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HBOT for Veterans: How Hyperbaric Oxygen Therapy Is Treating TBI and PTSD

June 13, 2026 · RxAir360 Editorial Team

Every day in the United States, an estimated 17.5 veterans die by suicide, according to the VA's 2025 National Veteran Suicide Prevention Annual Report. Behind that number are invisible wounds — traumatic brain injuries sustained from blast exposure, PTSD rooted in combat trauma, and neurological damage that standard treatments have struggled to fully address. For a growing number of veterans, hyperbaric oxygen therapy is offering something they had stopped expecting: measurable improvement.

This post covers what the research actually says about HBOT for veterans — not anecdote, not hype, but peer-reviewed clinical evidence. It also covers how RxAir360 and our CARE nonprofit are working to make this treatment more accessible for those who served.

The Invisible Wounds Veterans Carry Home

Modern warfare has changed the nature of combat injury. While physical wounds are visible and treatable, the neurological damage caused by blast exposure — improvised explosive devices, artillery, and repeated concussive events — often goes undetected on standard imaging.

Traumatic brain injury (TBI) is now recognized as the signature wound of the conflicts in Iraq and Afghanistan. An estimated 414,000 service members have been diagnosed with TBI since 2000. Many more go undiagnosed. Symptoms include chronic headaches, memory loss, difficulty concentrating, irritability, sleep disruption, and cognitive decline — often persisting for years or decades after the initial injury.

Post-traumatic stress disorder (PTSD) affects an estimated 11 to 20 percent of veterans who served in Operation Iraqi Freedom and Operation Enduring Freedom. It manifests as hypervigilance, flashbacks, emotional numbing, and social withdrawal — and it frequently co-occurs with TBI, making both conditions harder to treat in isolation.

Standard treatments — psychotherapy, medication, cognitive behavioral therapy — are valuable and necessary. But for many veterans, particularly those with underlying neurological damage, these approaches address the symptoms without reaching the root cause. That gap is where HBOT research has focused its attention.

How HBOT Works on the Brain

To understand why hyperbaric oxygen therapy is being studied for TBI and PTSD, you first need to understand what these conditions do to the brain at a cellular level.

Blast-induced TBI causes a cascade of damage that unfolds over time. The initial pressure wave disrupts neural pathways. Inflammation follows. Blood flow to affected regions decreases. Neurons that are not outright destroyed enter a state called "idling" — they are alive but not functioning, starved of the oxygen they need to fire properly.

HBOT addresses this at its source. Inside a pressurized chamber, oxygen dissolves directly into blood plasma at levels that cannot be achieved by breathing normal air. That oxygen-rich blood reaches areas of the brain with compromised circulation — the exact regions that blast injury tends to affect most severely.

The biological responses triggered by HBOT include:

  • Neuroplasticity — stimulating the brain to form new neural connections around damaged areas
  • Angiogenesis — growing new blood vessels to restore circulation to oxygen-deprived tissue
  • Reduced neuroinflammation — lowering the chronic inflammatory response that perpetuates TBI symptoms
  • Stem cell mobilization — releasing stem cells from bone marrow that migrate to damaged brain tissue
  • Gene expression changes — HBOT has been shown to activate biological pathways involved in tissue repair, anti-inflammation, and neurological recovery, an area of active clinical investigation

For PTSD, the mechanism is related but distinct. Research suggests that PTSD with an underlying neurological component — which is common in combat veterans — responds differently to treatment than PTSD without brain injury. HBOT may help by repairing the neurological substrate that is driving emotional dysregulation, hypervigilance, and intrusive memory — making psychological therapy more effective when combined.

What the Clinical Research Says

The evidence base for HBOT in veteran TBI and PTSD has grown substantially over the past decade. Several landmark studies have shaped how clinicians think about this treatment.

Dr. Paul G. Harch — Journal of Neurotrauma, 2011

16 active duty and retired veterans with blast-induced TBI received 40 HBOT sessions over one month. All 16 had sustained their injuries at least three years prior and suffered from post-concussion syndrome and PTSD. After treatment, veterans showed significant improvement in post-concussion symptoms including headaches and cognitive function, increased cerebral blood flow on imaging, and improved quality of life. Cognitive gains averaged nearly a 15-point improvement on IQ testing. PTSD symptoms also improved — an outcome not targeted by the protocol.

Dr. Paul G. Harch — Medical Gas Research, 2017

30 patients with chronic post-concussion syndrome, with or without PTSD, received HBOT treatment. Results showed significant improvement in neurological exam scores, IQ, memory, attention, and quality of life measures. The study reinforced earlier findings and expanded the evidence base for HBOT in chronic neurological injury.

U.S. Senate Committee on Veterans' Affairs Testimony, August 2025

Colonel James K. Wright, MD (USAF, Ret.) testified that HBOT affects more than 8,100 known human genes and thousands of cellular processes, and presented evidence supporting its use for TBI, PTSD, and spinal cord injury in veterans. The testimony marked a significant moment in the policy conversation around veteran access to HBOT.

