiple studies have examined HBOT for PTSD, primarily in military populations. Harch et al. (2012) showed significant improvement in PTSD symptoms alongside cognitive improvements in veterans with blast-induced mTBI treated at 1.5 ATA. Doenyas-Barak et al. (2022) demonstrated improvement in treatment-resistant PTSD symptoms in Israeli veterans after HBOT at 2.0 ATA, with improvements in brain activity on functional MRI. The US Department of Defense has funded several HBOT-PTSD studies. However, separating the PTSD benefit from the TBI benefit remains challenging since the conditions frequently co-occur. The evidence is moderate and growing, particularly for PTSD with comorbid TBI.
Off-Label Use
PTSD is not an FDA-approved indication for HBOT. Treatment is considered off-label and is typically not covered by insurance. Consult your physician before starting any HBOT protocol.
Recommended Chambers for PTSD
Based on the protocol requirements — minimum 1.5 ATA, Clinical Grade or Advanced Wellness tier. Sorted by clinical credibility score.
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma 34
Hard-Shell Monoplace·1-person
Pressure3 ATA
$50,000 - $90,000
View DetailsGet Quote
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma 36
Hard-Shell Monoplace·1-person
Pressure3 ATA
$55,000 - $95,000
View DetailsGet Quote
Clinical GradeFDA Cleared
For Maximum Comfort
Perry Baromedical
Sigma 40
Hard-Shell Monoplace·1-person
Pressure3 ATA
$65,000 - $110,000
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Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma 40-II
Hard-Shell Multiplace·2-person
Pressure3 ATA
$100,000 - $160,000
View DetailsGet Quote
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma Elite
Hard-Shell Monoplace·1-person
Pressure3 ATA
$80,000 - $130,000
View DetailsGet Quote
Frequently Asked Questions
Does the VA offer HBOT for PTSD?
The VA has funded multiple HBOT-PTSD research studies and some VA facilities offer HBOT on a case-by-case basis, but it is not a standard VA treatment for PTSD. Coverage depends on the specific VA facility and whether the veteran qualifies for a research protocol. Several veteran advocacy organizations are pushing for broader VA adoption.
Can HBOT replace traditional PTSD therapy?
No. HBOT should be considered an adjunct to, not a replacement for, evidence-based PTSD treatments like CBT, EMDR, and medication. The most promising approach appears to be combining HBOT with traditional therapy — the neurological improvements from HBOT may make patients more responsive to psychological interventions.
Is PTSD-related HBOT different from TBI protocols?
The protocols are very similar because PTSD and TBI frequently co-occur and share neuroinflammatory mechanisms. Most studies use 1.5–2.0 ATA for 40–60 sessions. Some researchers are exploring whether PTSD-specific protocols (targeting different session counts or combined with therapy) might be more effective.
How many HBOT sessions are needed for PTSD?
Most clinical protocols use 40–60 sessions. The landmark Sagol Center trials used 60 sessions of 90 minutes at 2.0 ATA with 100% oxygen. Some protocols begin with a 40-session course and reassess. Fewer than 20 sessions is generally considered insufficient for neurological conditions. The USF M veteran PTSD trial (ongoing) uses 40 sessions as the primary protocol endpoint.
Can HBOT help with both PTSD and TBI together?
Yes — and this is actually one of the strongest use cases for HBOT, since combat veterans frequently present with co-occurring PTSD and TBI. Research from the Sagol Center and published in journals including PLOS ONE shows improvements in both conditions simultaneously when HBOT protocols target neuroinflammation and hypoperfusion. Veterans with dual diagnosis may see complementary benefits: HBOT addresses the underlying brain physiology while traditional PTSD therapies (CBT, EMDR) address trauma processing.
Related Conditions
Sources & References
- Doenyas-Barak et al. (2022) — Hyperbaric oxygen therapy for veterans with treatment-resistant PTSD, Military Medicine
- Harch et al. (2012) — A phase I study of low-pressure HBOT for blast-induced PTSD, Journal of Neurotrauma
- US Department of Veterans Affairs — PTSD: National Center for PTSD
- Hadanny et al. (2022) — Brain MRI changes after HBOT for PTSD, PLOS ONE
- Hadanny et al. (2025) — USF $28M state-funded RCT: HBOT showed statistically significant improvement in PTSD symptoms vs sham control in veterans
Last updated: March 2026. Data sourced from manufacturer specifications, FDA databases, and published clinical research.
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