Sauna

Last Updated: May 8, 2023

Sauna is a form of passive heat therapy characterized by exposure to high ambient temperatures for short periods of time. It’s most heavily studied for its effects on the cardiorespiratory system, for which it can produce a number of benefits (many that are similar to exercise). The design and practices of saunas can vary considerably, which makes it difficult to directly compare studies on them.

Sauna is most often used for

What is sauna?

Broadly, sauna is a form of passive heat therapy in which individuals sit in small, high-temperature rooms for short periods of time. The specific design and practices of using the sauna vary considerably, but the majority of research has been on traditional Finnish sauna, which is characterized by:[1]

  • Rooms made of wood and heated by hot rocks
  • Temperature and humidity ranges of 90–100°C (194–212℉) and 10%–20%, respectively
  • Durations of 5–20 minutes, although some go longer
  • Cooling-off periods in which bathers swim, shower, or roll in snow
  • A frequency of 1–3 times each week
What are sauna’s main benefits?

The majority of sauna research focuses on its effects in people with cardiovascular disease. Acutely, sauna can lower blood pressure and improve measures of endothelial function and arterial stiffness (e.g., flow-mediated dilation and pulse-wave velocity). Over long durations, higher frequencies of sauna use have also been associated with 40%–70% reductions in the risk of all-cause mortality, cardiovascular mortality, hypertension and stroke. [1] Additionally, sauna may also benefit other conditions, such as dementia/Alzheimer’s disease, respiratory diseases, musculoskeletal disorders (e.g., arthritis), skin diseases, headache, and mental health disorders.[2][3]

It’s been proposed that sauna may be a strategy for increasing healthspan and lifespan. There is compelling observational research to support this, in addition to mechanistic/non-human/uncontrolled trials on the subject, but direct, high-quality, well-controlled trials in humans are still somewhat lacking.[4]

What are sauna’s main drawbacks?

Although people with cardiovascular conditions were previously discouraged from using sauna, it’s accepted that sauna is safe (and likely beneficial) for people with stable cardiovascular disease.[1] People with symptomatic, unstable, or unmanaged cardiovascular issues, such as unstable coronary artery disease, severe aortic stenosis, or recent myocardial infarction shouldn’t use sauna, however, because the physiological stress of sauna might precipitate a cardiac event. [5]

One of the biggest risk factors for adverse effects in the sauna is concurrent alcohol use: it both increases the risk of environmental injury (e.g., trauma from falling or heat injury from remaining in the sauna for too long) and can lower blood pressure to unsafe levels (sauna already has blood-pressure-lowering effects).[1]

A few papers have raised concerns about sauna use during pregnancy, but the practice is considered safe and is common in Finland.[6]

Overall, it’s worth appreciating that sauna is a low-risk but physiologically stressful activity. Individuals engaging in this practice should pay attention to how they feel and exit the sauna if they feel too uncomfortable.

How does sauna work?

Broadly, sauna seems to confer its benefits through the effects of heat on the cardiorespiratory, musculoskeletal, and integumentary (skin, hair, and nails) systems, among others. More specifically, sauna has been shown to reduce oxidative stress and inflammation, modulate immune and autonomic nervous system activity, and improve blood lipid and hormone levels.[1] One especially noteworthy characteristic of sauna is its role as a “hormetic stressor”: it puts a mild stress on the body, which provokes cellular processes that encourage repair and protection from future stressors (a phenomenon known as hormesis). Exercise is another form of hormetic stressor, and indeed, sauna and exercise have very similar (but not identical) physiological effects,[4] which include an increase in heart rate (120–150 beats per minute) and an elevation in skin and skeletal muscle blood flow, among others.

It’s worth remembering that, alongside its physiological effects, sauna is also simply a relaxing and pleasurable activity (with cultural significance for many); engaging in such activities is likely to benefit health in its own right.

What else is Sauna known as?
Note that Sauna is also known as:
  • Bastu (Swedish)
  • Banya (Russian)
  • Saun (Estonian)
  • Shvitz (Hebrew)
  • Hammam (Turkish)
  • Pirtis (Lithuanian)
  • Infrared therapy
  • Waon therapy

