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Hyperbaric Oxygen Therapy for Autism

December 2, 2020


Justin Bieber sleeps in a hyperbaric oxygen chamber. He has one at home and one at his studio. No, if you are wondering, JB has never been diagnosed with autism.

Hyperbaric Oxygen Therapy for AutismHe says he uses the therapy to rid his body of toxins and decrease anxiety by supplying more oxygen to the brain.

Consumer interest in HBOT therapy is high with promising results for anxiety and depression, as in the case of JB, and Alzheimer’s, and autism, among others.

Hyperbaric oxygen therapy chambers were initially used to treat decompression sickness experienced by deep-sea divers.

Today, the chambers are leveraged in diverse medical functions, including an intervention after carbon monoxide poisoning and smoke inhalation.

The therapy is also used in:

  • Treatment of stubborn wounds
  • Treatment of gangrene
  • Alzheimer’s and other mental conditions
  • Treatment of decompression sickness
  • Traumatic inadequate blood flow
  • Bone infections
  • Delayed radiation injury

As a solution for cognitive and motor skills improvement in old age, a new study has demonstrated positive results for hyperbaric oxygen therapy (HBOT).

The pilot study, a collaboration between the Sagol Center for Hyperbaric Medicine and Research and the Sagol School of Neuroscience at Tel Aviv University, found that hyperbaric oxygen therapy (HBOT) can significantly improve cognitive performance in healthy older adults. Key areas of improvement following the therapy included:

  • Attention and focus
  • Information processing speed
  • Cognitive function tests

In any person, these abilities tend to decline with age. The study found that HBOT significantly boosted cognitive performance by improving cerebral blood flow in specific brain locations.

This study is the first glimmer of hope regarding hyperbaric chamber therapy for autism. The reason is that there are significant overlaps between old-age related symptoms (decline in cognitive and motor skills) and the symptoms of autism in children and adults.

What is hyperbaric oxygen therapy (HBOT)?

In an HBOT therapy session, the patient gets in a pressurized oxygen chamber where they breathe in pure oxygen. In this chamber, the air pressure is doubled to twice that of normal air we breathe on the outside. The therapy raises oxygen solubility in the blood, which reaches the brain and the rest of the body.

Increased oxygen stimulates and accelerates oxygen-dependent bodily functions from heartbeat to thinking and moving. For this reason, HBOT has shown great potential in healing or reducing cognitive and mobility decline symptoms, such as in autism and old age.

Researchers have found that delivering a combination of high oxygen levels, known as hyperoxia and pressure in a hyperbaric environment, enhances tissue oxygenation. It manipulates oxygen and pressure-sensitive genes, leading to enhanced tissue metabolism.

Further, the target genes ignite new blood vessels’ formation for an even more efficient oxygen circulation. There is also an associated stem cell proliferation and a significant reduction in inflammation.

By allowing more oxygen to get into oxygen-deficient regions of the body, HBOT leads to the alleviation of many common sicknesses. The therapy supercharges body functions dissolving oxygen into the blood, plasma, and cerebrospinal fluids.

Medical specialists are still considering the impacts of HBOT treatment for kids with autism. A major focus has been on comorbid (simultaneously occurring) issues in autism spectrum disorders, including:

  • Healing gut-related issues and brain inflammation
  • Increasing blood circulation to key regions of the brain
  • Creating a friendly microbial environment in the gut

Does hyperbaric oxygen therapy work for autism?

In several studies, researchers mention neuroinflammation, mitochondrial dysfunction, and oxidative stress in the brain of children with autism as the principle explanations behind the potential of HBOT in managing the condition.

HBOT on neuro-inflammation

Evidence shows the brain’s neuroinflammation to be one of the major underlying causative factors for autism spectrum disorders. In fact, this is the hallmark finding after several decades of research in autism. There is a consensus in the scientific world that abnormal immune function, which encapsulates inflammation, anti-brain autoantibodies, and cytokine dysregulation, plays a significant role in developing ASD.

The direct consequence of neuro-inflammation is cerebral hypoperfusion, which refers to the brain’s diminished blood circulation. As a result, the autistic individual displays limited cognitive abilities, problems with focus and attention, communication, and social interactions.

In a 2006 study, scientists performed autopsies on 15 people determined to have ASD, aged between 5 and 44. They used a control group of nine autopsies of persons that had not been diagnosed with ASD. The study showed a significant neuro-inflammatory process in the cerebellum of patients with ASD.

HBOT proponents say that the therapy increases the measure of oxygen that is conveyed through the plasma and mixed into the tissues. Animal studies have confirmed that increasing oxygen content in the blood through HBOT reduces inflammation.

