Can Hyperbaric Oxygen Therapy (HBOT) Help With Stroke Recovery?

Key Takeaways

• Not standard care for stroke: HBOT is proven for a small number of conditions, but stroke is not one of them. The FDA has not approved HBOT for stroke recovery, and regulators have warned about unproven claims from some private clinics.

  
  

• Chronic stroke research: Some small studies suggest HBOT might improve function or memory in people living with long-term deficits after stroke. These results are intriguing but limited by design issues like small sample sizes and lack of independent replication, so HBOT remains investigational for stroke and is usually not covered by insurance.

  
  

• Safety: HBOT is generally safe under specialist supervision. Ear and sinus pressure problems are common. Temporary nearsightedness can develop during multiweek courses, and cataract progression has been reported in long-term use. Rarely, oxygen-toxicity seizures occur, and in one reported case, a seizure may have contributed to a stroke. An untreated collapsed lung (pneumothorax) is an absolute contraindication.

  
  

What HBOT Is and How It Works

In HBOT, you breathe nearly 100% oxygen inside a pressurized chamber, typically at 1.5–2.5 times normal air pressure. This allows more oxygen to dissolve into the blood plasma, raising tissue oxygen levels beyond what hemoglobin alone can carry.

Proposed effects on the brain include reducing swelling, modulating inflammation, promoting new blood vessel growth, and supporting neuroplasticity, the brain’s ability to rewire and recover function.

A Note on “Mild” HBOT

Some centers offer “mild” HBOT at low pressures (around 1.3 ATA). The Undersea and Hyperbaric Medical Society considers these treatments unproven, and soft-sided or non-medical chambers raise safety concerns.

What HBOT Treats in Stroke Care

Acute Stroke

For people experiencing an acute ischemic stroke, HBOT is not recommended. The only exception is when a stroke is caused by an air embolism, where HBOT can be lifesaving by reducing bubble size and speeding recovery.

Chronic Stroke

For people months or years past their stroke, small studies have explored HBOT. One well-known trial using 40 sessions at 2.0 ATA for 90 minutes reported improvements in function and quality of life, with brain scans showing activity in previously “silent” areas (Efrati and colleagues 2013). Another study suggested memory benefits (Hadanny and colleagues 2020).

These results are encouraging, but they came from a single research group, and the studies have been criticized for small sample sizes, inconsistent protocols, and limited controls. They have not yet been confirmed in larger, multi-center trials.

Importantly, a more recent randomized controlled trial by Harrison and colleagues (2024) tested HBOT in people 6–36 months post-stroke and found no meaningful benefit. In fact, outcomes on the Stroke Impact Scale-16 slightly favored the control group, leading the authors to conclude that HBOT should not be recommended for chronic stroke outside of research settings.

That means HBOT for stroke is still considered experimental.

Survivor Story: How HBOT Helped Dominica Padilla

Individual experiences vary. The research is still evolving, yet personal stories can help survivors understand what a course looks like and how it impacted that individual.

Dominica Padilla, co-founder of RebuildAfterStroke.org, experienced a stroke in September 2024. In the months that followed, she worked hard through traditional rehabilitation therapies. By December, however, she felt her recovery had stalled.

Looking for a way to regain momentum, Dom decided to try HBOT.

She committed to 43 one-hour sessions over two months, attending daily treatments in a hyperbaric chamber. The schedule was demanding, but she soon noticed meaningful changes.

What Changed for Dom:

• Her vision improved

• She experienced less pain

• Her energy levels increased, a common struggle for many survivors

The treatment came at a cost. Insurance did not cover the $11,000 expense, but Dom felt it was a worthwhile investment.

“I finally felt like I was moving forward again,” she said. “It gave me momentum when I needed it most.”

Dom’s results align with the type of protocols used in research, yet responses differ by person. Her story is inspiring, but it should be viewed as an individual case, not a guarantee. Some clinics market HBOT as a guaranteed cure, which is misleading. Survivors should be cautious of facilities that promise more than current science supports.

