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The Impact of High-Pressure Oxygen Therapy on Depression, Anxiety, Insomnia, and Headaches

Organic lesions are often accompanied by symptoms such as depression and anxiety. Hyperbaric oxygen can not only promote the recovery of the primary disease, improve the patient's mood, but also increase the blood supply to the hypothalamus, which has the effect of regulating the emotional center. At the same time, hyperbaric oxygen can also play a positive role in the treatment of insomnia and headache by promoting the recovery of nerve function, inhibiting inflammatory reactions and improving the state of cellular hypoxia, and the treatment effect is remarkable!

The effect of HBOT on depressive symptoms

The lifetime incidence of depression is 15%-20%, which can aggravate the cognitive impairment of patients, block the recovery of neurological function, reduce the quality of life of patients, and significantly increase the mortality rate. Previous studies have shown that 20% to 79% of stroke patients have varying degrees of depressive symptoms (10% to 15% of the elderly at the same age), and the mortality rate of patients with depression is 3.4 times higher than that of those without depression. Post-stroke depression (PSD) is a common complication of stroke. The main manifestations are loss of interest, sleep disturbance, low self-evaluation, and even self-injury, suicidal ideation or behavior in severe cases. Knowledge and other aspects of rehabilitation.

Hyperbaric oxygen (hyperbaric oxygen, HBO) can increase the blood flow of the vertebral artery, lead to an increase in the partial pressure of oxygen in the reticular structure and brainstem, improve the weakening of cerebral cortex inhibition, enhance the regulation and control of the subcortical autonomic nervous system, and promote Rehabilitation; increase the efficiency of aerobic metabolism in brain tissue, enhance glucose utilization, and promote the recovery of dysfunctional cortical functions; improve the degree of atherosclerosis, promote the repair of vascular damage, enhance the activity of the pentose phosphate pathway in nerve cells, and promote the recovery of neuron metabolism. Therefore, HBO can significantly improve the degree of depression in patients with cerebral hemorrhage during the recovery period, and promote the recovery of their neurological function. Similar to cerebral hemorrhage, the addition of HBOT to patients with depression after cerebral infarction can also greatly improve the total effective rate of treatment of depression after cerebral infarction and promote the recovery of neurological function in patients with cerebral infarction. The effect of HBO on high-level central nervous activity is likely to manifest as two consecutive phases of enhancement and inhibition. After 30-45 min of HBOT, the cortical function gradually shifts from the enhancement phase to the inhibition phase. It is recommended that the time of each HBOT be best controlled Preferably within 40 minutes. HBOT can not only reduce secondary damage to the cerebral cortex and related nerve functions, but also promote brain remodeling and functional reorganization in convalescent stroke patients, significantly improve the emotional and neural functions of PSD patients, and further improve the rehabilitation effect of PSD patients. HBOT for PSD is safe and effective, especially after the stroke enters the recovery period, and its curative effect is better than that of simple antidepressant treatment.

About 40% of patients with traumatic brain injury (TBI) will have moderate or severe disabilities, and the incidence of depression is 30%~48%. Restoration of function, improve the intelligence and memory of patients with traumatic brain injury, thereby effectively improving the physical and psychological function of TBI patients; increase the level of NE and 5-HT, improve the degree of depression of patients, promote nerve regeneration and functional compensation of non-damaged brain regions , to reduce the incidence of depression after TBI. In addition, HBO combined with antidepressant drugs such as sertraline, paroxetine or fluoxetine (Prozac) can significantly improve the depressive symptoms of PSD patients, improve their daily life ability and quality of life, and the total effective rate is significantly better than that of single HBOT or antidepressant medication.

The effect of HBOT on anxiety symptoms

HBO preconditioning can effectively maintain neuronal activity in the CA1 subregion of the hippocampus in rat animal models of post-traumatic stress disorder, reduce neuronal apoptosis, and reduce anxiety-like behavior and cognitive impairment in rats. The anxiolytic effect of 60min HBOT can last at least 90min after the end of treatment, indicating that HBOT has the potential to improve certain anxiety states. Zou Zhixian et al. implemented HBOT on senior high school students with anxiety and insomnia caused by study pressure. After 2 courses of treatment (once a day, continuous treatment for 20 days), their Anxiety Self-Rating Scale and Pittsburgh Sleep Quality Index scores gradually decreased. The quality is obviously improved and the curative effect is remarkable. The possible mechanism for HBOT to relieve anxiety is that it can effectively improve the oxygen supply of brain cells, improve metabolic efficiency and glucose utilization rate, increase the production of adenosine triphosphate, correct the dysfunction of the pituitary gland, limbic system and cerebral cortex, and restore the normal physiological functions of the nervous system. Jiang Liyan et al. applied 4 courses of HBOT to patients with chronic diabetic foot ulcers on the basis of routine dressing changes and nursing intervention, and found that the severity of the wound surface was significantly reduced, and the HAMA score was significantly reduced, indicating that HBOT can effectively promote the wound healing of diabetic foot ulcers. Improve the quality of life of patients and reduce their anxiety symptoms. However, some studies have shown that HBOT alone is not effective in treating anxiety and obsessive-compulsive symptoms in patients with neurosis. Comprehensive treatment is recommended to improve the treatment effect.

The effect of HBOT on insomnia symptoms

Insomnia is a non-organic sleep disorder characterized by frequent and persistent difficulty in falling asleep or maintaining sleep leading to poor sleep satisfaction, often affecting daytime social function, accompanied by depression, anxiety, tension and irritability Mood disorders are the most common sleep disorders with a high prevalence rate. At present, the main treatment methods for insomnia include drug therapy such as benzodiazepines and cognitive behavioral therapy. However, because drug therapy can easily lead to sleep-wake disorders and adverse reactions such as memory loss, anxiety, and addiction, and cognitive-behavioral therapy has poor patient compliance due to its long treatment cycle and slow onset, there is an urgent need for a safer, more effective treatment in clinical practice. Effective new treatment for insomnia.

