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11 October 2026Your first HBOT session should feel calm, safe and well supervised. This practical guide walks through screening, what to wear, each stage of the session, ear comfort, aftercare, side effect rates and how to choose a facility. It is the safety and practicalities article in our hyperbaric oxygen therapy series; for what the research reports, see the benefits article. For the chamber itself, visit the HBOT page.
Table of Contents
- Key Points
- Before You Come: Screening and Preparation
- What to Wear and What to Leave Out
- During the Session
- Easing Ear Pressure
- After the Session
- Possible Side Effects
- Who Should Check First
- Sports Examples With Evidence: What an Athlete Session Looks Like
- Choosing a Facility
- Frequently Asked Questions
- Sources
Key Points
- Screening comes first: a good facility reviews your medical history, medications and current health before session one.
- Ear pressure is the most common effect, and in a review of 5,962 patients about 69% of middle-ear barotrauma cases were the mildest grade.
- Safety rules are strict because the chamber contains enriched oxygen.
- Sessions typically last 60 to 90 minutes, and most people return to normal activities straight away.
- Reviews describe HBOT as one of the safest therapies in use today when screening and protocols are followed.
Before You Come: Screening and Preparation
A good facility will ask about your medical history, medications and current health before your first session. Be open about anything relevant, including recent colds or sinus problems, lung conditions, seizures, pregnancy and any treatment you are receiving. If you are under specialist care, check with your doctor first. Eat a light meal, stay hydrated and avoid arriving with a blocked nose or active cold, since congestion makes ear equalisation harder.
What to Wear and What to Leave Out
Because the chamber contains enriched oxygen, safety rules are strict. Typically you will be asked to:
- Wear clean, comfortable cotton clothing.
- Remove electronic devices, lighters and other ignition sources.
- Avoid oil-based products, heavy perfume or hair products, and makeup.
- Remove jewellery and anything with batteries.
Your therapist will confirm the exact list when you arrive.
During the Session
- Pressurisation: pressure builds gradually and you may notice slight warmth and ear fullness.
- Treatment: pressure stays steady while you breathe oxygen. Most people read, listen to music or rest.
- Depressurisation: pressure eases back to normal, and your ears may “pop” again.
A session typically takes around 60 to 90 minutes. The science behind each stage is in how does hyperbaric oxygen therapy work.
Easing Ear Pressure
Ear discomfort is the most common issue and feels similar to a flight. Helpful tips include swallowing, yawning, sipping water and gently moving your jaw as the pressure rises. If discomfort continues, tell the operator so the pressure change can be paused. Never force your ears. The clinical review notes that most middle-ear barotrauma is mild and self-limiting, and that patient coaching on equalising and appropriate compression rates are the main ways it is prevented.
After the Session
Most people go straight back to normal activities. Some feel relaxed, a little sleepy or hungry, while others feel energised. Drink water, eat well and note how you feel so you can share it with your provider before your next session.
Possible Side Effects
A review of HBOT side effects groups them into barotrauma, central nervous system and pulmonary oxygen toxicity, and ocular effects, and concludes that HBOT remains among the safest therapies used today. In an Italian analysis of 5,962 patients, middle-ear barotrauma cases were usually minor, with about 69% at the mildest grade.
| Effect | How common | Notes |
|---|---|---|
| Ear pressure or discomfort | Most common | Usually mild and managed with equalising |
| Sinus pressure | Occasional | More likely with congestion |
| Temporary change in eyesight | Uncommon | Linked to longer courses and usually settles |
| Claustrophobic feeling | Occasional | Tell staff beforehand so they can help |
| Oxygen toxicity or lung injury | Rare | Reduced through correct protocols and supervision |
Who Should Check First
Do not take part if you have an untreated collapsed lung (pneumothorax). Speak to your doctor before starting if you have a current respiratory infection, high fever, a history of seizures, significant lung disease, are pregnant, or take certain medications or chemotherapy drugs. Screening is there to protect you, so answer honestly.
Sports Examples With Evidence: What an Athlete Session Looks Like
If you train, it helps to know what a research-style session involves. In a 2025 single-blind crossover trial, healthy male university students who exercised regularly cycled at moderate intensity, then received one session of HBOT (2.5 ATA for 60 minutes) or an air placebo, with fatigue rated at five time points through the next 24 hours. The design is typical of athlete studies: a single hour in the chamber straight after a workout, with simple checks afterwards. Ask your provider which pressure and schedule they use, and see cold recovery for athletes if you are comparing recovery tools.
Choosing a Facility
Start with the FDA’s guidance (a provider’s recommendation, plus a facility inspected and accredited by the Undersea and Hyperbaric Medical Society), then use this checklist:
- Do they screen you before your first session?
- Is trained staff on site throughout?
- Are the safety rules clear and consistently enforced?
- Do they explain honestly what HBOT can and cannot do?
You can read about the clinical team on the Medical Leadership page.
Frequently Asked Questions
Is HBOT painful?
No. The main sensation is ear fullness, which swallowing or yawning relieves.
Can I bring a book or phone?
Books are usually fine, but electronic devices are normally not allowed inside the chamber. Ask your therapist beforehand.
How often is HBOT used?
It depends on the goal. Wellness research protocols commonly use repeated sessions over weeks to months, and your provider will recommend a schedule after screening.
Can I go back to work afterwards?
Most people resume normal activities straight away.
What if my ears will not clear?
Tell the operator straight away so the pressure change can be paused, and never force your ears.
Sources
- U.S. Food and Drug Administration. Hyperbaric oxygen therapy: get the facts (consumer bulletin).
- Heyboer M et al. Hyperbaric oxygen therapy: side effects defined and quantified. Advances in Wound Care, 2017.
- Middle ear barotrauma during hyperbaric oxygen therapy: a review of occurrences in 5,962 patients. Undersea and Hyperbaric Medicine, 2019.
- Yagishita K et al. Effect of one session of hyperbaric oxygen (2.5 ATA for 60 min) after moderate-intensity exercise on fatigue: a single-blind crossover randomized trial. Frontiers in Sports and Active Living, 2025.
This article is for general information and is not medical advice. Please consult a qualified doctor before starting any new therapy.