How HBOT Works?

Incorporating Hyperbaric Oxygen Therapy into a Functional Medicine Practice

by Drs. Jason and Melissa Sonners


Humans have very few absolute requirements for life; food, water, and oxygen. Well, especially in this group of people, we understand that we can go weeks (even months) without food, but we can only live a few days without water ultimately only a few minutes without oxygen. Proper oxygen levels is something our body literally needs every minute of everyday just to perform “normal” functions. If we look at oxygen through this lens, we begin to understand the role of oxygen not only as a gas, but as an essential nutrient. Like any other nutrient our body needs, there are times we may become deficient and this deficiency has consequences. Likewise, there may be times we want or need to get more the typical daily amount of oxygen required in order to help our body heal. The same way we might take “extra” vitamin C if we were getting a cold, there are time we would want “extra” oxygen to improve our ability to heal.

“Normal Oxygenation” 

Under normal circumstances, oxygen is transported throughout the body only by red blood cells. Assuming no cardiovascular or respiratory diseases, we are already carrying just about all the oxygen we are capable of carrying. Most of us are already between 96-99% saturated with oxygen. That said, learning how to maximize the remaining 1-4% of oxygen saturation can be very meaningful for optimizing function. Beyond that developing tools, techniques or other method of improving the rate and efficiency we oxygenate can have a powerful impact on our over health. Training at altitude (a legal strategy) and blood doping (not legal) are two techniques athletes have used to improve their oxygenation because they understand the massive benefits on performance, recovery and healing when we have access to increased oxygen!

Methods for Improving Oxygenation

Breathing techniques

We are designed to take in long, slow belly breaths using our diaphragm. If you ever watched a newborn breath, you’ll know what I’m talking about. Many of us however, live over-stressed lives. As a result, and without realizing it, many of us take very shallow chest breaths all day long.

This does 2 things:

1. Limits the amount of air and oxygen we are able to get into our lungs
2. Perpetuates the fight or flight bio-chemistry of the stress response.

Learning powerful breathing techniques (Fulford Breathing, Wim Hof Technique, even simple belly breathing techniques) will help to reduce the stress response so many of us deal everyday and equally important will maximize your lung capacity and oxygen absorption with each breath you take.

Pros: decreased stress response, improved relaxation, improved lung capacity, improved oxygenation

Cons: NONE

Exercise With Oxygen Therapy (EWOT)

The concept here is to improve oxygenation through increasing both oxygen demand and oxygen supply.


In this technique we are increasing demand through exercise. As we exercise our heart rate and breathing rate will both increase. The main reason for this change in rate is to increase the quantity of oxygen delivery to the working muscles supplying them with the fuel they need to keep moving.


As far as supply goes, we are using oxygen concentrators rather than ambient air as the oxygen source. Air is 21% oxygen which typically does supply us with enough oxygen for daily life but breathing through an oxygen concentrator we can breath 97% oxygen thereby increasing supply. The overall process here is that we create an increased oxygen demand through heavy exercise, usually through a bike, and then we massively increase the oxygen supply by breathing much higher levels of oxygen throughout the duration of that exercise session. This increases the saturation, the rate and amount of oxygen that our red blood cells can deliver to the working tissue helping to create an oxygen surplus.

Pros: Increased oxygen turn over, increased oxygen delivery, increased oxygen saturation.

Cons: Need to be able to exercise at a level meaningful to create the demand which depends on your health and ability or that of your patients. Also still relies on red blood cell carrying capacity Oxygen Deprivation Tents/Masks The theory here is similar to training at altitude. When we are exposed to low oxygen environments (like altitude) our body senses suboptimal oxygen levels and mild hypoxia. The response to that is an increase in red blood cell production. More red blood cells equal more oxygen carriers.

Pros: Increased red blood cell quantity which will increase the amount of oxygen able to be carried.

Cons: In order for this system to work the body needs to be in this low oxygen environment very consistently and for many hours each day. Also the amount of increased red blood cells is dependent on the amount of time spent in the oxygen deprived environment.

Hyperbaric Oxygen Therapy (HBOT)?

HBOT is a treatment which enhances the body’s natural healing process by inhalation of oxygen in a pressurized environment. Breathing in a pressurized environment allows our body to absorb more oxygen than any other tool on the market. Hyperbaric oxygen therapy (HBOT) is rapidly growing in popularity as a natural treatment used to help a large variety of conditions, usually as a part of a functional medicine care plan.

Pros: Very high increase in oxygen absorption, well beyond red blood cell carrying capacity. Passive therapy, almost anyone can receive this therapy

Cons: Sessions can be long, 30-90 minutes depending on patient needs.

How Does HBOT work?

With HBOT, oxygen is dissolved into all of the body’s fluids, the plasma, the central nervous system fluids, the lymph, and the bone and can be carried to areas where circulation is diminished or blocked. Breathing oxygen under pressure (depending on the amount of pressure and duration of the treatment) we can absorb not the 1-3% as mentioned above but actually between 20-60% more oxygen. In this way, extra oxygen can reach all of the damaged tissues and the body can support its own healing process.

The increased oxygen greatly enhances the ability of white blood cells to kill bacteria, reduces swelling and inflammation, allows new blood vessels to grow more rapidly into the affected areas, improves oxygenation of poor blood flow areas like joints, ligaments and spinal discs, stimulates neuroplasticity, improves cognition, aids detoxification, increases mitochondrial efficiency and density making more ATP production possible, and so much more.  It is a simple, non-invasive and painless treatment with incredible results. It has long been known that proper healing of the body cannot take place without appropriate oxygen levels in the tissue.  Most illnesses and injuries occur, and often linger, at the cellular or tissue level due to the microcirculation damage associated with the damage.  Even in traditional medicine HBOT is used to help heal in really tough cases of anaerobic infections like Gangrene and osteomyelitis, non-healing wounds and radiation burns, diabetic neuropathy osteonecrosis. In all of these cases, circulatory damage, chronic inflammation and infection are preventing the body’s ability to heal because adequate oxygen cannot reach the damaged area.  Even in these very difficult to treat, often life-threatening cases hyperbaric oxygen therapy provides these patients with the extra oxygen they need to heal naturally and with minimal, often no side effects.

What are we using HBOT for in our offices?

For the same way HBOT helps with these acute, complex and difficult cases, it helps the exact same way with less intense but more chronic conditions. The mechanisms of inflammation, circulatory damage and often immune dysregulation exist in most of our chronic diseases as well. We have been successfully treating patients with hyperbaric oxygen therapy for more than a decade, focusing primarily on conditions such as:

Cerebral palsy
Chronic fatigue
Lyme Disease
Multiple Sclerosis/ALS
Post-surgical care and healing

And many more…

For More on HBOT…Check out this video!

Our company, HBOT USA, works to bring hyperbaric oxygen therapy to the widest possible audience. We are committed to education and implementation strategies for clinics wanting to utilize hyperbaric therapy as well as improving access for patients in need of this modality. We rent and sell chambers to patients for in-home use and to providers for use in their clinics. In addition, we offer programs to help providers build and run HBOT facilities. We’re happy to answer any questions about hyperbaric oxygen therapy in general as well as the specifics of how to run a successful HBOT practice.

Drs. Jason and Melissa Sonners are co-owners of HBOT USA.

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