〔Abstract〕 Objective To explore the effects of hyperbaric oxygen (HBO) under different pressures on sleep quality and cerebral oxygen metabolism in patients with brain trauma. Methods 60 patients with traumatic brain injury admitted to the Department of Neurosurgery of the Second People's Hospital of Yichun City from March 2018 to August 2021. They were divided into observation group and control group with 30 cases in each group by random number table. The observation group was treated with HBO under 0.25 MPa pressure, while the control group was treated with HBO under 0.20 MPa pressure. The acute physiology and chronic health score Ⅱ (PACHE Ⅱ), mini-mental state examination scale (MMSE), Pittsburgh sleep quality index scale (PSQI), internal jugular venous oxygen saturation (SjvO2), cerebral arteriovenous oxygen content difference (AVDO2), cerebral oxygen uptake rate (CEO2) and cerebral oxygen partial pressure (PbtO2) were compared between the two groups. Results Compared with before treatment, the APACHE Ⅱ scores of both groups decreased after treatment and the PACHE Ⅱ scores of the observation group was significantly lower than that of the control group. The MMSE scores of both groups increased after treatment and the MMSE scores of the observation group was significantly higher than that of the control group, with statistical significance (P < 0.05). Compared with before treatment, sleep time, sleep efficiency, sleep disorder and sleep quality scores of the two groups were all decreased after treatment, and the indexes of the observation group were significantly lower than those of the control group, with statistical significances (P < 0.05). Compared with before treatment, after treatment, AVDO2 of the two groups decreased and AVDO2 of the observation group was significantly lower than that of the control group. After treatment, SjvO2 and CEO2 of the two groups increased and these indexes of the observation group were significantly higher than those of the control group (P < 0.05). Conclusion HBO under 0.25 MPa pressure can improve sleep quality and correct the disorder of cerebral oxygen metabolism in patients with brain trauma.