What Is Hyperbaric Oxygen Therapy for Autism?

Hyperbaric Oxygen Chamber

Question: What Is Hyperbaric Oxygen Therapy for Autism?

What is hyperbaric oxygen therapy (HBOT) for autism? Is it an effective therapy?

Answer: A hyperbaric chamber is a pressurized, oxygen-filled chamber or tube. It's an effective tool for treating the "bends" (a disorder among SCUBA divers who surface too quickly, causing oxygen bubbles in the bloodstream).

Over the years, medical researchers found a number of additional therapeutic uses for the chambers, which force large quantities of oxygen into the body very quickly.

For example, hyperbaric therapy (HBOT) can speed the development of blood vessels, thus improving outcomes for certain types of wounds, gangrene, cardiac illnesses, and other conditions. Typically, HBOT is conducted in a hospital setting, in a large non-portable chamber, under high pressure.

In recent years, some doctors theorized that HBOT could improve symptoms of autism by increasing oxygen intake and thus reducing inflammation and hypo-perfusion (lack of oxygen) in the brain. Of course, there is no agreement within the scientific community that inflammation or lack of oxygen cause autism - or are even generally associated with autism. This has not stopped researchers or parents, however, from experimenting with the treatment.

To investigate the possibility that HBOT could treat symptoms of autism, Dr. Daniel Rossignol ran a series of studies. The initial studies were not "blinded" (meaning that the researchers already knew who was receiving the treatment and who was not).

This type of study is usually considered to be less than ideal. A 2009 Rossignol study which was blinded seemed to confirm his initial study, showing that children did, indeed, seem to gain skills as a result HBOT.

While Rossignol's findings seemed to suggest that HBOT could, indeed, help with symptoms of autism, later studies showed NO difference between groups using real HBOT and groups using sham HBOT.

  In other words, when two groups of children were put into HBOT chambers, but just SOME of the children actually received HBOT treatment, ALL of the parents noted significant improvements in behavior. This type of finding is usually attributed to the "placebo effect," meaning that parents who expected to see improvements saw improvements, whether or not treatment was really provided.

Since interest in HBOT has risen, the FDA has issued a warning stating that use of HBOT for "off label" purposes (including treatments for autism, ADHD, depression, etc.) is neither safe nor effective: Patients receiving HBOT are at risk of suffering an injury that can be mild (such as sinus pain, ear pressure, painful joints) or serious (such as paralysis, air embolism). Since hyperbaric chambers are oxygen rich environments, there is also a risk of fire.

Despite very  limited and contradictory scientific evidence for HBOT as a useful treatment for autism, anecdotal evidence and word-of-mouth have made this an increasingly interesting option to parents of children with autism. "Home" oxygen chambers and expensive courses of HBOT treatment are being offered by various practitioners with anecdotal evidence of positive outcomes.

Because there are significant risks associated with it, and evidence for effectiveness is patchy at best, HBOT is a questionable choice as a treatment for autism. If parents do decide to consider HBOT, however, it makes sense to do so in the context of a formal autism clinic or children's hospital - both to ensure proper methodology and to reduce the risk of side effects.


FDA Consumer Update: "Hyperbaric Oxygen Therapy: Don't Be Misled." August, 2013.

Jepson, B. et al. "Controlled evaluation of the effects of hyperbaric oxygen therapy on the behavior of 16 children with autism spectrum disorders."J Autism Dev Disord.

2011 May;41(5):575-88. doi: 10.1007/s10803-010-1075-y.

Rossignol, Daniel et al. "The effects of hyperbaric oxygen therapy on oxidative stress, inflammation, and symptoms in children with autism: an open-label pilot study." BMC Pediatrics 2007, 7:36

Rossignol, Daniel et al.  "Hyperbaric treatment for BMC Pediatr. 2009 Mar 13;9:21. doi: 10.1186/1471-2431-9-21.children with autism: a multicenter, randomized, double-blind, controlled trial."

Sampanthavivat M., et all. "Hyperbaric oxygen in the treatment of childhood autism: a randomised controlled trial." Diving Hyperb Med. 2012 Sep;42(3):128-33.

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