Hyperbaric Oxygen Therapy for PTSD: What the Research Shows

Important: Hyperbaric oxygen therapy is not FDA-approved for PTSD. This is an investigational use. Evidence is preliminary. Insurance will not cover HBOT for this condition. All costs are out-of-pocket.

Post-traumatic stress disorder affects roughly 7-8% of the U.S. population at some point in their lives. For veterans, that number climbs higher. Standard treatments — therapy, medication — help many people. But a meaningful subset doesn’t respond well to first-line care. That gap is part of why HBOT has attracted serious research attention in this area.

The evidence is early. But it’s real, and it’s growing.

What a 2024 Randomized Trial Found

The strongest published evidence comes from Gottlieb et al. (2024), a randomized controlled trial published in PLOS ONE. The study enrolled 35 veterans with chronic PTSD. Half received 60 HBOT sessions at 2.0 atmospheres absolute (ATA). The other half received a sham protocol.

The HBOT group showed a 68% reduction in PTSD symptom severity, measured by the CAPS-5 scale — the standard clinical rating tool for PTSD. That improvement held at the 10-month follow-up, which is notable. Many treatments show results immediately after treatment but fade over months.

This is one RCT with 35 participants. It’s promising, not definitive. Larger trials are needed before any conclusions about effectiveness at a population level can be made.

An earlier study by Boussi-Gross et al. (2013) looked at a TBI and PTSD overlap population — veterans often have both — and found improvements in cognitive function and quality of life measures. That study used a crossover design. PMID: 24200068.

How HBOT Is Thought to Work for PTSD

PTSD involves measurable changes in brain structure and function. The amygdala — the brain’s threat-detection center — becomes hyperactive. The prefrontal cortex, which normally regulates the amygdala’s response, loses effective control. Regional cerebral blood flow patterns shift.

HBOT delivers oxygen at pressure, which increases the amount of dissolved oxygen in plasma and tissues significantly above what normal breathing provides. In the brain, this appears to trigger neuroplasticity — the brain’s ability to reorganize and form new connections. Studies using SPECT imaging have shown increased cerebral blood flow in PTSD-affected regions after HBOT protocols.

The treatment also reduces neuroinflammation. Chronic neuroinflammation is thought to contribute to PTSD persistence, particularly in veterans who’ve also had traumatic brain injuries.

None of this is fully proven as a mechanism. The research is still working out the exact pathways.

The Protocol Studied

The protocol in the Gottlieb (2024) trial was 60 sessions at 2.0 ATA with 100% oxygen. Sessions typically run 90 minutes each, five days a week. That’s roughly a 12-week commitment.

Not all clinics offer exactly this protocol. If you’re considering HBOT for PTSD, ask the facility what protocol they follow and whether it matches what was studied.

What the VA Covers — and Doesn’t

The Department of Veterans Affairs does not cover HBOT for PTSD. Full stop. This isn’t a gray area.

Some members of Congress have introduced legislation that would require the VA to study HBOT for veterans with PTSD or TBI. As of early 2026, no coverage mandate has passed. The legislative landscape can change, so veterans should check current VA policy directly at va.gov or speak with a VA benefits coordinator.

Cost Reality

At 60 sessions and $250-450 per session, the studied protocol costs $15,000-27,000 out of pocket. That’s a significant financial commitment for most families.

Private insurance won’t cover HBOT for PTSD either. It’s not a covered indication under any major insurer’s guidelines for this condition.

Some veterans have turned to nonprofit organizations that fund HBOT for veterans. Organizations like the Hyperbaric Hope Foundation and individual facility scholarship programs exist. They don’t cover everyone, but they’re worth asking about.

Clinical Trials as an Alternative Path

If you’re interested in HBOT for PTSD but can’t afford private-pay treatment, clinical trials are worth looking at. ClinicalTrials.gov lists multiple active and recruiting trials studying HBOT for PTSD and TBI. Participants typically receive the treatment at no cost in exchange for their participation.

Search “hyperbaric oxygen PTSD” on ClinicalTrials.gov to see what’s currently enrolling.

FAQ

Is HBOT FDA-approved for PTSD? No. It’s investigational. The VA doesn’t cover it and neither does private insurance.

What’s the cost of HBOT for PTSD? The studied protocol is 60 sessions. At $250-450 per session, expect $15,000-27,000 out of pocket.

What did the 2024 study find? Gottlieb et al. (2024) found a 68% reduction in PTSD symptoms (CAPS-5) in 35 veterans after 60 HBOT sessions. Results held at 10 months. PMID: 38748905.

Are clinical trials available? Yes. Multiple HBOT and PTSD trials are listed on ClinicalTrials.gov. Participation is typically free.

Does the VA cover HBOT for PTSD? No. As of early 2026, no VA coverage exists for HBOT for PTSD.

References

• Gottlieb et al. (2024). Hyperbaric oxygen therapy for veterans with PTSD: a randomized controlled trial. PLOS ONE. PMID: 38748905
• Boussi-Gross et al. (2013). Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury — randomized prospective trial. PLOS ONE. PMID: 24200068

Related Pages

• What Is Hyperbaric Oxygen Therapy?
• HBOT for Traumatic Brain Injury
• How Much Does HBOT Cost?
• Find an HBOT Provider

Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice. Hyperbaric oxygen therapy for PTSD is investigational and not FDA-approved. Consult a licensed physician before making any treatment decisions. Individual outcomes vary. This site does not establish a doctor-patient relationship.