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Prescription 2015: Sauna Therapy

March 9, 2015 Written by JP       [Font too small?]

When I was growing up, we had a beautiful sauna in my parent’s bedroom. But, since no one in our home was accustomed to sauna bathing, we simply used the space for storage. Looking back on it now, I wish we had put that “storage room” to better use! These days, I would love to have a sauna at home. What’s more, Mrs. Healthy Fellow grew up using saunas, so we would certainly put it to good use. Unfortunately, the probability of adding a sauna to our home is about as likely as the addition of an elevator. On the other hand, our local gym has a sauna that we can and should utilize more often. In fact, saunas are readily available in most communities. This is great news because there’s more reason than ever to use saunas on a regular basis.

You know a therapy has hit prime time when it’s featured in one of the Journals of the American Medical Association. In February 2015, the journal JAMA Internal Medicine published a study defining the effects of sauna bathing on cardiovascular and all-cause mortality. The investigation followed the use of saunas in 2,315 middle-aged Finnish men over a five year period. A subsequent follow-up, averaging 20.7 years, analyzed the participants’ likelihood of death from cardiovascular and other causes. The findings reveal that sauna bathing 4-7 times weekly reduced the risk of sudden cardiac death by half vs. those who only bathed once a week. The relative mortality risk for fatal coronary heart disease was 43% lower, fatal cardiovascular disease was 37% less likely and all-cause mortality declined by over 46%. The authors of the study also noted that longer sauna bathing, i.e. more than 11 minutes per session, conferred greater cardiovascular protection. Additionally, two other recent trials report that regular sauna time minimizes the intensity of tension headaches and improves pulmonary function in those with seasonal allergies.

The mechanisms by which sauna exposure improves health aren’t entirely elucidated. However, there are clues to be found in many peer reviewed, scientific studies on the subject. For instance, the previously mentioned seasonal allergy trial discovered that sauna therapy prompted positive effects on heart rate variability (HRV). Reduced HRV is associated with cardiovascular mortality and poor overall health status. A 2014 experiment consisting of 10 sauna baths (15 minutes each), at a temperature of 197.6 °F and 5-16% humidity, significantly lowered triglycerides and slightly increased HDL (“good”) cholesterol in a group of young men. Other studies have demonstrated improved antioxidant status and immune system stimulation as a result of single and repeated sauna sessions. All of these effects could conceivably account for the lowered mortality risks reported in the aforementioned JAMA study.

There are a few considerations to keep in mind prior to incorporating sauna therapy to your wellness routine. If you have any serious health concerns, it’s prudent to consult with your physician before making any major lifestyle change. Think of a regular sauna routine similarly to a new exercise regimen. Certain life events, including pregnancy, surgical recovery and medical conditions such as advanced heart disease, multiple sclerosis and severe skin diseases may render sauna inappropriate. For peace of mind and safety’s sake, this ought to be decided on a case-by-case basis. You should also remember that added hydration and nutrition is a must when sauna bathing. This is especially true if you enjoy wet saunas and/or are overweight as sauna-induced body mass loss via perspiration is greater in heavier individuals. This is an easy fix. Just make sure to drink plenty of pure water and eat more low-glycemic fruits and vegetables.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Association Between Sauna Bathing & Fatal Cardiovascular & All-Cause (link)

Study 2 - Effect of Sauna Bathing on Lipid Profile in Young, Physically Active (link)

Study 3 - Effect of a Single Finnish Sauna Session on White Blood Cell Profile (link)

Study 4 - The Influence of General Infrared Sauna on the Antioxidant Systems (link)

Study 5 – Effect of a Single Finnish Sauna Bath After Aerobic Exercise on the (link)

Study 6 - Comparison of Physiological Reactions & Physiological Strain in Healthy (link)

Study 7 - Effects of Heat Stress on Physical Functioning in Persons with Multiple (link)

Study 8 - Effects of Heat Stress on Cognition in Persons with Multiple Sclerosis (link)

Study 9 – Sauna as a Valuable Clinical Tool for Cardiovascular, Autoimmune (link)

Study 10 - AHA: Hot Tub and Sauna Use and High Blood Pressure (link)

Overweight Increases Sauna Therarpy-Induced Body Mass Loss

Source: ScientificWorldJournal. 2014;2014:307421. (Link)

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8 Comments & Updates to “Prescription 2015: Sauna Therapy”

  1. JP Says:

    Update: Waon therapy, a Japanese sauna regimen, improves cardiovascular function, exercise capacity and quality of life in CHF patients …

    http://www.ncbi.nlm.nih.gov/pubmed/25740582

    Int Heart J. 2015 Feb 27.

    Waon Therapy Improves Quality of Life as Well as Cardiac Function and Exercise Capacity in Patients With Chronic Heart Failure.

