Abstract

Background: Hyperbaric Oxygen Therapy (HBOT) has been increasingly investigated for its potential role in modulating neurophysiological mechanisms associated with sleep regulation. This study aimed to systematically evaluate the effects of HBOT on sleep quality through a systematic review and metaanalysis of Randomized Controlled Trials (RCTs).
Methods: Electronic databases, including PubMed, ScienceDirect, Ovid, the Cochrane Library, and Google Scholar, were searched to identify eligible studies comparing HBOT with control interventions and assessing sleep quality.
Results: A total of four RCTs involving 243 participants were included. Pooled analysis using a randomeffects model demonstrated no statistically significant difference in global PSQI scores between HBOT and control groups (mean difference=-0.03; 95% CI, (-5.42, 5.36); p=0.99). Subgroup analysis based on treatment pressure revealed no significant difference between <2 ATA and ≥2 ATA (p=0.15). However, a trend toward greater improvement was observed in the <2 ATA subgroup (mean difference=-3.01; 95% CI, (-6.14, 0.11); p=0.06), whereas no significant effect was found in the ≥2 ATA subgroup (mean difference=-0.23; 95% CI, (-2.30, 1.84); p=0.83). Sensitivity analysis excluding the study contributing most to heterogeneity yielded consistent non-significant results (mean difference=-2.09; 95% CI, (-4.85, 0.67); p=0.14).
Conclusion: Current evidence does not support a statistically significant overall effect of HBOT on sleep quality. Observed variability may be attributed to differences in clinical populations and treatment protocols. Further large-scale, well-designed RCTs with standardized HBOT protocols are warranted to clarify its therapeutic role in sleep modulation.

Keywords:Hyperbaric oxygen therapy; Sleep quality; PSQI

Abbreviations: ATA: Atmospheres Absolute; CI: Confidence Interval; HBOT: Hyperbaric Oxygen Therapy; I²: I-Squared Statistic; MD: Mean Difference; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PSQI: Pittsburgh Sleep Quality Index; RCT: Randomized Controlled Trials