In one human study, 12 autistic children were treated with HBOT at 1.3 atm/24% oxygen, while another group of six children received HBOT at 1.5 atm/100% oxygen. The researchers measured biomarkers for inflammation in the brain before and after the therapy sessions. Results showed that in both groups, HBOT significantly reduced cerebral inflammation and improved behavior.

HBOT on behavior

In a new study that directly shows hyperbaric oxygen’s effects on children with autism spectrum disorders, experts examined 18 kids with ASD after they’d undergone HBOT. In the study published in bmc Pediatr treatment for children, they found that treating autism using hyperbaric oxygen therapy led to a reduction of inflammation and improved cognition and movement.

They followed up with massive double-blind studies and benchmarked findings against:

  • Autism Treatment Evaluation Checklist (ATEC)
  • Aberrant Behavior Checklist-Community (ABC)
  • Clinical Global Impression-Improvement (CGI)

Though the evidence was largely anecdotal and obtained by reports from parents, the study indicates that hyperbaric oxygen treatment resulted in:

  • Improved skill acquisition and reduced problem behavior
  • Enhanced spontaneous communication during oxygen therapy

These studies suggest that HBOT can help to improve behavior in children with ASD. However, both of these discoveries were not duplicated across members and are therefore not considered to be accurately scientific.

Notwithstanding the findings of these group studies, a specific individual’s reaction over the long run is primarily the main factor of consideration for a parent or clinician.

In 2008, researchers individualized the investigations, focusing on three subjects. This allowed the analysts to search for specific differences between children during and after HBOT therapy.

They studied behavior, communication, and skills improvement. The findings showed small increases in spontaneous improvement for one subject and improved skills acquisition for another. However, this study was not replicated across subjects and similarly not deemed scientifically accurate.

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HBOT on mitochondrial weakness

A few people with ASD show proof of mitochondrial weakness, which results in low energy that slows down thinking and other body functions. Lately, HBOT has grown immensely popular as a possible intervention for mitochondrial dysfunction in individuals with autism.

In both animal and human studies, scientists have found that oxygen therapy improves mitochondrial function. In one investigation of rodents with healthy mitochondrial function, HBOT elevated ATP production in muscle tissue contrasted with a benchmark group. This study shows that oxygen therapy may improve symptoms of ASD associated with fine motor control and balance.

An ongoing test in the hippocampus of rats reveals that HBOT elevates mitochondrial biogenesis and autophagy. In a new controlled study of 69 patients with extreme traumatic brain injury, the use of HBOT at 1.5 atm/100% oxygen fundamentally increased brain oxygen levels and cerebral blood circulation. These two studies demonstrate great potential in the use of HBOT in improving cognitive performance in individuals with autism.

HBOT on oxidative stress

Various studies have found a close link between increased oxidative stress and kids with ASD. Oxidative stress leads to oxidative damage of cells and DNA. It can cause inflammation changes that damage brain tissue and drastically reduce metabolism, ultimately leading to autism’s clinical symptoms of autism.

A few specialists are wary that with hyperbaric therapy, symptoms in autistic children may be worsened. HBOT has the potential to heighten oxidative stress by increasing oxygen supply to mitochondria.

Even so, research has shown that HBOT appears to improve the production of antioxidant enzymes. These safeguard the cells from oxidative stress. In one study, HBOT was administered every day at 1.3 atm to 48 children with autism. The results showed a significant reduction in oxidative stress for up to 32 days from the day of the therapy. This study shows the possible benefit of HBOT therapy in boosting energy levels and improving brain health in children with autism.

Benefits oxygen therapy for autism: the conclusion from various studies:

A lot more scientific evidence is needed to prove the efficiency of oxygen therapy as a solution against autism. The conclusion from a number of findings so far, including anecdotal a double-blind studies, show that:

  • The underlying causes of autism include neuroinflammation, mitochondrial weakness, and oxidative stress are largely related (one causes the other)
  • Increasing oxygen supply in the blood can significantly reduce neuroinflammation, increase energy levels, and reduce oxidative stress
  • From various reports, treating ASD children with HBOT leads to significant social interactions and mood improvements
  • Further, evidence on the use of oxygen therapy against childhood autism shows promise in improving memory and cognitive performance, verbalizations, and social interactions
  • In controlled trial hyperbaric treatment studies, specialists have found significant improvements in coloring skills, speech, and self-help skills in teenagers with ASD using 20 sessions of HBOT at 1.5 atm/100% oxygen
  • A 1.3 atm/24% oxygen hyperbaric hbot treatment can positively impact a child with ASD, including a reduction of repetitive behaviours, improvement in handwriting and fine motor skills, better bowel function, and improved language communication
  • Also, research shows that the anti-inflammatory effects of autism hyperbaric oxygen therapy may improve social interaction and reduce stereotypical behaviors (20 HBOT sessions at 1.5 atm/100% oxygen)

Is HBOT safe for children with autism?