    Waon therapy (WT), which in Japanese means soothing warmth, is a repeated sauna therapy that improves cardiac and vascular endothelial function in patients with chronic heart failure (CHF). We investigated whether WT could improve the quality of life (QOL) of CHF patients in addition to improving cardiac function and exercise capacity.A total of 49 CHF patients (69 ± 14 years old) were treated with a 60°C far infrared-ray dry sauna bath for 15 minutes and then kept in a bed covered with blankets for 30 minutes once a day for 3 weeks. At baseline and 3 weeks after starting WT, cardiac function, 6-minute walk distance (6MWD), flow mediated dilation (FMD) of the brachial artery, and SF36-QOL scores were determined.WT significantly improved left ventricular ejection fraction (LVEF), B-type natriuretic peptide (BNP), 6MWD, and FMD (3.6 ± 2.3 to 5.1 ± 2.8%, P < 0.01). Moreover, WT significantly improved not only the physical (PC) but also mental component (MC) of the QOL scores. WT-induced improvement of PC was negatively correlated with changes in BNP (r = -0.327, P < 0.05), but MC improvement was not related directly to changes in BNP, LVEF, or 6MWD. WT-induced changes in MC were not parallel to PC improvement.WT improved QOL as well as cardiac function and exercise capacity in patients with CHF. Mental QOL improved independently of WT-induced improvement of cardiac function and exercise capacity.

    Be well!

    JP

  2. JP Says:

    Update: More support for Waon sauna therapy. This time, in patients living with chronic fatigue …

    http://www.ncbi.nlm.nih.gov/pubmed/25748743

    Intern Med. 2015;54(3):333-8. doi: 10.2169/internalmedicine.54.3042.

    Effects of waon therapy on chronic fatigue syndrome: a pilot study.

    Objective: Chronic fatigue syndrome (CFS) is a disabling condition of unknown etiology, and no definitive therapy has been identified to date. We developed Waon therapy, a form of thermal therapy using a far-infrared dry sauna, and in this study herein examined its feasibility and safety in patients with CFS.

    Methods: Ten consecutive inpatients with CFS stayed in a 60°C sauna for 15 minutes and then rested on a bed under a blanket for an additional 30 minutes outside the sauna room. The treatments were performed once a day, five days a week for four weeks. Perceived fatigue, the primary outcome measure, was evaluated using a numerical rating scale before, during (two weeks after the commencement of therapy) and after therapy. The pain level, evaluated using a numerical rating scale, mood, assessed using the Profile of Mood States questionnaire, and performance status, assessed using a scale developed for CFS patients were also examined before and after therapy.

    Results: Perceived fatigue significantly decreased after therapy, although no significant reductions were observed during therapy. In addition, a negative mood, including anxiety, depression and fatigue, and the performance status significantly improved after therapy. However, the levels of pain and vigor did not change significantly. No patients reported any adverse effects during the therapy.

    Conclusion: These findings suggest that Waon therapy may be a useful and safe treatment for CFS.

    Be well!

    JP

  3. JP Says:

    Update 03/13/15:

    http://informahealthcare.com/doi/abs/10.3109/09638288.2015.1044032

    Combined effects of repeated sauna therapy and exercise training on cardiac function and physical activity in patients with chronic heart failure.

    PURPOSE: We investigated the combined effects of repeated sauna therapy and exercise training on subjective symptoms, cardiac function, daily activities and ambulation capacity in patients with chronic heart failure.

    METHODS: Fifty four patients including 26 patients with repeated sauna therapy and exercise training (combined therapy group) and 28 patients with repeated sauna therapy (monotherapy group) participated in the study. Repeated sauna therapy and exercise training were performed once a day, 5 days a week. Clinical symptoms, brain natriuretic peptide concentration, cardiac functions evaluated by echocardiography, cardiac size on chest radiography, Barthel Index (BI) and ambulation capacity were examined and compared between the time of hospital admission and the time of discharge.

    RESULTS: Both the groups showed significantly improved New York Heart Association functional class, cardiothoracic ratio, brain natriuretic peptide concentration, left ventricular ejection fraction, BI score and ambulation capacity grade. The changes of New York Heart Association functional class, BI score and ambulation capacity in the combined therapy group were a higher level of statistical significance than those in monotherapy group. Notably, significant between group difference was observed in the changes of BI score.

    CONCLUSIONS: The addition of exercise training programs to repeated sauna therapy may be efficient and effective for improvement of cardiac function and daily activities for patients with chronic heart failure. Implications of Rehabilitation Repeated sauna therapy is an effective means of improving cardiac, vascular function and mental health in CHF patients. Exercise training is an effective means of improving exercise capacity, thus improving ADL. Combination of repeated sauna therapy and exercise training may be recommended as a comprehensive treatment to improve cardiac function, ambulation capacity, and ADL in CHF patients.