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References
  1. ^Laukkanen JA, Laukkanen T, Kunutsor SKCardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence.Mayo Clin Proc.(2018-Aug)
  2. ^Kanji G, Weatherall M, Peter R, Purdie G, Page REfficacy of regular sauna bathing for chronic tension-type headache: a randomized controlled study.J Altern Complement Med.(2015-Feb)
  3. ^Hannuksela M, Väänänen AThe sauna, skin and skin diseases.Ann Clin Res.(1988)
  4. ^Patrick RP, Johnson TLSauna use as a lifestyle practice to extend healthspan.Exp Gerontol.(2021-Oct-15)
  5. ^Ylikahri R, Heikkonen E, Soukas AThe sauna and alcohol.Ann Clin Res.(1988)
  6. ^Hannuksela ML, Ellahham SBenefits and risks of sauna bathing.Am J Med.(2001-Feb-01)
  7. ^Joy N Hussain, Marc M Cohen, Nitin Mantri, Cindy J O'Malley, Ronda F GreavesInfrared sauna as exercise-mimetic? Physiological responses to infrared sauna vs exercise in healthy women: A randomized controlled crossover trialComplement Ther Med.(2022 Mar)
  8. ^Vatansever F, Hamblin MRFar infrared radiation (FIR): its biological effects and medical applications.Photonics Lasers Med.(2012-Nov-01)
  9. ^Nguyen Y, Naseer N, Frishman WHSauna as a therapeutic option for cardiovascular disease.Cardiol Rev.(2004)
  10. ^ Farrell & TurgeonNormal Versus Chronic Adaptations To Aerobic Exercise(2022)
  11. ^Ketelhut S, Ketelhut RGThe blood pressure and heart rate during sauna bath correspond to cardiac responses during submaximal dynamic exercise.Complement Ther Med.(2019-Jun)
  12. ^Lee E, Kolunsarka I, Kostensalo J, Ahtiainen JP, Haapala EA, Willeit P, Kunutsor SK, Laukkanen JAEffects of regular sauna bathing in conjunction with exercise on cardiovascular function: a multi-arm, randomized controlled trial.Am J Physiol Regul Integr Comp Physiol.(2022-Sep-01)
  13. ^Haseba S, Sakakima H, Kubozono T, Nakao S, Ikeda SCombined effects of repeated sauna therapy and exercise training on cardiac function and physical activity in patients with chronic heart failure.Disabil Rehabil.(2016)
  14. ^Laukkanen T, Khan H, Zaccardi F, Laukkanen JAAssociation between sauna bathing and fatal cardiovascular and all-cause mortality events.JAMA Intern Med.(2015-Apr)
  15. ^Laukkanen T, Kunutsor S, Kauhanen J, Laukkanen JASauna bathing is inversely associated with dementia and Alzheimer's disease in middle-aged Finnish men.Age Ageing.(2017-Mar-01)
  16. ^Singh R, Kølvraa S, Bross P, Christensen K, Bathum L, Gregersen N, Tan Q, Rattan SIAnti-inflammatory heat shock protein 70 genes are positively associated with human survival.Curr Pharm Des.(2010)
  17. ^Ihsan M, Deldicque L, Molphy J, Britto F, Cherif A, Racinais SSkeletal Muscle Signaling Following Whole-Body and Localized Heat Exposure in Humans.Front Physiol.(2020)
Examine Database References
  1. Brain Natriuretic Peptide - Tei C, Imamura T, Kinugawa K, Inoue T, Masuyama T, Inoue H, Noike H, Muramatsu T, Takeishi Y, Saku K, Harada K, Daida H, Kobayashi Y, Hagiwara N, Nagayama M, Momomura S, Yonezawa K, Ito H, Gojo S, Akaishi M, Miyata M, Ohishi M, Waon Therapy for Managing Chronic Heart Failure - Results From a Multicenter Prospective Randomized WAON-CHF Study.Circ J.(2016)
  2. Brain Natriuretic Peptide - Miyata M, Kihara T, Kubozono T, Ikeda Y, Shinsato T, Izumi T, Matsuzaki M, Yamaguchi T, Kasanuki H, Daida H, Nagayama M, Nishigami K, Hirata K, Kihara K, Tei CBeneficial effects of Waon therapy on patients with chronic heart failure: results of a prospective multicenter study.J Cardiol.(2008-Oct)
  3. Brain Natriuretic Peptide - Kuwahata S, Miyata M, Fujita S, Kubozono T, Shinsato T, Ikeda Y, Hamasaki S, Kuwaki T, Tei CImprovement of autonomic nervous activity by Waon therapy in patients with chronic heart failure.J Cardiol.(2011-Jan)
  4. Brain Natriuretic Peptide - Kihara T, Biro S, Ikeda Y, Fukudome T, Shinsato T, Masuda A, Miyata M, Hamasaki S, Otsuji Y, Minagoe S, Akiba S, Tei CEffects of repeated sauna treatment on ventricular arrhythmias in patients with chronic heart failure.Circ J.(2004-Dec)
