For a growing number of holistic-leaning celebrities, hyperbaric oxygen therapy (HBOT) has become as de rigueur as cold plunges and fitness trackers. Mayim Bialik posts selfies from her at-home chamber, which she uses to address “inflammation and autoimmune issues.” LeAnn Rimes has said that HBOT led to “a significant reduction of anxiety and depression,” and Lebron James reportedly relies on the method to reduce swelling and increase circulation.
The treatment is increasingly popping up among longevity chasing biohackers—including Bryan Johnson, who just announced on X that he had moved his office into his personal hyperbaric chamber—and at many health clubs, spas and wellness residences, including the wellness club from Whole Foods founder John Mackey.
Moved my office into my hyperbaric oxygen chamber. pic.twitter.com/8TXfpPpICh
— Bryan Johnson /dd (@bryan_johnson) February 21, 2025
And U.S. Secretary of Health Robert F. Kennedy Jr. appears to be a supporter, as he accused the U.S. Food and Drug Administration of being behind an “aggressive suppression” of the treatment (along with a slew of other things, like raw milk, that “can’t be patented by Pharma”). That’s likely because the FDA has only approved HBOT for 13 specific issues, including severe anemia, burns, decompression sickness, and severe skin and bone infections.
So what’s HBOT all about and why is its spillover into the wellness world controversial?
Below, all you need to know about hyperbaric oxygen therapy.
What is HBOT?
The body’s tissues need oxygen to function. Hyperbaric oxygen therapy in a medical-grade, FDA-approved chamber allows you to breathe pure oxygen—as opposed to everyday air, which is mostly nitrogen and just 21% oxygen. Hyperbaric oxygen is also highly pressurized, thereby allowing the lungs to take more in.
The FDA has been regulating HBOT chambers since 1976, and has officially cleared 13 medical conditions, from decompression sickness to burns, for such treatment.
But it’s used off-label for many other reasons, including concussions, traumatic brain injury, long COVID, age reversal, stroke recovery, fibromyalgia, and improved brain function, many of which are being looked at in ongoing clinical trials.
“Indeed, the new indications for hyperbaric oxygen therapy are still not widely recognized or covered by general insurance, despite a significant body of scientific research supporting their efficacy,” says Dr. Shai Efrati, an associate professor at the Sackler School of Medicine and the Sagol School of Neuroscience at Tel Aviv University. He’s also director of the Sagol Center for Hyperbaric Medicine and Research, the world’s largest hyperbaric treatment center, where patients with conditions from long COVID to fibromyalgia are treated by wearing oxygen masks in large group pressurized suites.
“As with many emerging technologies and therapeutics, approving new indications requires substantial funding—not only for research but also for the regulatory and administrative processes involved,” explains Efrati, also the founder of Aviv Clinics in Florida, which uses personalized healthcare, including off-label HBOT, in an aim to improve health span.
A major factor delaying hyperbaric oxygen therapy’s mainstream acceptance, Efrati believes, is the lack of a commercial driver. “Unlike pharmaceuticals, HBOT is not patentable in the conventional sense, which means no pharmaceutical company or well-funded industry is lobbying for its approval,” he says. “Without this financial backing, the process takes longer, relying on independent research, growing clinical evidence, and patient demand.”
But he believes that progress is inevitable as more data accumulates and patient advocacy increases. “We have already seen this shift in Israel, where HBOT is covered for soldiers and veterans suffering from PTSD, traumatic brain injury (TBI), and post-concussion syndrome,” Efrati says. “This sets a precedent that could eventually influence other healthcare systems worldwide.”
Side effects from the pressure, according to the CDC, may include ear and sinus pain, middle ear injuries, temporary vision changes, or the rare lung collapse. (Also rare is the possibility of a chamber fire, as was seen with the tragic explosion of an HBOT chamber in January, which killed a 5-year-old Michigan boy and is still under investigation).
What about at-home HBOT chambers?
Home chambers—typically soft-sided, like tents—as well as those found at some clinics are not offering the same type of therapy as those that are medical-grade and FDA-approved, as they do not deliver 100% oxygen. Instead, they use regular air that is pressurized at 1.3 ATA (30% more pressurized than normal) for what’s known as “mild hyperbarics.”
“The main challenge in the U.S. today is the proliferation of non-medical-grade hyperbaric chambers that claim to offer advanced HBOT protocols but fail to deliver the necessary therapeutic conditions and lack critical safety measures,” says Efrati. “These chambers are ineffective in achieving the biological benefits of properly administered HBOT and pose serious safety risks due to insufficient quality control and regulatory oversight.” This includes potential exposure to toxic oils from some compressors, he says, as well as carbon dioxide buildup that brings a risk of hypoxia inside the chamber.
Still, Jason Sonners—a chiropractor, author of the off-label use textbook The Art and Science of Hyperbaric Medicine, and clinical director of NJ HBOT, where he is a practitioner—is a strong believer in the use of mild hyperbaric therapy.
“It’s not just about the pure oxygen, it’s also about the pressure, both of those things that are at work here,” he says. “I would even go so far as to say pressure is the reason that it works.”
Every single cell in our bodies requires oxygen to function normally, he says, but under “normal atmospheric conditions,” our body is limited as to how much oxygen it can carry.
“The only thing hyperbaric is doing is creating a temporary environment that allows you to carry more oxygen…and then the body can utilize that ingredient for the healing and regeneration of tissues, fighting infection, or improving energy production,” Sonners says. “That’s why I think it’s getting into that longevity and biohacking space.”
What does science say?
Efrati does not agree that pressurized air alone has benefits, and points to the research to explain why.
“The effectiveness of HBOT is pressure- and oxygen-dependent,” he says, noting that clinical studies demonstrating the therapeutic benefits of HBOT have been conducted at pressures of 1.5 to 3.0 ATA with 100% oxygen. “The 1.3 ATA air pressure used in mild hyperbarics has not been scientifically proven to provide any meaningful therapeutic benefits. Claims made regarding these chambers are not based on the physiological mechanisms observed in true hyperbaric medicine.”
Sonners does flag a handful of small studies that found some promising effects of mild hyperbarics—including those around stem cell generation, cerebral palsy, and autism—although each came to the conclusion that more research was needed.
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A more significant body of research, much of it conducted by Efrati, supports the efficacy of pure-oxygen HBOT for a range of issues, including cognitive function, traumatic brain injury, stroke, chronic pain, athletic performance, long COVID, and even erectile dysfunction. Many of the studies are featured on the website of the educational International Hyperbarics Association—though the organization also supports the use of mild hyperbarics, recently welcoming Rimes at its conference to speak about how it’s helped her with a range of health issues.
This is a point of controversy, with Efrati warning, “The risks associated with uncontrolled air quality, potential contamination, and inadequate pressure far outweigh any potential benefits” of mild hyperbarics.
“HBOT is not just a procedure—it is a therapeutic journey,” he says. “Throughout this journey, patients may experience physiological changes, particularly as the therapy induces regeneration. This is precisely why HBOT should be conducted only under the supervision of experienced professionals in the field who can monitor and manage these changes appropriately.”
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