Hyperbaric Oxygen Therapy on Elderly’s Sleep Quality : A Pre Experimental Study
Abstract
Background & Aim: The aging process makes the sleep quality of older people tend to decrease and affects sleep and rest patterns in the elderly population. Hyperbaric oxygen therapy is widely used to support clinical treatment. However, its use to address sleeping quality in the Indonesian elderly population is barely studied. This study aimed to determine the effects of hyperbaric oxygen therapy on the elderly’s sleep quality. Methods: The study used a pre-experimental design. The intervention variable was ten sessions of hyperbaric oxygen therapy (HBOT), while the outcome variable was the sleep quality in the elderly. The sample was 65 persons, selected by simple random sampling from the eligible elderly patients receiving hyperbaric oxygen therapy at Naval Health Institute, Surabaya, Indonesia. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the outcome and the data were analyzed with the Paired T-Test. Results: After receiving the HBOT, the average value of sleep quality in the elderly improved from 6.63 (poor category) to 4.35 (good category) with p = 0.001. The results indicate that HBOT could significantly improve sleep quality in the Indonesian elderly. Conclusions: HBOT can be used to treat elderly patients with sleep disorders. Further studies are needed to identify the long-term effect of HBOT on the outcome. Also, the provision of HBOT to improve sleep quality for the wider elderly population requires further investigation with a more rigorous methodology such as a randomized controlled trial.
Keywords:
Elderly, Hyperbaric Oxygen Therapy, Sleep Quality
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References
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Castro, C. M., Lee, K. A., Bliwise, D. L., Urizar, G. G., Woodward, S. H., & King, A. C. (2009). Sleep Patterns and Sleep-Related Factors Between Caregiving and Non-Caregiving Women. Behavioral Sleep Medicine, 7(3), 164–179. https://doi.org/10.1080/15402000902976713
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Gehmert, S., Geis, S., Lamby, P., Roll, C., Braumandl, U., Hidayat, M., ... & Prantl, L. (2011). Evaluation of hyperbaric oxygen therapy for free flaps using planar optical oxygen sensors. Preliminary results. Clinical Hemorheology and Microcirculation, 48(1-3), 75-79. https://doi.org/10.3233/CH-2011-1389
Gehrman, P., & Ancoli-Israel, S. (2016). Insomnia in the elderly. Insomnia: Diagnosis and Treatment, 224–234.
González-Castro, A., Rodríguez-Gorregán, J. C., Casado-Rojo, A., & Gordo-Vega, M. A. (2018). Hyperbaric oxygen therapy in the treatment of central retinal artery occlusion. Emergencias: revista de la Sociedad Espanola de Medicina de Emergencias, 30(5). Retrieved from: https://casereports.bmj.com/content/2017/bcr-2017-220113.short
Gottfried, I., Schottlender, N., & Ashery, U. (2021). Hyperbaric oxygen treatment—from mechanisms to cognitive improvement. Biomolecules, 11(10). https://doi.org/10.3390/biom11101520
Hidayat, S., Kusnanto, K., & Hannan, M. (2021). Elderly sleep quality in cross cultural perspective. Journal of International Dental and Medical Research, 14(3), 1279-1295. Retrieved from: http://www.jidmr.com/journal/wp-content/uploads/2021/10/67-1.-2333_SYAIFURRAHMAN-HIDAYAT_ELDERLY-SLEEP-QUALITY-IN-CROSSCULTURAL-PERSPECTIVE_28-Juli.pdf
Hisnindarsyah, H., & Nandaka, I. K. T. (2023). The effect of hyperbaric oxygen therapy on reducing blood cortisol levels in individuals with anxiety disorders. Asian Journal of Healthcare Analytics, 2(2), 325–334. https://doi.org/10.55927/ajha.v2i2.7542
Huchim, O., Rivas-sosa, F., & Méndez-domínguez, N. R. N. (2017). Fisiopatogénicos Y Terapéuticos. 938–945.
