Hyperbaric Oxygen Therapy or HBOT is a form of treatment in which the patient breathes up to 100% oxygen intermittently under pressures greater than normal atmospheric pressure. This method was first used to treat decompression sickness, or ‘the bends’ in deep sea divers who faced problems when surfacing too quickly. As time went on it was used to treat other conditions too, like air embolisms, carbon monoxide poisoning, exceptional blood loss and non healing wounds.
In recent years, research has shown that some individuals with autism may have less oxygen reaching the brain and some signs of brain cell inflammation, particularly in areas related to language and auditory processing. This encouraged the use of HBOT in people with Autism too, in the hope that enough oxygen reaching these areas, might help the symptoms. HBOT is currently an experimental treatment for Autism, and its popularity is mainly based on anecdotal evidence.
How Does it Work?
This therapy works on the principle that oxygen has the capacity to promote growth, reduce swelling and inflammation, improve the body’s ability to fight infection, clear out toxins and metabolic waste products and improve the rate of healing. The high pressures used in HBOT increases the free oxygen in body fluids, so tissues have more oxygen reaching them. Now, it was traditionally thought that if brain tissue is damaged or experiences lack of oxygen (say due to an umbilical cord wrapped tight around the neck of a fetus) cell death could occur in 4 to 6 hours. But newer theories speculate that perhaps these cells are not dead but dormant, just because they don’t have enough oxygen to perform functions normally. Or maybe a few dead cells are surrounded by a perimeter of these ‘idling cells’. HBOT thus aims at trying to provide much needed oxygen to these cells, hoping that they respond favorably.
Furthermore, it is also thought that HBOT could improve the brain’s overall ability to absorb oxygen. It may also improve intestinal health, which plagues many an Autistic child, by fighting anaerobic viruses, bacteria and parasites.
How Is It Done?
A special hyperbaric chamber is used in HBOT. This is usually a non-portable, long, tube-like chamber filled with pressurized oxygen. Two types of chambers are typically used: the monoplace chamber (that allows a single person inside) and the multiplace chamber (in which 2 or more people can enter). Patients may also breathe in oxygen through masks, hood systems or tubes.
A session could last for 45 to 60 minutes during which the patient can sit/lie down comfortably and watch TV, read a book, play on a Gameboy or take a nap. Communication with the outside is possible through intercom, a TV screen or glass windows. An adult can also accompany the child if there is room. Children are allowed to drink water to adjust ear pressures.
It usually just feels like sitting in an airplane. Highly trained technicians should closely monitor pressures and the child. Pressures can go up to 1.5 or even 1.7 ATA, which is the depth of 10 to 20 feet of sea water. Pressurization and depressurization are prolonged to reduce discomfort in the ears.
How Safe Is It? Are There Any Side Effects?
The most common side effects seen are ear pain and reversible myopia (near sightedness), which should return to normal in 8 weeks. Trauma to earsdrums and sinuses is what causes the pain. Some children may get claustrophobic but that can be averted with relaxation techniques and sometimes mild sedation. Seizures may occur, and very rarely, oxygen toxicity. HBOT is contraindicated for people with a history of seizures, acidosis, fever, low blood sugar levels, asthma and other lung problems, optic neuritis, colds and other infections.
What Does Research Have to Say About It?
HBOT is not scientifically verified and research is only in its early stages. Studies that have been done so far have shown results ranging from insignificant effects to greatly improving symptoms. Some favorable studies have shown that after 40 hours of treatment for over a month children have been less irritable, more responsive to conversation, showed more eye contact and proved to be more sociable than children who didn’t get the treatment. However, it was not clear exactly why the treatment might have helped. Some evidence even shows that HBOT might mobilize stem cells from human bone marrow and aid the recovery of neurodegenerative diseases. What all scientists agree on is that HBOT is not a cure for Autism and more research is required before its results can be confirmed. Testimonies from families are mostly encouraging.
How Do I Get Started?
HBOT should ideally be performed in a formal clinical setting like an Autism clinic or a children’s hospital. Doctors involved in it should be certified in HBOT and proper methodology should be used at every step.
Remember that small errors could cause big problems, so be careful about choosing a reliable place. Don’t hesitate to ask questions till you are satisfied. Some families may buy hyperbaric chambers to use at home but this is not recommended in the initial phase nor has it been researched. Make sure you know how to handle all types of complications before launching into this all by yourself.
How Long Does It Take To Work?
Results begin to show after around 40 sessions, and get better after 80 sessions. A session should last from 45 minutes to an hour.
How Much Would It Cost?
One session could cost between $120 and $150. Presently insurance companies do not pay for HBOT, but some parents are petitioning for the same.
HBOT is based on some very interesting theories and a lot of people are hoping that it will prove to have the effects we have all been looking for in the treatment of children with Autism.
But what cannot be argued with right now is that there is not enough research to deem it absolutely safe and effective and not every child responds to it.
Cost happens to be another let down, especially since at least 40 sessions of it are needed. Hopefully in the future, with better technological advancements it can be proved safer and more effective but at present, it should not be used except to complement more proven therapies and treatments.