{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T05:42:42Z","timestamp":1774849362101,"version":"3.50.1"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sleep disturbances are common in aging, post-traumatic stress disorder (PTSD), and long COVID, often linked to neuroinflammation, autonomic dysregulation, and neurodegeneration. Hyperbaric oxygen therapy (HBOT) promotes neuroplasticity through the hyperoxic-hypoxic paradox, improving cerebral perfusion, mitochondrial function, and reducing inflammation. While HBOT benefits sleep in certain conditions, its general effects across clinical populations remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective longitudinal study evaluated Pittsburgh Sleep Quality Index (PSQI) changes in patients undergoing 60 HBOT sessions (2.0 ATA, 100% oxygen, 90\u202fmin, 5\u202fdays\/week) at the Sagol Center. Participants included individuals treated for healthy aging (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f180), long COVID (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f92), or PTSD (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f123). Pre- and post-treatment PSQI total and component scores were compared using paired t-tests and Wilcoxon signed-rank test was used for PSQI components. Regression analysis identified predictors of improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 395 patients (mean age at baseline 57.9\u202f\u00b1\u202f14.6\u202fyears, 31% female), baseline PSQI scores were highest in PTSD. Post-HBOT, total PSQI scores improved significantly in all groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001; Cohen\u2019s d\u202f=\u202f0.37\u20130.91). Significant gains were observed in subjective sleep quality, sleep latency, and disturbances in all groups; daytime dysfunction improved in aging and long COVID but not PTSD. Medication use was unchanged. Baseline PSQI was a strong predictor of improvement (B\u202f=\u202f0.494,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001, r\u202f=\u202f0.46). Those with disturbed sleep (PSQI&amp;gt;5) showed broad, statistically significant gains, while normal sleepers exhibited minimal changes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HBOT was associated with improvement in sleep quality across diverse conditions, with greatest benefit in patients with poorer baseline sleep. Findings support HBOT\u2019s potential as a sleep-modulating therapy, warranting controlled trials to characterize the patients that can benefit the most and elucidate mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1690633","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T04:10:59Z","timestamp":1774843859000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of hyperbaric oxygen therapy on sleep quality across diverse patient populations"],"prefix":"10.3389","volume":"17","author":[{"given":"Keren","family":"Doenyas-Barak","sequence":"first","affiliation":[{"name":"Yitzhak Shamir Medical Center","place":["Tel Aviv, Israel"]},{"name":"Faculty of Medical and Health Sciences, Gray School of Medicine, Tel Aviv University","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Elman Shina","sequence":"additional","affiliation":[{"name":"Yitzhak Shamir Medical Center","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erez","family":"Lang","sequence":"additional","affiliation":[{"name":"Yitzhak Shamir Medical Center","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shachar","family":"Finci","sequence":"additional","affiliation":[{"name":"Yitzhak Shamir Medical Center","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicktoria","family":"Elkarif","sequence":"additional","affiliation":[{"name":"Yitzhak Shamir Medical Center","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Shorer","sequence":"additional","affiliation":[{"name":"Yitzhak Shamir Medical Center","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shai","family":"Efrati","sequence":"additional","affiliation":[{"name":"Yitzhak Shamir Medical Center","place":["Tel Aviv, Israel"]},{"name":"Faculty of Medical and Health Sciences, Gray School of Medicine, Tel Aviv University","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11065-011-9156-z","article-title":"Sleep and the brain","volume":"21","author":"Colrain","year":"2011","journal-title":"Neuropsychol Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1146\/annurev-clinpsy-032813-153716","article-title":"The role of sleep in emotional brain function","volume":"10","author":"Goldstein","year":"2014","journal-title":"Annu Rev Clin Psychol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1038\/nrn.2017.55","article-title":"The sleep-deprived human brain","volume":"18","author":"Krause","year":"2017","journal-title":"Nat Rev Neurosci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"219056","DOI":"10.4061\/2011\/219056","article-title":"Sleep disturbances associated with Parkinson\u2032 s disease","volume":"2011","author":"Suzuki","year":"2011","journal-title":"Parkinson\u2019s Disease"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2976","DOI":"10.4103\/0366-6999.247210","article-title":"Management recommendations on sleep disturbance of patients with Parkinson\u2019s disease","volume":"131","author":"Liu","year":"2018","journal-title":"Chin Med J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/S0272-7358(03)00032-1","article-title":"Sleep and posttraumatic stress disorder: a review","volume":"23","author":"Harvey","year":"2003","journal-title":"Clin Psychol Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.sleep.2021.07.021","article-title":"Sleep disorders and COVID-19","volume":"91","author":"Bhat","year":"2022","journal-title":"Sleep Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"929480","DOI":"10.3389\/fneur.2022.929480","article-title":"Sleep alterations following COVID-19 are associated with both neuroinflammation and psychological disorders, although at different