Lund, V., Kentala, E., Scheinin, H., Klossner, J., Koskinen, P., & Jalonen, J. (1999). Effect of hyperbaric conditions on plasma stress hormone levels and endothelin-1. Undersea & Hyperbaric Medicine : Journal of The Undersea and Hyperbaric Medical Society, Inc, 26(2), 87–92. Retrieved from: http://europepmc.org/abstract/MED/10372427
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Nursalam, N., Kurniasari, F., Elida, U., & Ferry, E. (2018). The effect of sleep hygiene and brain gym on increasing elderly comfort and sleep quality. Indian Journal of Public Health Research & Development, 9(12), 559-564. https://doi.org/10.5958/0976-5506.2018.01901.0
Oley, M. H., Oley, M. C., Aling, D. M. R., Kalangi, J. A., Islam, A. A., Hatta, M., ... & Faruk, M. (2021). Effects of hyperbaric oxygen therapy on the healing of thermal burns and its relationship with ICAM-1: a case-control study. Annals of Medicine and Surgery, 61, 104-109. https://doi.org/10.1016/j.amsu.2020.12.025
Oley, M. H., Oley, M. C., Noersasongko, A. D., Hatta, M., Philips, G. G., Faruk, M., ... & Tulong, M. T. (2021). Effects of hyperbaric oxygen therapy on vascular endothelial growth factor protein and mRNA in crush injury patients: a randomized controlled trial study. International Journal of Surgery Open, 29, 33-39. https://doi.org/10.1016/j.ijso.2021.01.003
Rosyanti, L., Hadi, I., Rahayu, D. Y. S., & Birawida, A. B. (2019). Mekanisme yang Terlibat dalam Terapi Oksigen Hiperbarik: theoritical review hyperbaric oxygen therapy/HBOT. Health Information : Jurnal Penelitian, 11(2), 180–202. https://doi.org/10.36990/hijp.v11i2.144
Rusoke-Dierich, O. (2018). Decompression Theory. In: Diving Medicine. Springer, Cham, Germany. https://doi.org/10.1007/978-3-319-73836-9_9
Rusoke-Dierich, O. (2018). Physical Behaviour of Gas. In: Diving Medicine. Springer, Cham, Germany. https://doi.org/10.1007/978-3-319-73836-9_8
Sedu, S. W., Oley, M. H., Tjandra, D. E., & Langi, F. F. (2020). Studi Pendahuluan Terapi Hiperbarik Terhadap Penyembuhan Ulkus Kaki Diabetik Penderita Diabetes Melitus Tipe-2 dengan Penanda Interleukin 6 dan Skor PEDIS. Jurnal Bedah Nasional, 4(1),19–25. http://dx.doi.org/10.24843/JBN.2020.v04.i01.p04
Shapira, R., Gdalyahu, A., Gottfried, I., Sasson, E., Hadanny, A., Efrati, S., ... & Ashery, U. (2021). Hyperbaric oxygen therapy alleviates vascular dysfunction and amyloid burden in an Alzheimer’s disease mouse model and in elderly patients. Aging (Albany NY), 13(17), 20935–20961. https://doi.org/10.18632/aging.203485
Shi, R., Meng, W., Liu, Z., Chang, L., Lu, R., Chen, X., … Deng, Y. (2024). Hyperbaric oxygen therapy for poststroke insomnia: a systematic review and meta-analysis protocol. BMJ Open, 14(3). https://doi.org/10.1136/bmjopen-2023-081642
Suarilah, I., Hayat, M., & Indarwati, R. (2020). The effect of cutaneous stimulation: slow stroke back massage on sleep quality improvement in elderly. Systematic Reviews in Pharmacy, 11(3), 918-920. https://doi.org/10.31838/srp.2020.3.137
Sugianto, S., Hadisaputro, S., Supriharti, S., Munasik, M., & Adi, M. S. (2017). Beberapa Faktor yang Berpengaruh terhadap Barotrauma Membran Timpani pada Penyelam Tradisional di Wilayah Kabupaten Banyuwangi. [Several Factors Affecting Tympanic Membrane Barotrauma in Traditional Divers in Banyuwangi Regency], Jurnal Epidemiologi Kesehatan Komunitas, 2(1), 27-35. https://doi.org/10.14710/jekk.v2i1.3969
