What Is Chronic Fatigue Syndrome?
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex multisystem condition characterised by persistent, debilitating fatigue that is not relieved by rest and worsens following physical or mental exertion.
This fatigue is not the ordinary tiredness experienced in everyday life. It is a profound and disabling exhaustion that can affect every aspect of a patient’s life.
It may be accompanied by a wide range of symptoms, including cognitive difficulties, often described as “brain fog”, sleep disturbances despite severe exhaustion, muscle and joint pain, headaches, swollen lymph nodes and manifestations of autonomic dysfunction such as orthostatic hypotension.
Characteristics of Chronic Fatigue Syndrome
The defining feature of chronic fatigue syndrome, and the factor that distinguishes it from ordinary exhaustion or depression, is post-exertional malaise. Even mild physical or mental activity may cause a disproportionate worsening of symptoms that last for hours or days.
This suggests that the body is unable to produce and restore cellular energy at a normal rate.
Mitochondrial dysfunction, which has been documented in studies of energy metabolism in patients with ME/CFS, represents one of the most promising therapeutic targets. Cells that cannot produce sufficient ATP are unable to function normally, whether they are neurons, muscle cells or immune cells.
Supporting mitochondrial activity through increased oxygenation therefore represents a biologically plausible and scientifically grounded therapeutic objective.
Clinical Studies
Several clinical studies and case series have evaluated the use of hyperbaric oxygen therapy in patients with chronic fatigue syndrome, reporting improvements in measures of fatigue, cognitive function and muscle strength.
Of particular interest is its use in patients with Long COVID presenting with a chronic fatigue syndrome-like pattern, an emerging indication supported by early but encouraging clinical findings.
The documented mechanisms of action include improved mitochondrial function, reduced neuroinflammation and activation of antioxidant systems.
In particular, increased mitochondrial biogenesis—the production of new mitochondria—reported in studies of hyperbaric oxygen therapy directly addresses one of the central pathophysiological mechanisms associated with the condition.
The Role of Hyperbaric Oxygen Therapy
In chronic fatigue syndrome, hyperbaric oxygen therapy may be used as an adjunctive intervention aimed at restoring cellular energy production, the fundamental biological deficit expressed clinically as profound fatigue.
It does not replace symptom management or supportive care but acts on the underlying metabolic dysfunction.
Each session provides mitochondria with more favourable conditions for energy production through increased oxygenation. Repeated exposure may stimulate mitochondrial biogenesis, activate antioxidant enzymes and reduce the neuroinflammation that interferes with normal neurological function.
In patients with Long COVID-related fatigue, treatment is delivered with particular care and according to an individualised protocol.
A typical treatment course consists of 20 to 40 sessions, under the supervision of a physician or a specialist in ME/CFS.