TL;DR: Hyperbaric oxygen therapy (HBOT) is a medical treatment in which a patient breathes 100% oxygen inside a pressurised chamber. For concussion and traumatic brain injury, HBOT is currently considered an emerging or off-label use in Canada. Recent research, including a 2025 cohort study from the Sagol Centre for Hyperbaric Medicine, suggests that HBOT may improve cognitive symptoms in adults with persistent post-concussion syndrome, even years after the original injury. It is not a Health Canada recognised indication, and access in Canada is limited. Speak with your physician and find a regulated facility through Canada Hyperbarics.
If you or a loved one are still living with headaches, brain fog, sleep problems, or mood changes months after a concussion, you may have come across hyperbaric oxygen therapy (HBOT) in your research. This patient FAQ explains what the science currently shows, what HBOT can and cannot do, and how Canadians can access regulated hyperbaric care. Every answer is based on real studies indexed in PubMed, and every claim links to either a peer-reviewed source or a Canadian regulator.
This guide is written for patients and families, not clinicians. If you want the clinical detail, our research bank has thousands of full study summaries.
Frequently asked questions about HBOT for concussion in Canada
Below are the questions Canadian patients most often ask Canada Hyperbarics about hyperbaric oxygen therapy for concussion and traumatic brain injury. Each answer cites recent published research and points back to authoritative sources you can review with your own physician.
What is hyperbaric oxygen therapy and how is it used for brain injury?
Hyperbaric oxygen therapy is a medical treatment in which a patient sits or lies inside a sealed chamber pressurised to roughly 1.5 to 2.5 times normal atmospheric pressure while breathing pure (100%) oxygen. This combination dissolves much more oxygen into the blood plasma than breathing room air at sea level can achieve. The goal is to flood injured tissue with oxygen, calm inflammation, and support cellular repair.
For brain injury, researchers believe HBOT may help by stimulating several biological processes at once. According to a 2024 review published in Frontiers in Neurology, repeated HBOT sessions can promote mitochondrial function, support new blood vessel growth, increase markers of new synapse formation, and reduce inflammatory cytokines such as TNF-alpha and IL-6 (Bin-Alamer et al., 2024). These mechanisms are why HBOT has been studied in conditions such as post-concussion syndrome, traumatic brain injury, post-traumatic stress disorder, and fibromyalgia.
Is HBOT approved by Health Canada for concussion or TBI?
No. Concussion, mild traumatic brain injury (mTBI), and post-concussion syndrome are not on the list of Health Canada recognised indications for hyperbaric oxygen therapy. Recognised indications in Canada generally follow the Undersea and Hyperbaric Medical Society (UHMS) list and include conditions such as decompression sickness, carbon monoxide poisoning, non-healing wounds in selected cases, radiation injury, certain bone and tissue infections, and crush injury.
This means HBOT for concussion is currently classified as an off-label or investigational use. A 2022 review published in Undersea and Hyperbaric Medicine describes how the U.S. Department of Defense and U.S. Department of Veterans Affairs have reached similar conclusions about the evidence not yet meeting their threshold for clinical coverage of mTBI (Biggs et al., 2022). Canadian provincial health plans broadly mirror this position. For an overview of approved versus emerging indications, see our conditions index.
What does the latest research say about HBOT for post-concussion syndrome?
The evidence is mixed, but a number of recent studies suggest a measurable benefit for some patients with persistent symptoms. A 2025 review in Expert Review of Neurotherapeutics by Hadanny and Efrati describes a paradigm shift toward personalised, multimodal treatment for persistent post-concussion syndrome, with HBOT positioned as one of the emerging interventions worth further study (Hadanny and Efrati, 2025).
The most recent cohort study, published in 2025 in Frontiers in Neurology, looked at adults who had sustained a TBI in childhood and were still struggling with cognitive symptoms decades later. After roughly 40 HBOT sessions of 90 minutes each at 2 ATA, the 26 participants showed statistically significant improvements across global cognition, memory, executive function, attention, and information processing speed, with effect sizes between 0.62 and 0.78 (Shabi Shlifer et al., 2025). Improvements were independent of the time since injury or the original severity.