Sukmawati, N. M. H., & Putra, I. G. S. W. (2019). Reliabilitas Kusioner Pittsburgh Sleep Quality Index ( Psqi ) Versi Bahasa Indonesia Dalam Mengukur. Jurnal Lngkungan Dan Pembangunan, 3(2), 30–38. https://doi.org/10.22225/wicaksana.3.2.2019.30-38
Untari, N. K. S. D., Kusumastuti, K., Suryokusumo, G., & Sudiana, I. K. (2021). Acute motor axonal neuropathy improvement 20 days after hyperbaric oxygen therapy. International Medical Case Reports Journal, 151-155. https://doi.org/10.2147/IMCRJ.S289627
Vitiello, M. V., Moe, K. E., & Prinz, P. N. (2002). Sleep complaints cosegregate with illness in older adults: Clinical research informed by and informing epidemiological studies of sleep. Journal of Psychosomatic Research, 53(1), 555–559. https://doi.org/10.1016/S0022-3999(02)00435-X
Bin-Alamer, O., Abou-Al-Shaar, H., Efrati, S., Hadanny, A., Beckman, R. L., Elamir, M., ... & Maroon, J. C. (2024). Hyperbaric oxygen therapy as a neuromodulatory technique: a review of the recent evidence. Frontiers in Neurology, 15, https://doi.org/10.3389/fneur.2024.1450134
Bu, S., Liu, W., Sheng, X., Jin, L., & Zhao, Q. (2024). Hyperbaric oxygen therapy improves motor symptoms , sleep , and cognitive dysfunctions in parkinson ’ s disease. Dementia and Geriatric Cognitive Disorders, 1-14. https://doi.org/10.1159/000542619
Castro, C. M., Lee, K. A., Bliwise, D. L., Urizar, G. G., Woodward, S. H., & King, A. C. (2009). Sleep Patterns and Sleep-Related Factors Between Caregiving and Non-Caregiving Women. Behavioral Sleep Medicine, 7(3), 164–179. https://doi.org/10.1080/15402000902976713
Foley, D., Ancoli-Israel, S., Britz, P., & Walsh, J. (2004). Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. Journal of Psychosomatic Research, 56(5), 497-502. https://doi.org/10.1016/j.jpsychores.2004.02.010
Gehmert, S., Geis, S., Lamby, P., Roll, C., Braumandl, U., Hidayat, M., ... & Prantl, L. (2011). Evaluation of hyperbaric oxygen therapy for free flaps using planar optical oxygen sensors. Preliminary results. Clinical Hemorheology and Microcirculation, 48(1-3), 75-79. https://doi.org/10.3233/CH-2011-1389
Gehrman, P., & Ancoli-Israel, S. (2016). Insomnia in the elderly. Insomnia: Diagnosis and Treatment, 224–234.
González-Castro, A., Rodríguez-Gorregán, J. C., Casado-Rojo, A., & Gordo-Vega, M. A. (2018). Hyperbaric oxygen therapy in the treatment of central retinal artery occlusion. Emergencias: revista de la Sociedad Espanola de Medicina de Emergencias, 30(5). Retrieved from: https://casereports.bmj.com/content/2017/bcr-2017-220113.short
Gottfried, I., Schottlender, N., & Ashery, U. (2021). Hyperbaric oxygen treatment—from mechanisms to cognitive improvement. Biomolecules, 11(10). https://doi.org/10.3390/biom11101520
Hidayat, S., Kusnanto, K., & Hannan, M. (2021). Elderly sleep quality in cross cultural perspective. Journal of International Dental and Medical Research, 14(3), 1279-1295. Retrieved from: http://www.jidmr.com/journal/wp-content/uploads/2021/10/67-1.-2333_SYAIFURRAHMAN-HIDAYAT_ELDERLY-SLEEP-QUALITY-IN-CROSSCULTURAL-PERSPECTIVE_28-Juli.pdf
Hisnindarsyah, H., & Nandaka, I. K. T. (2023). The effect of hyperbaric oxygen therapy on reducing blood cortisol levels in individuals with anxiety disorders. Asian Journal of Healthcare Analytics, 2(2), 325–334. https://doi.org/10.55927/ajha.v2i2.7542
Huchim, O., Rivas-sosa, F., & Méndez-domínguez, N. R. N. (2017). Fisiopatogénicos Y Terapéuticos. 938–945.
