How to dose HBOT.
Beginner intro, recovery, cognitive, longevity, post-concussion and long-COVID. Six protocols based on the published trials — with the pressure, duration, frequency and total dose you actually need.
Protocol 01
Beginner intro — the first three sessions
Pressure
1.3 ATA → 1.5 ATA
Duration
30 → 45 → 60 min
Frequency
1–3 days apart
Total dose
3 sessions over ~1 week
Three structured sessions designed to acclimate body, ears, and confidence. Most members notice better sleep and clearer thinking within these first sessions.
Session 1. 30 min soft-shell at 1.3 ATA. The gentlest possible introduction. Lie horizontally, breathe ambient enriched air, no mask required. Most first-timers fall asleep.
Session 2. 45 min soft-shell at 1.3 ATA or 30 min hard-shell at 1.5 ATA. Extend the soft-shell rest dose, or step up to the hard-shell with a mask for the first time. The team will recommend based on session 1.
Session 3. 60 min hard-shell at 1.5–1.75 ATA. The working dose for most R1SE protocols. By this session you're confident equalising and the cumulative signal starts to land: deeper sleep that night, sharper morning the next day.
Space these out by 1–3 days. No benefit to back-to-back — let your body acclimate. After session three, your team will recommend a structured protocol matched to your goal.
Protocol 02
Athletic recovery
Pressure
1.5–1.75 ATA
Duration
60 min
Frequency
1–2× per week
Total dose
Ongoing during training blocks
Acute and chronic recovery support during demanding training. Best scheduled within 24 hours of high-load workouts.
Pre-exercise HBOT is unusual; the dominant evidence is for post-exercise application. Schedule HBOT within 24 hours of high-load training (resistance, intense cardio, competition) for the strongest signal. Avoid HBOT within 4 hours of heavy strength training if hypertrophy is the goal — the anti-inflammatory effect may blunt mTOR signalling similar to cold immersion.
Mechanism: HBOT supports tissue repair (fibroblast and collagen response), accelerates angiogenesis in damaged tissue, and mobilises CD34+ stem cells. The Ferraresi/Branco 2016 work on athletic populations supports the recovery direction even though the trials are smaller than the clinical-condition literature.
Stack for maximum effect: Red light therapy 660 + 850nm in the hour before HBOT (ATP support), HBOT 60 min at 1.5–1.75 ATA, light walk on exit. Repeat 1–2× weekly through heavy training blocks.
Protocol 03
Cognitive performance block
Pressure
1.75–2.0 ATA
Duration
60–90 min
Frequency
3× per week
Total dose
20–40 sessions over 6–10 weeks
Designed around the Hadanny 2020 cognitive findings. Most members notice sharper attention and processing speed within 8–12 sessions.
The Hadanny trial used 60 sessions; the cognitive benefits accumulated across the protocol. A shorter 20–40 session block still delivers meaningful gains for healthy adults targeting attention, executive function, and processing speed.
Session structure follows the Hadanny / Efrati pattern: 20 minutes on 100% O₂ via mask, 5 minutes on ambient air, repeated three times across a 90-minute session. The air breaks are not optional — they're the active ingredient (hyperoxic-hypoxic paradox).
Stack for cognitive blocks: Morning breathwork (10 min) → HBOT 1.75 ATA 60–90 min → light cognitive work in the post-session window when attention is sharpest. Track sleep quality and HRV weekly — both typically improve through the block.
Protocol 04
Longevity (the Hachmo telomere protocol)
Pressure
2.0 ATA
Duration
90 min
Frequency
5× per week
Total dose
60 sessions over ~3 months
The gold standard. Replicates the Hachmo / Hadanny Tel Aviv protocol that produced 38% telomere lengthening and 8/9 cognitive domain improvements.
This is the dose-protocol combination that delivered the strongest cellular regeneration signals published to date. It's also a serious commitment — 60 sessions, 90 minutes each, five days per week, over roughly three months. Not for the casually curious.
Session structure: 20 min on 100% O₂ via mask, 5 min on ambient air, repeated four times across a 90-minute session at 2.0 ATA. This is the exact Hadanny protocol from the published trials.
Stack for longevity: HBOT 2.0 ATA 90 min → Red Light Therapy 2× weekly → cold plunge 2–3 min on alternate days. Add the R1SE longevity package for priority booking. Track via wearable (HRV, sleep, RHR) weekly. Most members report a clear step-change at sessions 18–24.
Discuss with the R1SE team before committing. We don't push members into the longevity protocol — if your goal is better recovery and sleep, that's achievable at a lower dose with much less commitment.