How Effective Is HBOT for Stroke?

• Acute stroke: No proven benefit, except in cases of air embolism.

• Chronic stroke: Small studies suggest possible improvements in selected patients, especially in cognition, but the certainty of evidence is low.

  
  

The safest path, if you are interested, is to pursue HBOT within a clinical trial.

Safety and Side Effects

Common side effects

• Ear or sinus pressure and mild barotrauma

• Temporary nearsightedness during treatment courses

• Claustrophobia in the chamber

Rare but serious risks

• Oxygen-toxicity seizures (usually brief)

• Lung injury in people with underlying risk factors

• Cataract progression after prolonged courses

Absolute contraindication

• An untreated pneumothorax (collapsed lung)

  
  

What a Typical HBOT Course Looks Like

1. Pre-treatment evaluation: A physician reviews your medical history, medications, lung and ear health, and screens for contraindications.

2. The session: You sit in a chamber while the pressure is gradually increased. You breathe nearly 100% oxygen through a hood or mask, usually for 60–90 minutes with short “air breaks.”

3. The course: Most research protocols use 40 sessions, five days per week, at 2.0 ATA for 90 minutes. Some extend to 60 sessions.

4. After the session: Most people return to normal activities right away. You are advised how to equalize ear pressure and what symptoms to report.

Who Might Consider HBOT After Stroke?

• Survivors in the chronic phase who have already completed standard rehabilitation and want to explore research-based options

• People with realistic goals, such as improving memory, reducing fatigue, or making daily care tasks easier

• Those willing to pursue HBOT through a clinical trial when available

Coverage and Cost

Medicare and most commercial insurers do not cover HBOT for stroke. Sessions are typically self-pay.

In the U.S., costs generally range from $250 to $600 per session, and Medicare data estimate about $596 per sessionwhen all fees are included. A 40-session course can therefore cost between $10,000 and $24,000.

Because stroke is not an FDA-approved indication, insurance does not cover HBOT. Some clinics exploit this by charging high fees for unproven treatments, which can create significant financial strain for families.

Questions to Ask Before Starting

• What is the goal of HBOT in my case, and how will success be measured?

• Is there a clinical trial I can join instead of paying out of pocket?

• How many sessions are recommended, and at what pressure and duration?

• What safety measures are in place to reduce risks?

• What is the total cost, including facility and physician fees?

  
  

The Bottom Line

Hyperbaric oxygen therapy is an established treatment for several conditions, but stroke is not currently one of them. In acute ischemic stroke, it has no proven benefit except in air embolism. In chronic stroke, early studies suggested possible improvements, but a recent randomized controlled trial (Harrison et al., 2024)

provided stronger evidence that HBOT does not confer a meaningful benefit.

Dom’s story shows how HBOT can feel meaningful for some survivors, but research still needs to catch up. If you are considering HBOT, involve your stroke team, examine safety and costs carefully, and prioritize participation in a well-designed clinical trial. Be especially cautious of clinics that advertise HBOT as a guaranteed cure, since this is not supported by science.

We would also love to hear from you. If you’ve tried HBOT after stroke, please share your experience with us so that other survivors and caregivers can learn from your journey.

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician, rehabilitation specialist, or another qualified healthcare provider before starting hyperbaric oxygen therapy or any new treatment after stroke. Never ignore or delay medical advice because of something you have read here.

Useful Links For More Information

• Undersea and Hyperbaric Medical Society: Approved Indications and Safety Statements

• Efrati S. et al. (2013). Hyperbaric Oxygen Induces Late Neuroplasticity in Post Stroke Patients – Randomized, Prospective Trial (PLoS ONE)

• Review on Hyperbaric Oxygen Therapy as a Stroke Treatment

• Hadanny A. et al. (2020). Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients - a retrospective analysis

• Harrison et. al. (2024). Hyperbaric Oxygen Post Established Stroke

• Search for a Clinical Trial