Lund, V., Kentala, E., Scheinin, H., Klossner, J., Koskinen, P., & Jalonen, J. (1999). Effect of hyperbaric conditions on plasma stress hormone levels and endothelin-1. Undersea & Hyperbaric Medicine : Journal of The Undersea and Hyperbaric Medical Society, Inc, 26(2), 87–92. Retrieved from: http://europepmc.org/abstract/MED/10372427
Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J. P., & Mérette, C. (2006). Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Medicine, 7(2), 123–130. https://doi.org/10.1016/j.sleep.2005.08.008
Nursalam, N., Kurniasari, F., Elida, U., & Ferry, E. (2018). The effect of sleep hygiene and brain gym on increasing elderly comfort and sleep quality. Indian Journal of Public Health Research & Development, 9(12), 559-564. https://doi.org/10.5958/0976-5506.2018.01901.0
Oley, M. H., Oley, M. C., Aling, D. M. R., Kalangi, J. A., Islam, A. A., Hatta, M., ... & Faruk, M. (2021). Effects of hyperbaric oxygen therapy on the healing of thermal burns and its relationship with ICAM-1: a case-control study. Annals of Medicine and Surgery, 61, 104-109. https://doi.org/10.1016/j.amsu.2020.12.025
Oley, M. H., Oley, M. C., Noersasongko, A. D., Hatta, M., Philips, G. G., Faruk, M., ... & Tulong, M. T. (2021). Effects of hyperbaric oxygen therapy on vascular endothelial growth factor protein and mRNA in crush injury patients: a randomized controlled trial study. International Journal of Surgery Open, 29, 33-39. https://doi.org/10.1016/j.ijso.2021.01.003
Rosyanti, L., Hadi, I., Rahayu, D. Y. S., & Birawida, A. B. (2019). Mekanisme yang Terlibat dalam Terapi Oksigen Hiperbarik: theoritical review hyperbaric oxygen therapy/HBOT. Health Information : Jurnal Penelitian, 11(2), 180–202. https://doi.org/10.36990/hijp.v11i2.144
Rusoke-Dierich, O. (2018). Decompression Theory. In: Diving Medicine. Springer, Cham, Germany. https://doi.org/10.1007/978-3-319-73836-9_9
Rusoke-Dierich, O. (2018). Physical Behaviour of Gas. In: Diving Medicine. Springer, Cham, Germany. https://doi.org/10.1007/978-3-319-73836-9_8
Sedu, S. W., Oley, M. H., Tjandra, D. E., & Langi, F. F. (2020). Studi Pendahuluan Terapi Hiperbarik Terhadap Penyembuhan Ulkus Kaki Diabetik Penderita Diabetes Melitus Tipe-2 dengan Penanda Interleukin 6 dan Skor PEDIS. Jurnal Bedah Nasional, 4(1),19–25. http://dx.doi.org/10.24843/JBN.2020.v04.i01.p04
Shapira, R., Gdalyahu, A., Gottfried, I., Sasson, E., Hadanny, A., Efrati, S., ... & Ashery, U. (2021). Hyperbaric oxygen therapy alleviates vascular dysfunction and amyloid burden in an Alzheimer’s disease mouse model and in elderly patients. Aging (Albany NY), 13(17), 20935–20961. https://doi.org/10.18632/aging.203485
Shi, R., Meng, W., Liu, Z., Chang, L., Lu, R., Chen, X., … Deng, Y. (2024). Hyperbaric oxygen therapy for poststroke insomnia: a systematic review and meta-analysis protocol. BMJ Open, 14(3). https://doi.org/10.1136/bmjopen-2023-081642
Suarilah, I., Hayat, M., & Indarwati, R. (2020). The effect of cutaneous stimulation: slow stroke back massage on sleep quality improvement in elderly. Systematic Reviews in Pharmacy, 11(3), 918-920. https://doi.org/10.31838/srp.2020.3.137
Sugianto, S., Hadisaputro, S., Supriharti, S., Munasik, M., & Adi, M. S. (2017). Beberapa Faktor yang Berpengaruh terhadap Barotrauma Membran Timpani pada Penyelam Tradisional di Wilayah Kabupaten Banyuwangi. [Several Factors Affecting Tympanic Membrane Barotrauma in Traditional Divers in Banyuwangi Regency], Jurnal Epidemiologi Kesehatan Komunitas, 2(1), 27-35. https://doi.org/10.14710/jekk.v2i1.3969
Sukmawati, N. M. H., & Putra, I. G. S. W. (2019). Reliabilitas Kusioner Pittsburgh Sleep Quality Index ( Psqi ) Versi Bahasa Indonesia Dalam Mengukur. Jurnal Lngkungan Dan Pembangunan, 3(2), 30–38. https://doi.org/10.22225/wicaksana.3.2.2019.30-38
Untari, N. K. S. D., Kusumastuti, K., Suryokusumo, G., & Sudiana, I. K. (2021). Acute motor axonal neuropathy improvement 20 days after hyperbaric oxygen therapy. International Medical Case Reports Journal, 151-155. https://doi.org/10.2147/IMCRJ.S289627
Vitiello, M. V., Moe, K. E., & Prinz, P. N. (2002). Sleep complaints cosegregate with illness in older adults: Clinical research informed by and informing epidemiological studies of sleep. Journal of Psychosomatic Research, 53(1), 555–559. https://doi.org/10.1016/S0022-3999(02)00435-X
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Rachmawati, D., Chabibah, N., & Mayasari, A. (2025). Hyperbaric Oxygen Therapy on Elderly’s Sleep Quality : A Pre Experimental Study. International Journal of Advancement in Life Sciences Research, 8(1), 154-160. https://doi.org/https://doi.org/10.31632/ijalsr.2025.v08i01.014
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