Deep Diving Maladies – High Pressure Nervous Syndrome – HPNS
HPNS or High Pressure Nervous Syndrome (also called High-Pressure Neurological Syndrome) can onset beyond a depth of 150m/500ft when using heliox or trimix breathing gasses.
The severity of HPNS is determined by the speed of descent (rate of compression), depth attained (absolute pressure) and the percentage of helium inspired by the diver. There is also a varying level of individual susceptibility, but an individual diver is likely to see no variation in susceptibility on different dives.
High Pressure Nervous Syndrome is a neurological/physiological disorder, that was first described using the term “helium tremors” by the navy physiologist Peter Bennett in 1965 (they were first discovered by Russian scientist G. L. Zal’tsman in 1961, but this report was not made public until 1967). Numerous studies have been completed since that time but, despite much research, the physiological/neurological causes of HPNS are still unknown.
High Pressure Nervous Syndrome symptoms
The symptoms of high pressure nervous syndrome are:
- tremors
- seizures, twitches or jerks,
- somnolence (strong desire to sleep)
- visual disturbances
- nausea
- dizziness
- decreased mental performance
On dives up to 300m/1000ft, these symptoms may subside after some time stabilizing at depth. However, beyond 300m/1000ft, the symptoms typically persist, regardless of time.
Avoiding HPNS
To avoid High-Pressure Nervous Syndrome, the following advice is given:
- Refrain from diving Heliox (O2/He) beyond 122m/400ft.
- Refrain from diving Trimix (O2/He/N2) beyond 180m/600ft
- Descend at slower rates (less than 30cm/1ft per minute can mitigate HPNS, but is impractical for technical diving).
See also: Deep Diving Maladies – Compression Arthralgia

About the Author
Andy Davis is a RAID, PADI TecRec, ANDI, BSAC and SSI-qualified independent technical diving instructor who specializes in teaching sidemount, trimix and advanced wreck diving courses.
Currently residing in Subic Bay, Philippines; he has amassed more than 10,000 open circuit and CCR dives over 27 years of diving across the globe.
He has published numerous diving magazine articles, designed courses for dive training agencies and tests/reviews dive gear for scuba equipment manufacturers. He is currently writing a series of advanced diving books and creating a range of tech diving clothing and accessories.
Prior to becoming a professional technical diving educator in 2006, Andy was a commissioned officer in the Royal Air Force and has served in Iraq, Afghanistan, Belize and Cyprus.
Originally posted 2018-11-05 06:10:40.