EWOT vs. Hyperbaric Oxygen Therapy: Which One Is Right for You?

Oxygen is critical for how the body heals, recovers, and performs. Whether you are managing a chronic condition, recovering from illness, or simply aiming to improve energy and well-being, oxygen therapy may offer significant benefits.

The two most commonly discussed options are Exercise With Oxygen Therapy (EWOT) and Hyperbaric Oxygen Therapy (HBOT). While both methods aim to increase oxygen levels in the body, they differ significantly in how they work, how accessible they are, and the results they deliver.

Below, we compare these two modalities to help you determine which is best for your health goals and lifestyle.

What’s the Difference Between EWOT and HBOT?

1. Basic Difference

At a basic level, both EWOT and HBOT aim to increase the amount of oxygen delivered to your tissues, but they go about it differently.

• EWOT involves performing cardiovascular exercise while breathing high-flow, concentrated oxygen. The movement increases heart rate and circulation, pushing oxygen more deeply into tissues.

• HBOT is a passive modality where you lie in a sealed, pressurized chamber while breathing near-pure oxygen. The increased pressure helps force oxygen into your lungs.

Each method enhances oxygen availability through very different mechanisms — one active, one passive.

2. How Each Therapy Works

EWOT = Fast, Efficient Results

EWOT, pioneered by physicist Manfred von Ardenne, combines high-flow oxygen delivery with 15 minutes of cardiovascular exercise. This dual approach helps dilate blood vessels, increase circulation, and rapidly oxygenate tissues, including those impacted by inflammation or poor blood flow.

At One Thousand Roads, we work with clients using EWOT to recover from chronic conditions like long COVID, Lyme, fatigue, stroke, cancer, Alzheimer’s disease and more. We’ve seen firsthand how quickly people begin to feel stronger with increased wellness.

HBOT

HBOT uses increased atmospheric pressure and high-purity oxygen. There are two types of chambers:

• Soft-shell chambers (1.3 ATA): These are often used at home and require a prescription.

• Hard-shell chambers (up to 2.3 ATA): Found in medical facilities and require medical supervision.

A standard HBOT session lasts approximately 90 minutes and can deliver 670 to 1,365 extra liters of oxygen, depending on the chamber type and pressure used.

3. How Long Each Session Takes

A 15-minute EWOT session can deliver up to 1,370 excess liters of oxygen, slightly more than a 60 to 90-minute session in a hard-shell HBOT chamber. This is because movement dramatically boosts oxygen delivery.

With HBOT, you might absorb 670 to 1,365 extra liters of oxygen, depending on the chamber type and duration. However, the process is slower and fully passive.

4. What Each One Helps With

EWOT is widely used for:

• Fatigue and brain fog

• Recovery from long COVID, Lyme, or stroke

• Autoimmune and inflammatory conditions

• Cancer

• Alzheimer's & Parkensons’s disease 

• Performance and stamina

• General wellness and aging support

HBOT is best suited for:

• Non-healing wounds (e.g., diabetic ulcers).

• Individuals unable to exercise.

While both therapies may offer overlapping benefits, such as improved circulation, immune support, and enhanced cellular function, EWOT is generally better suited for individuals who can engage in light activity and want faster, more cost-effective results.

5. How Easy Are They to Do?

EWOT requires some movement, even light activity like walking or slow biking. However, once people start, they find it helps reduce joint pain and inflammation and makes exercise easier to do.

We at One Thousand Roads work with many people dealing with arthritis, and EWOT has been a helpful part of their routine. It may feel challenging at first if you're extremely fatigued, but it often gets easier as your energy and mobility improve.

Whereas HBOT requires no movement at all. You simply lie in the chamber and breathe. If you’re recovering from surgery or your energy is very low, HBOT might be easier to start with.

6. Time, Cost, and Convenience

EWOT is typically more affordable and widely accessible through wellness centers, and with the right equipment, it can even be performed at home.

In contrast, HBOT, particularly when using a medical-grade hard-shell chamber, is significantly more expensive and less convenient. While soft-shell chambers are available for home use, they offer reduced effectiveness. To put it into perspective, a single 15-minute EWOT session can deliver the same oxygen level as a 90-minute session in a hard-shell HBOT chamber, or approximately 6.5 hours in a soft-shell unit.

For those seeking a sustainable, cost-effective, and impactful solution, EWOT is a more practical choice. It fits easily into most routines and doesn’t require a prescription or a clinical environment.

7. How Soon Can You Expect Results?

Many users report noticeable improvements with EWOT within just a few sessions, including better energy, mental clarity, and reduced inflammation. However, everybody's results are different and some folks require several weeks to notice benefits.  Research also indicates that the benefits of just two EWOT sessions can last several weeks.  

In contrast, HBOT often requires multiple longer sessions before noticeable results are achieved. While highly effective in targeted use cases, HBOT is generally less practical for ongoing, frequent therapy.

8. Can You Combine Both?

Although using both EWOT and HBOT is technically possible, it is often unnecessary and inefficient. For most individuals, starting with EWOT is the recommended path. It helps improve oxygenation, reduce inflammation, and restore stamina in a time- and cost-effective manner.

HBOT may be considered for non-healing wound care or when exercise is not an option due to medical limitations.

Quick Comparison: EWOT vs. HBOT

The Best Therapy Is the One That Matches Your Needs

Choosing between EWOT and HBOT isn’t about which is “better.” It’s about which one fits your body and your life.

EWOT and HBOT are both helpful tools to increase oxygen and support health. The best choice depends on your condition, time, and comfort level. Some people use both, depending on what they need.

If you’re not sure where to start, don’t worry. At One Thousand Roads, we help people determine the best path based on their unique health story. Whether it’s boosting recovery, helping with long-term conditions, or improving overall wellness, we’ll help you choose what’s right for you.