A body locked in sympathetic dominance cannot heal — regardless of what other interventions are used. Rebalance Impulse uses applied neuroscience to shift the nervous system into the parasympathetic recovery state, creating the biological foundation that makes every other therapy more effective. Available at Aim Health, Hoylake.
Hyperbaric Oxygen and Hydrogen Therapy for Long COVID and Chronic Fatigue
Long COVID & Chronic Fatigue — Aim Health Hoylake, Wirral
Hyperbaric Oxygen and Hydrogen Therapy for Long COVID and Chronic Fatigue
How pressurised oxygen and molecular hydrogen restore the brain and body — and what the clinical evidence shows for persistent fatigue and post-viral illness.
Of all the therapies showing promise for long COVID and chronic fatigue, hyperbaric oxygen therapy has one of the most compelling evidence bases — including a landmark randomised controlled trial published in one of the world’s most respected scientific journals. The reason it works is not mysterious. Long COVID and many forms of chronic fatigue share a specific biological problem: the brain and tissues are not receiving enough oxygen. Hyperbaric therapy addresses this directly — not by improving circulation, but by bypassing it entirely.
For the full science behind how hyperbaric oxygen and hydrogen therapy works, read our complete guide to hyperbaric oxygen and hydrogen therapy. This article focuses on the evidence and mechanisms specific to long COVID and chronic fatigue. For an overview of all the therapies Aim Health offers for these conditions, read our chronic fatigue and long COVID hub.
The oxygen problem at the heart of long COVID and chronic fatigue
In long COVID, functional brain imaging studies have found reduced blood flow and oxygen delivery to specific brain regions. This is a measurable physical finding — not a psychological symptom — and it directly accounts for the brain fog, memory difficulties, cognitive impairment and profound exhaustion that characterise the condition.
The same oxygen deficit affects peripheral tissue. Muscles that are not receiving adequate oxygen cannot recover normally from exertion. This is why post-exertional malaise is so severe and so disproportionate — the body cannot replenish what activity depletes.
In chronic fatigue more broadly, mitochondrial dysfunction — impaired cellular energy production — is increasingly recognised as a central mechanism. Mitochondria require oxygen to produce ATP, the molecule that powers every cellular process. When oxygen delivery is compromised and mitochondrial function is impaired, the result is exactly the symptom picture that chronic fatigue produces: exhaustion, cognitive impairment, poor recovery, disturbed sleep, and a body that cannot maintain the energy demands of normal life.
How hyperbaric oxygen and hydrogen therapy helps
Mechanisms specific to long COVID and chronic fatigue
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Oxygen dissolves into plasma and reaches hypoxic tissue
At 1.1 to 1.35 ATA, oxygen dissolves directly into blood plasma — independently of haemoglobin — and diffuses into brain regions and peripheral tissues that compromised circulation cannot adequately supply. The oxygen deficit driving the symptoms is addressed directly, at its source.
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Mitochondrial function restores
Increased oxygen availability restores mitochondrial function in cells that have been running below capacity. ATP production recovers. The body begins to have the cellular energy resources it needs to repair, regenerate and sustain normal function.
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Neuroinflammation reduces
Hyperbaric oxygen reduces the neuroinflammation that is a consistent feature of long COVID and post-viral fatigue — directly improving the conditions in which brain tissue can recover and cognitive function can restore.
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Stem cells mobilise
A course of hyperbaric sessions produces a significant increase in circulating stem cells — the body’s regenerative reserve. This provides a mechanistic basis for the tissue repair and neurological recovery that clinical trials have documented.
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Molecular hydrogen crosses the blood-brain barrier
Hydrogen is added to every session because it neutralises the specific oxidative molecules that high concentrations of oxygen generate — particularly in inflamed tissue. It crosses the blood-brain barrier freely, providing anti-inflammatory protection deep within neural tissue, and independently suppresses the inflammatory pathways that drive post-viral immune dysregulation.