Important context

HBOT is not currently FDA-cleared specifically for TBI or PTSD. The research cited here represents promising clinical evidence from peer-reviewed studies. Veterans interested in HBOT should discuss it with their physician or VA care team. RxAir360 does not make claims of treating PTSD or TBI beyond what FDA clearance supports.

VA Coverage and Access: Where Things Stand in 2026

Despite a growing body of research, the Department of Veterans Affairs has not broadly approved HBOT as a covered treatment for TBI or PTSD. Coverage remains limited to specific FDA-cleared indications, and access to hyperbaric facilities through the VA system is inconsistent across regions.

This gap between evidence and access is one of the most significant challenges facing veterans seeking HBOT. Fewer than 1,400 hyperbaric facilities exist nationwide — and most are hospital-based, concentrated in urban centers, and not easily accessible to veterans in rural or underserved communities.

The practical result is that many veterans who could benefit from HBOT either cannot find a nearby facility, cannot afford out-of-pocket costs without VA coverage, or are simply unaware the treatment exists.

Advocacy organizations, researchers, and now medical device companies like RxAir360 are working to change that picture — both through policy advocacy and through expanding the infrastructure that makes HBOT physically accessible.

RxAir360 and the CARE Nonprofit — Expanding Veteran Access

RxAir360 was founded on a belief that geography and economics should not determine who has access to evidence-based medical treatment. That belief extends directly to veterans.

C.A.R.E. — Children Are Really Everything is RxAir360's registered 501(c)(3) nonprofit arm. While CARE's primary mission focuses on expanding HBOT access for uninsured and underinsured children, the organization's broader mandate aligns directly with the veteran access challenge — bringing hyperbaric therapy to communities that the current system leaves behind.

As RxAir360 advances toward FDA 510(k) clearance and commercial deployment, the physician-office model we are building is uniquely positioned to address veteran access. A monoplace chamber that fits in a standard exam room can be deployed in VA community clinics, private practices near military bases, and veteran health centers — settings that currently have no hyperbaric capability at all.

Every physician office that adds an RxAir360 chamber is a new point of access. That is the model. That is the mission.

Frequently Asked Questions

Does the VA cover hyperbaric oxygen therapy for TBI or PTSD?

Currently, VA coverage for HBOT is limited to specific FDA-cleared indications. TBI and PTSD are not among those cleared indications, meaning VA coverage for these conditions is not standard. Some veterans access HBOT through private pay, nonprofit programs, or clinical trials. The policy landscape is evolving as research accumulates.

How do veterans access HBOT?

Veterans can access HBOT through private hyperbaric centers, some VA facilities that have hyperbaric units for other indications, nonprofit organizations that subsidize treatment, and clinical trials studying HBOT for TBI and PTSD. A physician referral is required. Veterans should discuss options with their primary care provider or VA care team.

How many HBOT sessions do veterans typically need for TBI or PTSD?

Research protocols have varied, but most studies have used between 40 and 80 sessions. Dr. Harch's landmark 2011 study used 40 sessions over approximately one month. Treatment protocols are individualized and should be determined by a qualified physician based on the severity and chronicity of the condition.

Is HBOT safe for veterans with blast-induced TBI?

Clinical studies to date have reported a strong safety profile for HBOT in veterans with blast-induced TBI. Common side effects are mild — primarily ear pressure during pressurization. Serious adverse events have been rare in published research. All HBOT must be administered under physician supervision following established safety protocols.

What is the RxAir360 CARE nonprofit and how does it help veterans?

C.A.R.E. (Children Are Really Everything) is RxAir360's 501(c)(3) nonprofit dedicated to expanding hyperbaric oxygen therapy access for underserved populations. While the organization's core mission focuses on children, its broader mandate supports expanded HBOT access across communities that lack it — including veteran populations. Learn more at rxair360inc.com/rxair-cares.

Understanding Hyperbaric Oxygen Therapy — Series

Learn about the CARE nonprofit mission

C.A.R.E. — Children Are Really Everything — is RxAir360's 501(c)(3) nonprofit expanding hyperbaric oxygen therapy access for underserved populations across Texas and beyond.

About RxAir360

RxAir360 Inc. is a Bellaire, Texas medical device company developing the first patented vertical monoplace hyperbaric oxygen therapy chamber designed for physician offices. Manufactured by Electroimpact — precision engineering partners for Boeing and Airbus — the RxAir360 chamber is pending FDA 510(k) clearance. The company's nonprofit arm, C.A.R.E., is a registered 501(c)(3) dedicated to expanding HBOT access for underserved populations.

RxAir360 manufactures the chamber; all clinical protocols and patient treatment decisions are determined exclusively by the licensed physician overseeing care.

rxair360inc.com 5555 W Loop South, Suite 150, Bellaire TX 77401 (240) 640-4560