Microbaric oxygen therapy modulates EEG microstates and spectral power in patients with chronic insomnia disorder

Zhao, Yixin; Shi, Yongyan; Zhang, Yihui; Ouyang, Xuan; Yuan, Shiqi; Guo, Huili; Kuang, Zebo; Guo, Weilong; Tan, Liwen · 2026 · DOAJ

DOI: 10.1186/s12888-026-07994-2

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Summary

This study investigates the efficacy of microbaric oxygen therapy (MOT) as a non-pharmacological intervention for Chronic Insomnia Disorder (CID), specifically examining its impact on neural mechanisms using electroencephalography (EEG). Motivated by the limitations of current pharmacotherapies, such as dependence and cognitive side effects, and the potential of MOT to improve tissue oxygenation with fewer adverse events than hyperbaric oxygen therapy, the research aims to provide electrophysiological evidence for MOT’s ability to mitigate insomnia-related cognitive impairment and hyperarousal. The researchers conducted a longitudinal, non-randomized study involving 78 CID patients recruited from a tertiary hospital, allocated into an oxygen therapy (OT) group (n=40) or a non-oxygen therapy (NOT) group (n=38) based on patient preference. The OT group received daily 45-minute MOT sessions in pressurized chambers (35 ± 2 kPa) combined with standard pharmacotherapy, while the NOT group received pharmacotherapy alone. Assessments were conducted at baseline, week 1, and week 5 (four weeks post-MOT discontinuation). High-density EEG data were collected during eyes-closed resting states and during a go/no-go task to evaluate inhibitory control. Analyses included EEG microstate parameters, event-related potentials (ERPs), and time-frequency spectral power, utilizing repeated-measures ANOVA and other statistical tests to compare groups. Results indicated that MOT induced significant electrophysiological changes by week 5. In resting-state EEG, the OT group exhibited shorter duration and reduced contribution of microstate D, which is associated with hyper-arousal, alongside increased occurrence and contribution of microstate C. Transition probabilities between microstates were also altered. During the go/no-go task, time-frequency analysis revealed enhanced theta (4–8 Hz) and alpha (8–13 Hz) power during inhibition in the OT group, along with a posterior beta (13–20 Hz) shift, suggesting improved conflict monitoring and resource allocation. However, conventional time-domain ERP analysis (N200 and P300 components) showed no significant between-group differences. The findings suggest that MOT facilitates a shift from maladaptive hyper-vigilance toward more efficient cognitive control in CID patients. The reduction in microstate D and enhancement of task-related theta/alpha power provide novel electrophysiological evidence for the neural basis of insomnia-related cognitive impairment. These results support the development of MOT as a complementary therapeutic strategy for CID, offering a low-risk intervention that addresses underlying neurophysiological deficits beyond subjective sleep improvements.

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• microsleep