  5. Brain Natriuretic Peptide - Ichiki T, Burnett JC, Scott CG, Heublein DM, Miyata M, Kinugawa K, Inoue T, Tei C, Neurohumoral Modulation During Waon Therapy in Chronic Heart Failure - Subanalysis of Waon-CHF Study.Circ J.(2017-Apr-25)
  6. Brain Natriuretic Peptide - Fujita S, Ikeda Y, Miyata M, Shinsato T, Kubozono T, Kuwahata S, Hamada N, Miyauchi T, Yamaguchi T, Torii H, Hamasaki S, Tei CEffect of Waon therapy on oxidative stress in chronic heart failure.Circ J.(2011)
  7. Heart Failure Class - Basford JR, Oh JK, Allison TG, Sheffield CG, Manahan BG, Hodge DO, Tajik AJ, Rodeheffer RJ, Tei CSafety, acceptance, and physiologic effects of sauna bathing in people with chronic heart failure: a pilot report.Arch Phys Med Rehabil.(2009-Jan)
  8. Depression Symptoms - Masuda A, Nakazato M, Kihara T, Minagoe S, Tei CRepeated thermal therapy diminishes appetite loss and subjective complaints in mildly depressed patients.Psychosom Med.(2005)
  9. Swimming Performance Metrics - Skorski S, Schimpchen J, Pfeiffer M, Ferrauti A, Kellmann M, Meyer TEffects of Postexercise Sauna Bathing on Recovery of Swim Performance.Int J Sports Physiol Perform.(2019-Dec-22)
  10. Heart Rate - Dariusz Sitkowski, Tomasz Cisoń, Zbigniew Szygula, Olga Surała, Michał Starczewski, Dorota Sadowska, Jadwiga Malczewska-LenczowskaHematological Adaptations to Post-Exercise Sauna Bathing with No Fluid Intake: A Randomized Cross-Over StudyRes Q Exerc Sport.(2021 Nov 2)
  11. Oxygen Uptake - Lee E, Kolunsarka I, Kostensalo J, Ahtiainen JP, Haapala EA, Willeit P, Kunutsor SK, Laukkanen JAEffects of regular sauna bathing in conjunction with exercise on cardiovascular function: a multi-arm, randomized controlled trial.Am J Physiol Regul Integr Comp Physiol.(2022-Sep-01)
  12. Blood Pressure - Akinori Masuda, Masaaki Miyata, Takashi Kihara, Shinichi Minagoe, Chuwa TeiRepeated sauna therapy reduces urinary 8-epi-prostaglandin F(2alpha)Jpn Heart J.(2004 Mar)
  13. Wound Healing - Papp AA, Alhava EMSauna-bathing with sutures. A prospective and randomised study.Scand J Surg.(2003)
  14. Common Cold Symptoms - Pach D, Knöchel B, Lüdtke R, Wruck K, Willich SN, Witt CMVisiting a sauna: does inhaling hot dry air reduce common cold symptoms? A randomised controlled trial.Med J Aust.(2010)
  15. Heart Rate Variability - Kunbootsri N, Janyacharoen T, Arrayawichanon P, Chainansamit S, Kanpittaya J, Auvichayapat P, Sawanyawisuth KThe effect of six-weeks of sauna on treatment autonomic nervous system, peak nasal inspiratory flow and lung functions of allergic rhinitis Thai patients.Asian Pac J Allergy Immunol.(2013-Jun)
  16. Plasma Volume - Kissling LS, Akerman AP, Campbell HA, Prout JR, Gibbons TD, Thomas KN, Cotter JDA crossover control study of three methods of heat acclimation on the magnitude and kinetics of adaptation.Exp Physiol.(2022-Apr)
  17. Perceived Body Temperature - Campbell HA, Akerman AP, Kissling LS, Prout JR, Gibbons TD, Thomas KN, Cotter JDAcute physiological and psychophysical responses to different modes of heat stress.Exp Physiol.(2022-May)
  18. Blood Pressure - Bartolomé I, Siquier-Coll J, Pérez-Quintero M, Robles-Gil MC, Grijota FJ, Muñoz D, Maynar-Mariño M3-Week passive acclimation to extreme environmental heat (100± 3 °C) in dry sauna increases physical and physiological performance among young semi-professional football players.J Therm Biol.(2021-Aug)
  19. Exercise Tolerance - Kikuchi H, Shiozawa N, Takata S, Ashida K, Mitsunobu FEffect of repeated Waon therapy on exercise tolerance and pulmonary function in patients with chronic obstructive pulmonary disease: a pilot controlled clinical trial.Int J Chron Obstruct Pulmon Dis.(2014)
  20. Microbiome - Karolkiewicz J, Nieman DC, Cisoń T, Szurkowska J, Gałęcka M, Sitkowski D, Szygula ZNo effects of a 4-week post-exercise sauna bathing on targeted gut microbiota and intestinal barrier function, and hsCRP in healthy men: a pilot randomized controlled trial.BMC Sports Sci Med Rehabil.(2022-Jun-16)
  21. Migraine Duration - Kanji G, Weatherall M, Peter R, Purdie G, Page REfficacy of regular sauna bathing for chronic tension-type headache: a randomized controlled study.J Altern Complement Med.(2015-Feb)