A randomised, double-blinded pilot trial called HOT-POCS is currently testing 20 sessions of HBOT versus a true sham gas in 100 civilian adults with persistent post-concussion symptoms 3 to 12 months after injury (Wright et al., 2023). Trials like HOT-POCS are important because earlier studies often used active sham conditions, which may have hidden a real treatment effect.
How does HBOT compare to other treatments for concussion recovery?
HBOT is one option among many. A 2024 literature review in Cureus grouped current concussion therapies into several categories, summarised in the table below (Patel et al., 2024).
| Treatment Approach | What It Targets | Evidence Level |
|---|---|---|
| Rest and graded return to activity | Acute symptom recovery | Standard of care |
| Vestibular and balance therapy | Dizziness, balance issues | Established |
| Aerobic sub-symptom exercise | Persistent symptoms after 2 to 4 weeks | Established |
| Pharmacotherapy (headache, sleep, mood) | Specific symptom management | Symptom-targeted |
| Osteopathic manipulative medicine | Musculoskeletal contributors | Limited but supportive |
| Hyperbaric oxygen therapy (HBOT) | Persistent post-concussion syndrome | Emerging / off-label |
HBOT is generally considered after standard care has been tried for several months without complete recovery. It is not a replacement for vestibular therapy, aerobic rehabilitation, or proper symptom management, and most clinicians use it alongside these other approaches.
How many HBOT sessions are typically used for concussion?
Research protocols vary widely. Looking at recent studies, the most common patterns include:
- Short protocols: 20 sessions of 100% oxygen at 2.0 ATA, used in the HOT-POCS pilot trial
- Standard cognitive protocols: 40 sessions of 90 minutes at 2.0 ATA, used at the Sagol Centre for Hyperbaric Medicine in Israel
- Extended protocols: 60 to 80 sessions, sometimes split into two courses with a break in between
- Sessions per week: 3 to 5 per week, Monday to Friday is most typical
One published case report described a hockey player who only completed 11 of a recommended 40 sessions and experienced limited improvement, then returned for two further courses of 40 sessions and reported substantial gains in cognition and quality of life (Peterson et al., 2025). This is anecdotal evidence from one patient, but it does illustrate why most research protocols recommend completing the full course rather than stopping early.
Is HBOT safe for someone with a concussion or post-concussion syndrome?
When delivered in a regulated facility by trained staff, HBOT has a strong overall safety record. The most common side effect is middle ear barotrauma, which feels like ear pressure or popping during the descent and ascent of the chamber. Other possible side effects include sinus discomfort, temporary nearsightedness that usually resolves after treatment ends, and rarely oxygen toxicity seizures.
Patients with active untreated pneumothorax (collapsed lung), certain types of pacemakers, untreated middle ear disease, or some chemotherapy agents may not be eligible. A pre-treatment medical screening is mandatory at any reputable Canadian facility. Health Canada also regulates which chambers can be used for medical treatment, and approved chambers must meet strict construction and safety standards. You can read more about Canadian medical device regulation on the Health Canada medical devices page.
Will HBOT help with brain fog, headaches, or sleep problems after a concussion?
This is the most common question Canada Hyperbarics receives from patients. The honest answer is: maybe. Some published studies show improvement in cognitive symptoms such as brain fog, attention, and memory, especially in patients with persistent post-concussion syndrome. Mood symptoms such as anxiety and depression have also improved in some cohorts. Headaches, dizziness, and noise sensitivity are less consistent and sometimes do not respond.
Patients should not expect a cure. They should expect a possibility of partial improvement that may make daily function easier, with response varying widely from person to person. Symptoms present for less than 12 months tend to respond more favourably in research cohorts than symptoms present for many years, although the 2025 Sagol cohort showed that recovery can still occur decades later in some patients.
