HBOT, High-Altitude Travel and Sleep: What Does the 2025 Research Tell Us?
For many people, a trip to the mountains means skiing, snowboarding, hiking and enjoying the unique environment of high altitude.
But high altitude also means less available oxygen.
For some people, particularly those travelling quickly from sea level to significant altitude, this can affect sleep, energy levels, recovery and overall wellbeing. For people who work at altitude - including ski-field staff, mountain guides and others who spend weeks or months in high-altitude environments - the effects can be even more relevant.
The results provide an interesting insight into the relationship between altitude, oxygen availability and sleep.
Why can altitude affect sleep?
As altitude increases, atmospheric pressure decreases. This means the partial pressure of oxygen in the air also falls.
In simple terms, each breath contains the same percentage of oxygen, but there is less oxygen pressure available to drive oxygen into the body.
The body responds by making a number of adaptations. These are important for acclimatisation, but they can also contribute to disrupted sleep.
People at altitude may experience:
Difficulty falling asleep
More frequent waking
Fragmented sleep
Reduced sleep quality
Fatigue during the day
Changes in breathing during sleep
For someone spending a week skiing at altitude, this may simply mean feeling more tired than expected.
For someone working on a ski field or living at altitude for an extended period, ongoing sleep disruption can potentially become a much bigger issue.
What did the 2025 HBOT study investigate?
Researches conducted a randomised controlled trial in people living at 3,800 metres altitude in Xinjiang, China.
Eighty people with chronic insomnia were divided into two groups.
The HBOT group received 1.6 ata for 1.5 hours per day for 10 consecutive days.
The control group did not receive HBOT.
The researches assessed sleep using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) as well as fatigue, anxiety and depression.
The results were impressive
After the 10 day treatment period, the HBOT group showed significantly better sleep outcomes than the control group.
The average PSQI score was: 4.6 with HBOT vs 9.1 in the control group.
The average insomnia severity score was: 5.0 with HBOT vs 9.8 in the control group.
The researchers also found improvements in fatigue, anxiety and depression.
These findings suggest that improving oxygen availability may have an important role in people experiencing sleep disturbance associated with high-altitude hypoxia.
What could this mean for people travelling to the mountains?
This is where the research becomes particularly interesting. You don't necessarily have to live permanently at 3,800 metres to experience the effects of alititude.
People travelling from sea level to ski resorts, mountain destinations or high-altitude trekking locations can experience a significant change in their oxygen environment within a matter of hours.
For example, someone travelling to a high-altitude ski resort may spend several days: flying--travelling rapidly to altitude--skiing hard during the day--sleeping at altitude at night.
That combination can place considerable demands on the body.
Sleep is also one of the most important components of recovery.
If altitude is disturbing sleep, the resulting fatigue may affect how well someone recovers from skiing, hiking, or other physical activity the following day.
This is particularly relevant for skiers and snowboarders who want to perform at their best throughout a holiday, rather than spending the first few days feeling tired or poorly rested.
And what about people who work at ski fields?
The research may be even more relevant to people who regularly spend extended periods at altitude.
Ski-field employees, instructors, guides, mountain rescue personnel and other workers can spend weeks or months in an environment where oxygen availability is lower than at sea level.
For these people, altitude isn't simply a holiday experience. It's their working environment. Maintaining good sleep, recovery and energy levels may therefore be particularly important.
The 2025 study raises the possibility that HBOT could be a meaningful therapy to support people who are repeatedly exposed to high-altitude hypoxia.
Why might HBOT help?
HBOT creates an environment where increased atmospheric pressure is combined with a high concentration of oxygen. This increases the amount of oxygen available to the body compared with breathing normal air at altitude.
The researchers proposed that improving oxygen availability may help counter some of the physiological effects of high-altitude hypoxia that contribute to sleep disturbance.
There may also be effects involving the brain, circulation, respiratory regulation and nervous system.
Could HBOT be useful before or after a high-altitude trip?
Based on the theoretical physiological effects HBOT could be deemed useful for people who:
Regularly travel between sea level and high altitude
Spend extended periods working on ski fields
Experience poor sleep when travelling to the mountains
Are undertaking high-altitude trekking or expeditions
Need to optimise recovery while training or competing at altitude.
Oxygen, sleep and recovery
One of the key messages from this research is that oxygen availability matters.
Sleep is not simply about being unconscious for several hours. It is an active biological process during which the brain and body carry out essential repair, regulation and recovery.
When the body is exposed to a hypoxic environment, such as high altitude, sleep can be affected. The 2025 study provides an intriguing example of how changing the environment with HBOT positively influences sleep and wellbeing.
For people who love the mountains, whether they're there for a ski holiday, a high-altitude adventure or a season working on the slopes, it is another reminder that altitude places unique demands on the body.
For those heading to the mountains, understanding how your body responds to altitude - and giving it the right environment to recover - may be just as important as choosing the right skis.
- Samantha Winters