The brain is not receiving what it needs to function properly. That is not a psychological problem — it is a physiological one. And it is one that hyperbaric therapy addresses directly.
The evidence
The 2022 double-blind randomised controlled trial published in Scientific Reports — part of the Nature portfolio — remains the most rigorous clinical evidence for HBOT in long COVID. A 40-session HBOT protocol produced significant improvements in cognitive function, fatigue, sleep quality and pain compared to placebo. Functional MRI showed increased blood flow in previously hypoxic brain regions. These were not subjective reports — they were measurable biological changes.
The proposed mechanisms align precisely with the established science: mitochondrial restoration, cerebral oxygenation, and neuroinflammation reduction — the same mechanisms that explain why long COVID produces its specific pattern of symptoms in the first place.
Earlier research from the Sagol Center in Israel demonstrated significant neurological recovery in traumatic brain injury patients using HBOT — years after conventional medicine had considered recovery plateaued. The parallels with long COVID neurological symptoms are well-recognised in the research literature.
2022
Nature RCT — long COVID and HBOT Double-blind randomised controlled trial showing significant improvements in cognitive function, energy, sleep quality and pain — with functional MRI confirming restored cerebral perfusion in previously hypoxic brain regions.
What to expect at Aim Health, Hoylake
Sessions take place in our hard-shell AirPod hyperbaric chamber at 1.1 to 1.35 ATA. You are seated comfortably throughout. Sessions run from 30 to 90 minutes depending on your protocol. There is no recovery time required.
For chronic fatigue and long COVID, most clients attend 1 to 2 sessions per week. The effects are cumulative — they build meaningfully across a course of sessions. Most clients notice early signals of change within the first two to three weeks: improved sleep, clearer thinking, more stable energy through the day.
Hyperbaric therapy works particularly well alongside red light therapy and Rebalance Impulse — the combination addressing cellular energy, nervous system regulation and oxygen delivery together. Your programme is designed at your free wellness assessment around your specific symptoms and history.
Frequently asked questions
Is hyperbaric therapy safe for people with long COVID and chronic fatigue?
Yes — at 1.1 to 1.35 ATA in a hard-shell chamber, hyperbaric therapy is extremely well-tolerated. It requires no physical exertion and does not trigger post-exertional malaise. Our team carries out a health assessment before your first session.
How many sessions will I need?
The Nature 2022 trial used a 40-session protocol. In practice, most clients notice meaningful improvement within the first 10 to 15 sessions, attending 1 to 2 sessions per week. The right protocol for you is discussed at your free wellness assessment.
Can I use it alongside my existing medical care?
Yes — hyperbaric therapy is compatible with all standard medications and does not conflict with any conventional treatment. We always recommend keeping your GP informed.
Will it work for me if I have had fatigue for a long time?
Duration of illness does not preclude response to HBOT. The Sagol Center research showed meaningful neurological recovery in patients years after their original injury — when recovery was considered to have plateaued. The same mechanisms apply in chronic fatigue and long COVID.
Further reading
References
1. Zilberman-Itskovich S et al. Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition. Scientific Reports. 2022;12:11252. Read study →
2. Boussi-Gross R et al. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury. PLOS ONE. 2013;8(11):e79995. Read study →
3. Hadanny A, Efrati S. The hyperoxic-hypoxic paradox. Biomolecules. 2020;10(6):958. Read study →
4. Missailidis D et al. An isolated complex V inefficiency and dysregulated mitochondrial function in ME/CFS. Int J Mol Sci. 2020;21(3):1074. Read study →
5. Milovanova TN et al. Hyperbaric oxygen stimulates vasculogenic stem cell growth and differentiation in vivo. J Appl Physiol. 2009;106(2):711–728. Read study →
6. Ohsawa I et al. Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals. Nature Medicine. 2007;13(6):688–694. Read study →
© Aim Health Hoylake 2026. This article is for educational purposes and does not constitute medical advice. Please continue with any existing medical care alongside your programme at Aim Health.
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