Can HBOT help athletes recover from a sports concussion?
The evidence specific to athletes is limited. A 2025 narrative review in Undersea and Hyperbaric Medicine looked at HBOT use in elite athletes for both musculoskeletal injury and brain injury (Johnson-Arbor, 2025). The author concluded that animal studies show improved muscle healing and that some human data suggest faster return to play after soft tissue injury. For brain injury specifically, the review noted that data are limited but that HBOT may improve neurobehavioural symptoms in athletes with persistent concussion sequelae.
The same review raised an important warning. So-called mild HBOT, which uses portable soft chambers and lower pressures, is intended for altitude sickness only and is not authorised as a medical treatment for concussion or sports recovery. Patients should always confirm that any clinic uses a Health Canada-licensed chamber and a trained medical team.
How much does HBOT for concussion cost in Canada?
Because concussion is not on the Health Canada recognised indication list, provincial health plans (OHIP, MSP, AHCIP, RAMQ, and others) do not cover HBOT for this purpose. Patients pay out of pocket or through private insurance where coverage applies.
Per-session pricing in Canada generally ranges from a few hundred dollars to over five hundred dollars depending on the facility and chamber type. A full 40-session course can therefore cost several thousand to tens of thousands of dollars. Some private extended health plans may reimburse a portion of the cost when the treatment is delivered in a regulated facility under physician oversight. Always request a written treatment plan and pricing schedule before committing.
For broader information about coverage by province, see our coverage guide.
What questions should I ask a Canadian HBOT clinic before starting treatment?
Asking the right questions helps you tell a regulated medical provider apart from a wellness operator using a soft chamber. Use this short checklist before booking your first session:
- Is your hyperbaric chamber approved by Health Canada as a medical device?
- Who is the medical director, and are they trained in hyperbaric medicine?
- What is the operating pressure (in ATA) used for concussion patients?
- Do you require a referral or pre-treatment screening from a physician?
- What protocol do you recommend for my specific symptoms, and how many sessions?
- What is the total estimated cost, and is any portion eligible for private insurance reimbursement?
- What is your protocol if I experience ear pain, claustrophobia, or other side effects?
- Can you connect me with the published evidence supporting your protocol?
If a clinic cannot answer these clearly, look elsewhere. You can find verified hospitals and regulated facilities through Canada Hyperbarics on the facilities directory.
How do I get started with HBOT for concussion in Canada?
The recommended pathway is straightforward:
- Speak with your family physician or the specialist managing your concussion recovery
- Request a referral or written letter of medical necessity if your physician believes a trial of HBOT is reasonable
- Use the Canada Hyperbarics directory to find a hospital or regulated private facility near you
- Book a screening consultation, including ear, lung, and cardiac assessment
- Confirm the treatment plan, total cost, and any insurance reimbursement
- Begin the course at the recommended pressure, frequency, and duration, and complete the full series rather than stopping early
Canada Hyperbarics maintains an independent directory that lists hospitals and regulated facilities across all provinces. We do not own, operate, or refer to any specific clinic. You can browse facilities by province or by condition on our facilities page.
Where can I read more or find a facility near me?
If you want to keep researching, our public research bank contains thousands of full study summaries that you can search by condition. Our main FAQ page has plain-language answers to dozens of other common questions, and our facilities directory shows hospitals and regulated facilities across Canada that offer hyperbaric care.
Recovery from a concussion is rarely linear, and decisions about treatment should be made together with your physician based on your symptoms, history, and goals. If HBOT is something you want to consider, Canada Hyperbarics can help you find a regulated facility and the published evidence to bring to your next medical appointment.
This content is for informational purposes only and does not constitute medical advice. Hyperbaric oxygen therapy for concussion and traumatic brain injury is currently considered an emerging or off-label use in Canada and is not among Health Canada’s recognised conditions. Always consult a qualified healthcare professional before starting any treatment. Canada Hyperbarics is an independent information resource and does not own, operate, or refer to any specific clinic.