Hydrogen–oxygen therapy alleviates sleep disorders and improves mood

Inhalation of a low-dose mixture of hydrogen and oxygen effectively improves sleep quality and mood through its antioxidant properties, by reducing wake time, enhancing sleep quality and relieving psychological stress, a Chinese study has found.

In the single-blind, randomized controlled clinical trial conducted from September 2022 to July 2023 at the Second Medical Center of the PLA General Hospital and the Affiliated Hospital of Chengde Medical College, 66 participants (age, 36–81 years; male, 36 percent)  with sleep disorders were randomly divided into two groups, to receive a mixture of 66.7 percent hydrogen and 33.3 percent oxygen (H–O  group) or  air (control group) through nasal inhalation for 7 days. [Med Gas Res 2025;doi:10.4103/mgr.MEDGASRES-D-25-00020]

Sleep quality and mood were assessed using the Pittsburgh Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS) before and after 1, 3, 5 and 7 days of treatment. An Actiwatch was used to record total sleep time, sleep efficiency, and wake time of the participants.

While no improvements were noted in the control group, H–O group participants experienced significant improvements with therapy. Total sleep time improved from about 380 min before treatment to around 440 min on days 3 and 5, and 475 min on day 7 (all p<0.01), while wake time reduced from 65 min before treatment to 40 min on day 7 of treatment (p<0.01). Sleep efficiency improved from a pretreatment value of 77.5 percent to 87.5 percent on day 7 (p<0.01).

The bidirectional relationship between subjective sleep quality and mood was demonstrated in significant decreases in PSQI and SDS scores (both p<0.01) after 7 days of treatment among H–O group participants, which differed significantly vs the control group (p<0.05), indicating that H–O inhalation significantly improved emotions, alleviating stress and depression. However, it did not significantly impact anxiety levels, with a nonsignificant SAS score difference between the two groups (p>0.05).

Sleep disorders are known to be associated with a myriad of physiological, mental and social problems, including precipitation of chronic diseases and comorbidities, accelerated decline in cognitive function, impairment in memory and attention, Alzheimer’s disease, and aggravation of underlying mental and behavioural symptoms, negatively impacting the mental health of caregivers and increasing the economic burden associated with these conditions on society. [Emerg Top Life Sci 2023;7:457-466; Nutrients 2022;14:5196; ACS Chem Neurosci 2022;13:1467-1478; Environ Res 2018;164:149-157; Sleep Med Clin 2020;15:71-76]

While many pharmacological treatments are available for sleep disorders, they typically do not yield long-term benefits, are often associated with undesirable side effects, and may lead to dependence. Cognitive behavioural therapy for insomnia (CBTi) has been found to be safe and effective (comparable to medication) for treating insomnia and sleep maintenance disorders. However, trained personnel for CBTi delivery are severely lacking. Ongoing search for nondrug interventions for insomnia with minimal side effects provided impetus for the investigation, and hydrogen therapy, which is recognized as an antioxidant and anti-inflammatory treatment, is an emerging therapeutic strategy. [Neuropsychiatr Dis Treat 2021;17:2549-2566; Psychiatry Res 2023;329:115527; Rev Neurol (Paris) 2023;179:767-781; Ann Intern Med 2024;177:177-188; Molecules 2023;28:7785; Med Gas Res 2025;15:120-121]

“Our research introduces a new, nonpharmacological intervention with promising implications for personalized medicine … for people with sleep disorders,” concluded the authors.