Low-Dose Ozone Therapy Improves Sleep Quality in Patients with Insomnia and Coronary Heart Disease

Background

Insomnia is common in people living with coronary heart disease (CHD), and poor sleep is linked to worse anxiety, worse mood, and greater cardiovascular strain over time. Standard sleep medications can help but often bring side effects and dependency risks, which is a particular concern in patients who already have heart disease. Researchers have been looking for gentler, non-drug options that can improve sleep without adding to a CHD patient's medication burden. This study examined whether a low-dose ozone therapy (LDOT) protocol could improve sleep quality in patients with both CHD and insomnia, and explored a possible biological mechanism behind any improvement.

Study design

The researchers followed a group of patients diagnosed with both CHD and insomnia through a three-month course of low-dose ozone therapy, delivered at a low concentration (60 parts per billion). Before and after the course, the team measured blood serum levels of two molecules involved in sleep and mood regulation: brain-derived neurotrophic factor (BDNF) and gamma-aminobutyric acid (GABA). Sleep quality, anxiety and depression were assessed using three validated tools: the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale (HADS), and the Self-Rating Scale of Sleep (SRSS). Saliva samples were also tested for antioxidant markers, including catalase activity and markers of oxidative stress.

Findings

After the three-month course of low-dose ozone therapy, serum BDNF and GABA levels were significantly higher than before treatment. Sleep quality improved, shown by better PSQI and SRSS scores, and anxiety and depression scores on the HADS also improved. The authors reported that higher serum BDNF and GABA levels were closely and negatively correlated with PSQI and HADS scores - in other words, patients whose BDNF and GABA rose the most tended to show the greatest improvements in sleep and mood. Markers of antioxidant status in saliva also changed favourably over the course of treatment. No adverse reactions to the therapy were reported.

What the authors concluded

The authors concluded that low-dose ozone therapy improved sleep quality in patients with CHD and insomnia, and suggested this happens partly through raising serum BDNF and GABA, two molecules known to support healthy sleep and mood regulation. They proposed LDOT as a potentially useful option for managing insomnia in this patient group, noting it avoided the adverse reactions associated with sleep medication and was straightforward for patients to undergo.

Limitations of this study

The publicly available summary of this study does not confirm whether a control or comparison group was used, so it is not clear how much of the improvement can be attributed specifically to the ozone therapy rather than other factors, such as natural fluctuation in symptoms or increased clinical attention during the study period. The exact number of patients enrolled and full methodological detail (for example, randomisation, blinding, or long-term follow-up) were not available in the sources reviewed. The correlation reported between BDNF/GABA levels and sleep or mood scores does not by itself prove that raising these molecules causes better sleep - it may reflect a shared underlying process. As with many single-centre studies, further independent research with larger groups and a comparison group would help confirm these findings.