    Be well!

    JP

  4. JP Says:

    Updated 07/20/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493260/

    Springerplus. 2015 Jul 7;4:321.

    Effects of far-infrared sauna bathing on recovery from strength and endurance training sessions in men.

    PURPOSE: This study investigated effects of far-infrared sauna (FIRS) bathing on recovery from strength training and endurance training sessions, but also possible differences between FIRS and traditional (TRAD) Finnish sauna bathing.

    METHODS: Ten healthy physically active male volunteers had on various days either a 60 min hypertrophic strength training session (STS) or a 34-40 min maximal endurance training session (ETS), which was following by 30 min bathing in special FIRS sauna at temperature of 35-50°C and humidity of 25-35%. After the sauna, subjects sat for 30 min at room temperature (21°C and 25-30% humidity). In comparison, 30 min of TRAD took place at 35-50°C and in 60-70% humidity. Performance tests included maximal isometric bench press and leg press, counter movement jump (CMJ) and maximal oxygen uptake on a treadmill.

    RESULTS: After STS, there were decreases in maximal isometric bench press (p < 0.001), maximal isometric leg press (p < 0.001), CMJ (p < 0.001) and pH (p < 0.001), but increases in heart rate (p < 0.001) and lactate concentration (p < 0.001) as expected. During recovery there were no differences in any variables between FIRS and no sauna bathing (NO SAUNA). Maximal ETS increased oxygen uptake (p < 0.001), heart rate (p < 0.001), lactate concentration (p < 0.001) and decreased pH (p < 0.001) as expected. During recovery at 30 min, CMJ was significantly (p < 0.05) higher (0.34 ± 0.09 m) after FIRS bathing than after sitting with NO SAUNA (0.32 ± 0.0 m). After sauna heart rate was higher (p < 0.05) in TRAD (92 ± 13 beats/min) than in FIRS (71 ± 7 beats/min).

    CONCLUSION: In conclusion, deep penetration of infrared heat (approximately 3-4 cm into fat tissue and neuromuscular system) with mild temperature (35-50°C), and light humidity (25-35%) during FIRS bathing appears favorable for the neuromuscular system to recover from maximal endurance performance. FIRS bathing is a very light loading for the body and provides a comfortable and relaxing experience.

    Be well!

    JP

  5. JP Says:

    Updated 04/06/16:

    https://www.jstage.jst.go.jp/article/circj/80/4/80_CJ-16-0051/_html

    Circ J. 2016 Mar 25;80(4):827-34.

    Waon Therapy for Managing Chronic Heart Failure - Results From a Multicenter Prospective Randomized WAON-CHF Study.

    BACKGROUND: Waon therapy improves heart failure (HF) symptoms, but further evidence in patients with advanced HF remains uncertain.

    METHODS AND RESULTS: In 19 institutes, we prospectively enrolled hospitalized patients with advanced HF, who had plasma levels of B-type natriuretic peptide (BNP) >500 pg/ml on admission and BNP >300 pg/ml regardless of more than 1 week of medical therapy. Enrolled patients were randomized into Waon therapy or control groups. Waon therapy was performed once daily for 10 days with a far infrared-ray dry sauna maintained at 60℃ for 15 min, followed by bed rest for 30 min covered with a blanket. The primary endpoint was the ratio of BNP before and after treatment. In total, 76 Waon therapy and 73 control patients (mean age 66 years, men 61%, mean plasma BNP 777 pg/ml) were studied. The groups differed only in body mass index and the frequency of diabetes. The plasma BNP, NYHA classification, 6-min walk distance (6MWD), and cardiothoracic ratio significantly improved only in the Waon therapy group. Improvements in NYHA classification, 6MWD, and cardiothoracic ratio were significant in the Waon therapy group, although the change in plasma BNP did not reach statistical significance. No serious adverse events were observed in either group.

    CONCLUSIONS: Waon therapy, a holistic soothing warmth therapy, showed clinical advantages in safety and efficacy among patients with advanced HF. (Circ J 2016; 80: 827-834).

    Be well!

    JP

  6. JP Says:

    Updated 08/29/16:

    http://jap.physiology.org/content/early/2016/07/11/japplphysiol.00424.2016

    J Appl Physiol (1985). 2016 Jul 14:jap.00424.2016.

    Passive heat therapy improves cutaneous microvascular function in sedentary humans via improved nitric oxide-dependent dilation.

    Passive heat therapy (repeated hot tub or sauna use) reduces cardiovascular risk, but its effects on the mechanisms underlying improvements in microvasculature function have yet to be studied. We investigated the effects of heat therapy on microvascular function and whether improvements were related to changes in nitric oxide (NO) bioavailability using cutaneous microdialysis.