times","volume":"13","author":"Pellitteri","year":"2022","journal-title":"Front Neurol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.neuron.2017.02.004","article-title":"Sleep and human aging","volume":"94","author":"Mander","year":"2017","journal-title":"Neuron"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/B978-0-444-53752-2.00012-6","article-title":"Age-related changes in the cognitive function of sleep","volume":"191","author":"Pace-Schott","year":"2011","journal-title":"Prog Brain Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e19002","DOI":"10.1371\/journal.pone.0019002","article-title":"Short-term complexity of cardiac autonomic control during sleep: REM as a potential risk factor for cardiovascular system in aging","volume":"6","author":"Viola","year":"2011","journal-title":"PLoS One"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1186\/1471-2458-9-130","article-title":"Sleep quality in middle-aged and elderly Chinese: distribution, associated factors and associations with cardio-metabolic risk factors","volume":"9","author":"Haseli-Mashhadi","year":"2009","journal-title":"BMC Public Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1450134","DOI":"10.3389\/fneur.2024.1450134","article-title":"Hyperbaric oxygen therapy as a neuromodulatory technique: a review of the recent evidence","volume":"15","author":"Bin-Alamer","year":"2024","journal-title":"Front Neurol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1586\/14737175.2014.884928","article-title":"Reflections on the Neurotherapeutic Effects of hyperbaric Oxygen","volume":"14","author":"Efrati","year":"2014","journal-title":"Expert Rev Neurother"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3390\/biom10060958","article-title":"The Hyperoxic-hypoxic paradox","volume":"10","author":"Hadanny","year":"2020","journal-title":"Biomolecules"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e0264161","DOI":"10.1371\/journal.pone.0264161","article-title":"Hyperbaric oxygen therapy improves symptoms, brain's microstructure and functionality in veterans with treatment resistant post-traumatic stress disorder: a prospective, randomized, controlled trial","volume":"17","author":"Doenyas-Barak","year":"2022","journal-title":"PLoS One"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"24m15464","DOI":"10.4088\/JCP.24m15464","article-title":"Hyperbaric oxygen therapy for veterans with combat-associated posttraumatic stress disorder: a randomized, sham-controlled clinical trial","volume":"85","author":"Doenyas-Barak","year":"2024","journal-title":"J Clin Psychiatry"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2495","DOI":"10.3389\/fpsyg.2018.02495","article-title":"Hyperbaric oxygen therapy can induce neuroplasticity and significant clinical improvement in patients suffering from fibromyalgia with a history of childhood sexual abuse-randomized controlled trial","volume":"9","author":"Hadanny","year":"2018","journal-title":"Front Psychol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"11252","DOI":"10.1038\/s41598-022-15565-0","article-title":"Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial","volume":"12","author":"Zilberman-Itskovich","year":"2022","journal-title":"Sci Rep"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"943","DOI":"10.3233\/RNN-150585","article-title":"Hyperbaric oxygen may induce angiogenesis in patients suffering from prolonged post-concussion syndrome due to traumatic brain injury","volume":"33","author":"Tal","year":"2015","journal-title":"Restor Neurol Neurosci"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1037\/neu0000149","article-title":"Improvement of memory impairments in poststroke patients by hyperbaric oxygen therapy","volume":"29","author":"Boussi-Gross","year":"2015","journal-title":"Neuropsychology"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e53716","DOI":"10.1371\/journal.pone.0053716","article-title":"Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial","volume":"8","author":"Efrati","year":"2013","journal-title":"PLoS One"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"13740","DOI":"10.18632\/aging.103571","article-title":"Cognitive enhancement of healthy older adults using hyperbaric oxygen: a randomized controlled trial","volume":"12","author":"Hadanny","year":"2020","journal-title":"Aging (Albany NY)"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e081642","DOI":"10.1136\/bmjopen-2023-081642","article-title":"Hyperbaric oxygen therapy for poststroke insomnia: a systematic review and meta-analysis protocol","volume":"14","author":"Shi","year":"2024","journal-title":"BMJ Open"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1080\/01616412.2016.1275454","article-title":"Hyperbaric oxygen therapy is safe and effective for the treatment of sleep disorders in children with cerebral palsy","volume":"39","author":"Long","year":"2017","journal-title":"Neurol Res"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.sleep.2018.06.006","article-title":"Sleep assessment in a randomized trial of hyperbaric oxygen in US service members with post concussive mild traumatic brain injury compared to normal controls","volume":"51","author":"Walker","year":"2018","journal-title":"Sleep Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1328911","DOI":"10.3389\/fneur.2024.1328911","article-title":"Efficacy of hyperbaric oxygen therapy as an adjunct therapy in the treatment of sleep disorders among patients with Parkinson\u2019s disease: a meta-analysis","volume":"15","author":"Tan","year":"2024","journal-title":"Front Neurol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1159\/000542619","article-title":"Hyperbaric oxygen therapy improves motor symptoms, sleep, and cognitive dysfunctions in Parkinson\u2019s disease","volume":"54","author":"Bu","year":"2025","journal-title":"Dement Geriatr Cogn Disord"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1259473","DOI":"10.3389\/fnins.2023.1259473","article-title":"The