Safety & Tolerability

The safety profile of HBOT is well-established across decades of military, clinical, and research use. Common adverse events are mild and self-resolving: middle-ear barotrauma (most frequently reported), transient myopia (resolves after treatment cessation), and occasional claustrophobia. These findings are consistent across all clinical populations examined in this brief. Serious adverse events are rare across thousands of documented sessions. The Rockswold Phase II severe TBI trial showed no signs of pulmonary or cerebral oxygen toxicity despite treating critically injured patients (mean GCS 5.7). The Doenyas-Barak veteran PTSD RCT, Zilberman-Itskovich post-COVID RCT, and Hachmo aging trial all reported no serious adverse events. Chamber sessions were consistently described as well-tolerated across military populations. In a 2023 systematic review of HBOT for fibromyalgia (Chen et al., BMJ Open, n=288), no serious adverse events or complications were observed. Only 6.5% withdrew due to mild adverse reactions. Low-pressure protocols (<2.0 ATA) were associated with fewer adverse events. HBOT is FDA-cleared for 14 indications and has been safely administered for decades in military and clinical settings. The protocols used in the TBI and cognitive studies cited here (typically 1.5–2.0 ATA, 60–90 minutes, 40–60 sessions) represent moderate, well-tolerated protocols with established safety margins.