Protocol 05
Post-concussion / TBI
Pressure
1.5–2.0 ATA
Duration
60–90 min
Frequency
3–5× per week
Total dose
40–60 sessions over 8–12 weeks
Modelled on the Shamir / Efrati / Boussi-Gross protocols. Most members notice a step-change at sessions 12–18 if the intervention is going to work for them.
Persistent post-concussion symptoms (months-to-years post-injury) have responded well to HBOT in multiple published trials. The Boussi-Gross 2013 RCT used 40 sessions at 1.5 ATA; the Hadanny / Efrati extensions have used 60 sessions at 2.0 ATA. Both pressures show effect; the higher dose appears stronger.
Track symptoms weekly (cognitive symptoms, headache frequency/intensity, sleep, mood, light/noise tolerance). A consistent pattern in the literature is “responders” vs “non-responders” — if no signal is appearing by session 18–24, the protocol is unlikely to deliver dramatic gains. The team will review with you at the mid-point.
Stack for post-concussion: HBOT 1.5–2.0 ATA 60–90 min → gentle yoga or breathwork → avoid post-exertional flares. Members often pair HBOT with the R1SE breathwork track for autonomic regulation. Sleep hygiene is critical — the recovery happens overnight.
Protocol 06
Long COVID / post-viral
Pressure
1.5–2.0 ATA
Duration
60–90 min
Frequency
3–5× per week
Total dose
40 sessions over ~10 weeks
Modelled on Zilberman-Itskovich 2022, the strongest sham-controlled HBOT trial to date. Significant gains in cognition, energy, sleep, pain, and psychiatric symptoms.
The Zilberman-Itskovich trial used 40 sessions over ~10 weeks at 2.0 ATA with the air-break structure. The signal was strongest for cognitive symptoms (brain fog), fatigue, sleep quality, and pain — the predominant long-COVID complaints.
Important nuance for long-COVID specifically: pacing matters. Post-exertional malaise (PEM) is a hallmark of post-viral fatigue, and pushing intensity in or after HBOT sessions can trigger flares. Most members benefit from a slower start (1.5 ATA, 60 min) and progression based on tolerance.
Stack for long-COVID: HBOT 1.5–2.0 ATA → gentle restorative yoga → sleep priority. Avoid combining with high-intensity training. The R1SE post-COVID package includes structured pacing guidance from the team.
Inside the chamber
The technique under every protocol.
The Hadanny air-break structure
Every session above 1.5 ATA uses the air-break structure pioneered by the Shamir Medical Center research group. The pattern: 20 minutes breathing 100% oxygen via mask, 5 minutes breathing ambient air, repeated 3 to 4 times across the session.
Two reasons it's essential. First, oxygen toxicity. Extended high-pressure oxygen exposure can damage lung tissue and (rarely) cause CNS oxygen toxicity. Air breaks reset the clock and keep cumulative exposure within safe limits.
Second — and more importantly — the air breaks activate the hyperoxic-hypoxic paradox. The sudden return to room-air oxygen tension after 100% O₂ triggers HIF-1α signalling, the same pathway exercise and altitude trigger. This is what drives the angiogenesis and stem cell mobilisation that underwrite HBOT's downstream benefits. Skip the air breaks and you lose much of the active ingredient.
Breathing inside the chamber
Breathe normally. Nose preferred (warming, filtering, slightly slowing). Don't hyperventilate — this is the opposite of what cold exposure requires. HBOT works on oxygen-pressure physics, not on respiratory drive.
During pressurisation, swallow or use gentle Valsalva every 30 seconds to keep ears equalised. Stop if anything feels stuck; the team will slow the descent.
During the at-depth phase, you're free to read, listen to audio, or sleep. Some members use the time for guided meditation via headphones (soft-shell) or chamber speakers (hard-shell). The breathing pattern doesn't need to be active or controlled.
Hydration
HBOT mildly dehydrates. Plasma volume expands as oxygen-rich plasma redistributes; you breathe drier air for an hour at pressure; and the post-session afterglow burns through fluid reserves.
Before: 500ml of water 30 minutes before the session. Avoid coffee or alcohol within 2 hours pre-session.
During: R1SE chambers include a water bottle inside (BPA-free, sealed). Sip as needed; you don't need to chug.
After: 250ml within the first hour. Continue normal hydration through the day. Electrolytes are a nice-to-have on long-session days, especially during a longevity protocol block.
Common questions
Match the protocol to the goal.
Our team will recommend a starting protocol, track your response, and adjust as you progress. Most members start with the beginner intro.
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