    METHODS: Eighteen young, sedentary, otherwise healthy subjects participated in 8 weeks of heat therapy (hot water immersion to maintain rectal temperature ≥38.5°C for 60min per session; N=9) or thermoneutral water immersion (sham; N=9), and participated in experiments before and after the 8-week intervention in which forearm cutaneous hyperemia to 39°C local heating was assessed at three microdialysis sites receiving 1) Lactated Ringer’s (Control), 2) Nω-nitro-L-arginine (L-NNA, non-specific NO synthase inhibitor), and 3) Tempol, a superoxide dismutase mimetic. The arm used for microdialysis experiments remained out of the water at all times. Data are mean±S.E. cutaneous vascular conductance (CVC = laser Dopper flux/mean arterial pressure), presented as percent maximal CVC (%CVCmax).

    RESULTS: Heat therapy increased local heating plateau from 42±6 to 53±6%CVCmax (p<0.001) and increased NO-dependent dilation (difference in plateau between Control and L-NNA sites) from 26±6 to 38±4%CVCmax (p<0.01), while no changes were observed in the sham group. When data were pooled across all subjects at 0wks, Tempol had no effect on the local heating response (p=0.53 vs. Control). There were no changes at the Tempol site across interventions (p=0.58).

    CONCLUSIONS: Passive heat therapy improves cutaneous microvascular function by improving NO-dependent dilation, which may have clinical implications.

    Be well!

    JP

  7. JP Says:

    Updated 12/16/16:

    http://ageing.oxfordjournals.org/content/early/2016/12/07/ageing.afw212.abstract

    Age Ageing. 2016 Dec 7.

    Sauna bathing is inversely associated with dementia and Alzheimer’s disease in middle-aged Finnish men.

    BACKGROUND: there are no previous studies linking repeated heat exposure of sauna and the risk of memory diseases. We aimed to investigate whether frequency of sauna bathing is associated with risk of dementia and Alzheimer’s disease.

    SETTING: prospective population-based study.

    METHODS: the frequency of sauna bathing was assessed at baseline in the Kuopio Ischaemic Heart Disease population-based prospective cohort study of 2,315 apparently healthy men aged 42-60 years at baseline, with baseline examinations conducted between 1984 and 1989. Hazard ratios (HRs) with 95% confidence intervals (CIs) for dementia and Alzheimer’s disease were ascertained using Cox-regression modelling with adjustment for potential confounders.

    RESULTS: during a median follow-up of 20.7 (interquartile range 18.1-22.6) years, a total of 204 and 123 diagnosed cases of dementia and Alzheimer’s disease were respectively recorded. In analysis adjusted for age, alcohol consumption, body mass index, systolic blood pressure, smoking status, Type 2 diabetes, previous myocardial infarction, resting heart rate and serum low-density lipoprotein cholesterol, compared with men with only 1 sauna bathing session per week, the HR for dementia was 0.78 (95% CI: 0.57-1.06) for 2-3 sauna bathing sessions per week and 0.34 (95% CI: 0.16-0.71) for 4-7 sauna bathing sessions per week. The corresponding HRs for Alzheimer’s disease were 0.80 (95% CI: 0.53-1.20) and 0.35 (95% CI: 0.14-0.90).

    CONCLUSION: in this male population, moderate to high frequency of sauna bathing was associated with lowered risks of dementia and Alzheimer’s disease. Further studies are warranted to establish the potential mechanisms linking sauna bathing and memory diseases.

    Be well!

    JP

  8. JP Says:

    Updated 12/12/17:

    https://link.springer.com/article/10.1007%2Fs10654-017-0335-y

    Eur J Epidemiol. 2017 Dec 5.

    Sauna bathing and systemic inflammation.

    We aimed to investigate whether frequency of sauna bathing is associated with the levels of serum C-reactive protein. C-reactive protein is a leading blood marker of systemic inflammation. The study consisted of 2084 men (42-60 years) without acute or chronic inflammation. A total of 533 (25.6%), 1368 (65.6%), and 183 (8.8%) participants reported having a sauna bath once a week, 2-3 times, and 4-7 times per week; mean serum C-reactive protein levels were 2.41 (standard deviation 2.91), 2.00 (2.41), 1.65 (1.63) mmol/L, respectively. In a multivariable analysis adjusted for baseline age, body mass index, systolic blood pressure, smoking, type 2 diabetes, previous myocardial infarction, and serum low density lipoprotein cholesterol, alcohol consumption and physical activity, there was a significant inverse association between the frequency of sauna bathing and the level of C-reactive protein. Further studies are warranted to investigate the relationship between sauna bathing and systemic inflammation.

    Be well!

    JP

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