use of hyperbaric oxygen for veterans with PTSD: basic physiology and current available clinical data","volume":"17","author":"Doenyas-Barak","year":"2023","journal-title":"Front Neurosci"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.smrv.2015.01.009","article-title":"The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: a systematic review and meta-analysis","volume":"25","author":"Mollayeva","year":"2016","journal-title":"Sleep Med Rev"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/S0022-3999(02)00330-6","article-title":"Test-retest reliability and validity of the Pittsburgh sleep quality index in primary insomnia","volume":"53","author":"Backhaus","year":"2002","journal-title":"J Psychosom Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1046\/j.1365-201x.2000.00761.x","article-title":"Hyperbaric oxygen increases parasympathetic activity in professional divers","volume":"170","author":"Lund","year":"2000","journal-title":"Acta Physiol Scand"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.3390\/biom11121827","article-title":"Hyperbaric oxygen treatment: effects on mitochondrial function and oxidative stress","volume":"11","author":"Schottlender","year":"2021","journal-title":"Biomolecules"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40798-021-00403-w","article-title":"Effects of hyperbaric oxygen therapy on mitochondrial respiration and physical performance in middle-aged athletes: a blinded, randomized controlled trial","volume":"8","author":"Hadanny","year":"2022","journal-title":"Sports Medicine-Open"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.3390\/biom11081210","article-title":"The effects of hyperbaric oxygenation on oxidative stress, inflammation and angiogenesis","volume":"11","author":"De Wolde","year":"2021","journal-title":"Biomolecules"},{"key":"ref36","first-page":"233","volume-title":"Reflections on the Neurotherapeutic Effects of Hyperbaric Oxygen","author":"Efrati","year":"2014"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"508","DOI":"10.3389\/fnhum.2017.00508","article-title":"Hyperbaric oxygen therapy can induce angiogenesis and regeneration of nerve fibers in traumatic brain injury patients","volume":"11","author":"Tal","year":"2017","journal-title":"Front Hum Neurosci"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1080\/00207450212027","article-title":"Improvement in cerebral metabolism in chronic brain injury after hyperbaric oxygen therapy","volume":"112","author":"Golden","year":"2002","journal-title":"Int J Neurosci"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"102733","DOI":"10.1016\/j.conb.2023.102733","article-title":"Mitochondrial control of sleep","volume":"81","author":"Hartmann","year":"2023","journal-title":"Curr Opin Neurobiol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"929386","DOI":"10.3389\/fneur.2022.929386","article-title":"Hyperbaric oxygen therapy promotes consciousness, cognitive function, and prognosis recovery in patients following traumatic brain injury through various pathways","volume":"13","author":"Chen","year":"2022","journal-title":"Front Neurol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1340117","DOI":"10.3389\/fnagi.2024.1340117","article-title":"Enriched oxygen improves age-related cognitive impairment through enhancing autophagy","volume":"16","author":"Wang","year":"2024","journal-title":"Front Aging Neurosci"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"431","DOI":"10.2147\/IJGM.S172460","article-title":"Hypoxia and hyperbaric oxygen therapy: a review","volume":"11","author":"Choudhury","year":"2018","journal-title":"Int J General Med"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1951","DOI":"10.3390\/ijms20081951","article-title":"Dose-dependent effect of hyperbaric oxygen treatment on burn-induced neuropathic pain in rats","volume":"20","author":"Wu","year":"2019","journal-title":"Int J Mol Sci"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1447742","DOI":"10.3389\/fneur.2024.1447742","article-title":"Optimizing hyperbaric oxygen therapy for PTSD-the importance of dose and duration for sustained benefits","volume":"15","author":"Doenyas-Barak","year":"2024","journal-title":"Front Neurol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"132","DOI":"10.4103\/mgr.MEDGASRES-D-24-00029","article-title":"Why provide 40 sessions of hyperbaric oxygen therapy to patients with traumatic brain injury?","volume":"15","author":"Borlongan","year":"2025","journal-title":"Med Gas Res"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e094386","DOI":"10.1136\/bmjopen-2024-094386","article-title":"Ten sessions of hyperbaric oxygen versus sham treatment in patients with long covid (HOT-LoCO): a randomised, placebo-controlled, double-blind, phase II trial","volume":"15","author":"Kjellberg","year":"2025","journal-title":"BMJ Open"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"25009","DOI":"10.1038\/s41598-025-09978-w","article-title":"Relationship between pain, quality of sleep, sleep bruxism and patients\u2019 personality among individuals with reported orofacial pain","volume":"15","author":"Orzeszek","year":"2025","journal-title":"Sci Rep"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"549","DOI":"10.17219\/dmp\/177008","article-title":"Assessment of sleep quality in patients with orofacial pain and headache complaints: a polysomnographic study","volume":"61","author":"Orzeszek","year":"2024","journal-title":"Dental Med Problems"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1690633\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T04:11:02Z","timestamp":1774843862000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1690633\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":48,"alternative-id":["10.3389\/fneur.2026.1690633"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1690633","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"article-number":"1690633"}}