Previous studies have shown that HBOT can not only reduce the time to fall asleep, prolong sleep time, improve sleep efficiency, improve sleep quality, improve daytime activities and cognitive function, but also significantly improve the depression and anxiety of insomnia patients. HBO combined with benzodiazepines has a total clinical effective rate of 96.3% for elderly patients with chronic insomnia, and significantly improved sleep quality, PSQI, and Montreal Cognitive Assessment Scale scores. Studies have shown that the addition of HBOT on the basis of conventional treatment can significantly reduce the PSQI and Athens Insomnia Scale scores in patients with insomnia after cerebral infarction, and has a significant effect in improving sleep quality, sleep latency, sleep duration and sleep disturbance. As a result, the use of a hyperbaric oxygen chamber for home is a viable option for individuals seeking to improve their overall sleep quality.

In addition, perimenopausal women may have insomnia symptoms such as anxiety, difficulty falling asleep, and short sleep duration due to ovarian failure and decreased estrogen secretion, causing autonomic dysfunction and neuropsychological symptoms, causing great pain and psychological burden to patients. , seriously affecting physical and mental health. Qiao Lijuan applied HBOT to patients with perimenopausal insomnia and found that HBO can regulate endocrine disorders by activating the secretory function of the hypothalamus-pituitary-ovary axis; at the same time, it can effectively improve the blood supply of the vertebral artery, increase the oxygen partial pressure of the reticular structure and the brainstem, and restore The regulatory function of the cerebral cortex can effectively improve the sleep quality of patients, and the PSQI score can be significantly reduced. The curative effect is definite and safe. HBO combined with acupuncture at the "first four gates" has a better curative effect on patients with insomnia, and can effectively improve the sleep quality of patients.

In recent years, HBO has emerged as a potential treatment for neurological disorders such as Parkinson's disease by providing neuroprotection. After 4 days of HBOT, the patient's sleep duration increased from 2 to 3 hours to about 5 hours, the sleep quality improved significantly, and the overall mood also improved. After 1 month of HBOT, sleep time returned to the normal level (8-10 h), and the symptoms of resting tremor and bradykinesia were also significantly improved, which lasted at least 1 month after discharge.

Effect of HBOT on headache symptoms

Migraine is a common primary chronic neurovascular disease with a prevalence of 5% to 10%. Its pathogenesis may be related to vasomotor dysfunction, neurological dysfunction and aseptic inflammation. Basal migraine (BAM) is a special type of migraine with aura, which may have prodromal symptoms such as dizziness, diplopia, tinnitus, speech dysfunction, numbness and weakness of limbs, ataxia, amaurosis, manifested as occipital pulse Sexual pain, often accompanied by nausea and vomiting, lasts for several hours or even 1 day, is more common in young patients, and is prone to repeated attacks. Basilar artery hemodynamic changes generally occur during BAM attacks. HBOT can inhibit the release of inflammatory factors and platelets, improve the blood flow velocity and pulsatility index of the basilar artery, and significantly reduce the headache severity and attack frequency of BAM patients, and its curative effect is better than that of flunarizine hydrochloride. Studies by Myers et al. have shown that, compared with normal pressure pure oxygen therapy, HBO is more effective in relieving migraine symptoms and can be used for migraine treatment. In addition to the constriction of cerebral blood vessels by HBO, its mechanism of action may also be closely related to the increase in the rate of energy production and neurotransmitter-related metabolic reactions in the brain. In addition, metabolites such as adenosine, lactate, prostaglandins, and nitric oxide, which can cause pain and hyperemia, increase markedly after hypoperfusion/hypoxia. HBO can inhibit the formation of the above metabolites in hypoperfusion/hypoxic headache and relieve headache symptoms. The production of high-quality hyperbaric oxygen chambers by hyperbaric oxygen chamber manufacturers is critical to the efficient administration of this therapy to patients.

Cluster headache (CH) is another primary neurovascular headache, which may be caused by hypothalamic nerve dysfunction with the participation of the trigeminal neurovascular complex. ~3 times, in severe cases, it manifested as unilateral pain around the eyes accompanied by autonomic symptoms. Oxygen therapy is the first choice for CH acute attack. Daily HBOT can confer some benefit in the duration and frequency of pain episodes in some patients with CH, and has some degree of prophylaxis against subsequent CH episodes in some patients, and can be used as a transient prophylaxis in patients with refractory CH treatment method. HBO may exert its efficacy through non-specific effects such as stimulating the synthesis of 5-HT in the central nervous system and affecting the prostaglandin cascade reaction.

Peng Huiping compared the curative effects of HBOT and normal pressure high flow oxygen therapy on post-TBI headache on the basis of improving microcirculation, nourishing nerves, analgesia and other drugs and found that HBOT was effective for meningeal injury, brain tissue necrosis, hydrocephalus, Headache after TBI induced by mechanical stimulation such as increased intracranial pressure, local nerve compression and stretching has the highest cure rate and the best curative effect.

HBOT can increase the blood flow of the vertebral artery, improve the blood supply of the reticular structure and brainstem and other brain regions, improve the efficiency of aerobic metabolism, increase energy synthesis, improve the weakening of cerebral cortex inhibition, and restore the normal cortical function of the brain, thereby alleviating depression and anxiety of patients secondly, HBOT can shorten the time to fall asleep, prolong the duration of sleep, and significantly improve the sleep quality of patients; HBOT can also play a good role in migraine, CH, etc. Therapeutic effect is a very promising clinical treatment method for depression, anxiety, insomnia, headache and other psychosomatic symptoms.

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