Like any other treatment, HBOT has been shown to have undesirable side effects. This is not a surprise, considering that the studies which support the use of the therapy as a treatment for ASDA are largely mixed and inconclusive.

Possible side effects during and after HBOT can include dizziness and fatigue, while more severe side effects can include:

Sinus damage

Sinus trauma is a common side effect of oxygen therapy if the patient gets into the chamber with an upper respiratory infection. During HBOT, drastic changes in pressure occur following the compression phase in the sinus cavities.

A negative pressure gradient leads to the inflammation of sinuses’ mucosal tissues, thereby blocking these sinuses. This compression leads to congestion and edema. The patient may report facial pain that reduces as the air volume in the chamber expands. The use of decongestant nasal spray before the therapy significantly reduces this undesired effect.

Lung damage

During and after the HBOT therapy, patients may sustain lung tissue damage because of pressure change. The results include air leaking from the lungs into the chest, leading to a dropped lung. This side effect mostly happens in patients with emphysema and asthma.

During decompression, air-filled pockets begin to expand, and, when the pressure is not relieved by the air passages in the lungs, these pockets rupture. The released air causes excess pressure in the chest cavity leading to decreased blood pressure and difficulty in breathing.

Fluid buildup in the middle ear

Middle ear barotrauma is a common side effect of oxygen therapy. Patients experience difficulty with ear balance. They may report feelings of pressure, ear pain, or discomfort during the therapy.

If there is no intervention, this can cause edema in the middle ear, and in some cases, rupture of the inner membrane leading to hearing loss. In rare cases, the therapy can cause a rupture of the oval window membranes and impair inner ear function, leading to vertigo.

Oxygen toxicity and seizures

The increased oxygen level in the blood that happens during HBOT sessions can be poisonous to the focal sensory system and can bring about seizures. While this is uncommon during clinical hyperbaric sessions, it does happen and might be more probable in those with prior seizure issues or hypoglycemia (low glucose). Treatment comprises essentially eliminating the supplemental oxygen from the patient, which will end the seizure.

Decompression sickness (the bends)

Decompression disorder is a side effect of nitrogen build up in the blood when air is inhaled at more atmospheric pressure. This is common to a greater degree a side effect experienced by those administering the oxygen therapy and not patients. This can be an issue for patients if they are taken out of the hyperbaric oxygen therapy for breaks during the treatment. Decompression sickness can cause pain, neurological injury, and cardiopulmonary breakdown.

Oxygen toxicity in the lungs

Elevated oxygen concentrations can be detrimental to the lungs. Longer sessions of autism hyperbaric oxygen therapy can lead to chest pain, troubled breathing, and in the long run, the risk of respiratory failure. After the therapy, the lungs quickly recline baseline once the oxygen level is diminished.

In this way, because HBOT sessions are not an everyday thing, oxygen toxicity in the lungs is rarely a reported side effect in clinical settings. Even so, this can be a cause for worry in very sick patients who must be kept up on supplemental oxygen between therapies or those patients who require prolonged oxygen therapy sessions.

Visual disturbances and myopia

The use of HBOT can briefly change the state of the lens in the eye. This generally worsens myopia. However, there is an improvement in the ability to focus on items close to the eye in older adults following HBOT sessions. This change generally returns to its pre-treatment status six two months after the session.

Claustrophobia

Because of the hyperbaric treatment chamber’s enclosed nature, a few patients experience claustrophobia, a fear of enclosed spaces. Persons who are now claustrophobic can encounter an exacerbation of their side effects during the HBOT session. A multi-place chamber can help mitigate these emotions because of the size of the chamber. In the event that claustrophobic indications become serious enough, pre-treatment sedation can be considered dependent on the situation.

Cautions and considerations when using hyperbaric oxygen chambers:

  • The therapy session should not go beyond two hours
  • The pressure in the chamber must be less than three times that of the normal pressure outside the chamber
  • The treatment is a risk if the individual has lung diseases or a history of a collapsed lung
  • HBOT is not advised when the patient has flu, cold or has had a recent ear surgery
  • HBOT may not be a good idea for claustrophobic children and autistic adults
  • The Food and Drug Administration and the U.S. Department of Health and Human Services have neither endorsed nor cleared HBOT as a safe treatment

Moreover, numerous insurance agencies’ rules on hyperbaric oxygen therapy HBOT show that treating autism with this oxygen therapy isn’t supported.

The bottom line

Multiple studies show that hyperbaric oxygen therapy can help to alleviate the symptoms of autism in children and adults. Clinically supervised use of the therapy can potentially improve their cognitive abilities, communication behavior, and fine motor skills by increasing oxygenation circulation and reducing inflammation. However, the evidence supporting the efficiency of HBOT is mixed and anecdotal. Consult with your doctor before trying HBOT for your child.

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