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Editor's Note
April 2015

Health Benefits of Sauna Bathing

JAMA Intern Med. 2015;175(4):548. doi:10.1001/jamainternmed.2014.8206

Often I have advised a patient who was considering an unnecessary test, such as a coronary artery calcium test or carotid ultrasonography from a mobile van, to forgo that test and instead spend the money on something that he or she would actually enjoy, such as a massage or spa treatment. In this issue, Laukkanen et al1 present data indicating that my advice would not only help my patients feel good but would also, if they chose to regularly use a sauna bath, help them live longer. Analyzing data from the Finnish Kuopio Ischemic Heart Disease Study, the authors found that men who took more frequent saunas (4-7 times per week) actually live longer than once-per-week users. Although we do not know why the men who took saunas more frequently had greater longevity (whether it is the time spent in the hot room, the relaxation time, the leisure of a life that allows for more relaxation time, or the camaraderie of the sauna), clearly time spent in the sauna is time well spent.

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Article Information

Conflict of Interest Disclosures: None reported.

Laukkanen  T, Khan  H, Zaccardi  F, Laukkanen  JA.  Association between sauna bathing and fatal cardiovascular and all-cause mortality events [published online February 23, 2015].  JAMA Intern Med. doi:10.1001/jamainternmed.2014.8187.Google Scholar
2 Comments for this article
Sauna bathing vs. Hot tub-bathing
Mohamed Hamid MD, PhD | Associate Professor of ENT. CWRU/MetroHealth-Cleveland, OH
This articles further supports the documented health benefits of sauna bathing. I am curious however by the authors comment that their results \"can not be extended to other forms of heat exposure such as hot tubs-bathing\". These forms of heat exposure, which are practiced in other parts of the world, have been a tradition for years. I am unable to see physiologic difference between a 15 min sauna or hot tub bathing assuming equal, or near equal, temperatures. It would be helpful to discern this difference. Given the health benefits of \"controlled heat exposure\", the practicality of hot tubs readily available in most homes is more evident.
Observational studies cannot distinguish between cause and effect
David L. Keller, MD | Independent internist
The association between sauna bathing and improved cardiovascular outcomes may be due to self-selection. Persons at higher risk for adverse cardiac events may experience unpleasant symptoms due to the tachycardia induced by sitting in a hot sauna, such as mild dyspnea, orthostasis, or chest discomfort, at higher frequency or severity than persons in good cardiovascular health, These adverse symptoms might cause them to avoid saunas, thereby biasing the group of sauna-takers to include persons at lower risk of adverse cardiac events than the general public. The authors suggest that, based on this study, \"sauna bathing is a recommendable health habit\". I disagree, and suggest that physicians should await the results of a randomized trial of sauna bathing before we recommend it for health enhancement.Further, let us suppose an asymptomatic male patient in his fifties, with average lipids and no other identified cardiac risk factors wants to learn more about his risk for atherosclerotic vascular disease (ASVD). Such a patient should be counselled against obtaining a CT coronary calcium screen based on the fact that we do not have the full long-term risk-benefit data for such exposure to ionizing radiation. However, I would like to know why you advise against ultrasound screening of his carotid arteries. If atherosclerotic carotid stenosis were found, this would be evidence of systemic ASVD, what many refer to as a \"coronary equivalent\", making him a candidate for intensified statin therapy and education regarding TIA symptoms. Although the evidence does not specifically support carotid ultrasound screening yet, why would you feel any more comfortable advising him to sit in a hot sauna, which may be a harmful form of cardiovascular stress if he has undetected coronary disease?