The Power of Sauna

By Julie Gregory, Chief Health Liaison for Apollo Health

What if there was an enjoyable, relaxing way to dramatically reduce your risk of dementia, heart disease, and all-cause mortality that may also help to rid your body of toxins? There is, and a growing body of evidence suggests that the more often you engage, the greater the health benefits. If you haven’t guessed by now, sauna has powerful healing properties.

The first sauna was designed by the Finns over 2,000 years ago. It was originally intended to be used as a form of a bath to clean the body, but it’s become so much more. It’s still an integral part of Finnish culture, where many use it as more than a place to cleanse their bodies but also a place to cleanse their minds and to find inner peace. Saunas can be found in private homes and in public facilities where it is often enjoyed socially. 

With the weather cooling off, it’s the perfect time to experiment with this multi-purpose strategy. Before we get into the specifics of how to best incorporate sauna bathing into your lifestyle, let’s examine the evidence to recommend its use.   

Dementia Benefits

Evidence strongly suggests that regular sauna bathing can reduce your risk of developing dementia. A large prospective study examining data from over 2,000 middle-aged men in Finland that were followed for over a 20-year period showed that those who used sauna four to seven times per week had a 66% lower risk of developing dementia compared to those who engaged in sauna bathing once per week. (1) Researchers aren’t sure why, but proposed mechanisms for improved cognitive health include increased expression of brain-derived neurotrophic factor (BDNF), which supports the development of new neurons and increased blood flow to the brain. Others have surmised that heat shock may be responsible for the neurological benefit. Heat shock, which occurs in a cell, tissue, or organism when exposed to elevated temperatures, is a protective response that enables the body to counteract potential damage caused by the temperature increase.

Heart Disease Benefits

Given that vascular disease is a risk factor for dementia, it’s not surprising that the same study showed that men who used sauna bathing two to three times a week had a 27% reduction in mortality associated with cardiovascular disease compared to those who used saunas once a week, and men who used saunas four to five times a week had a 50% reduction rate in mortality associated with cardiovascular disease. (2) Exposure to high temperatures stresses the body and induces protective responses that promote cardiovascular health, such as increased heart rate, decreases in blood pressure, and improved blood flow. Researchers have proposed other mechanisms, including endothelium-dependent dilatation, reduced arterial stiffness, modulation of the autonomic nervous system, and beneficial changes in circulating lipid profiles. Many of the physiological effects of sauna use are similar to those elicited during moderate to vigorous-intensity aerobic exercise. Studies show that aerobic exercise, in combination with frequent sauna use, has a synergetic effect in reducing cardiovascular and all-cause mortality.

All-Cause Mortality Benefits

Likely because both dementia and heart disease increase the risk of death, data from the same study showed that men who used saunas more frequently had a lower risk of all-cause mortality. For those who used a sauna once per week, 49% died over a 20.7-year median follow-up period. Interestingly that percentage dropped to 38% when men used the sauna 2 to 3 times a week and even lower to 31% when sauna was used four to seven times per week. (2) While the initial dataset was comprised of all men, the original study has since been repeated, including women, and very similar benefits were found. (3)  

Detoxification Benefits

The news for sauna gets even better when you look at early evidence focused on detoxification. Research suggests that heavy metals, environmental organic chemicals, and mycotoxins may be sweated out during sauna bathing, but we need more research in this area. (4) While it is typically the liver and kidneys that will excrete these toxins when appropriate chelators and binders are used, research has found that higher levels of heavy metals were found in post-sauna sweat, suggesting this may be a more effective means of treatment. (5) Additionally, case studies have shown that the use of sauna therapy improved the condition of patients with confirmed exposure to mold with impaired cognition and autonomic dysfunction when other treatments failed. (6) Some researchers have noted the very high level of mold in Finnish homes and workplaces and speculated that many of the health improvements may have been driven by improved detoxification.

What Kind of Sauna is Best?

The short answer is we don’t know. The majority of sauna research used traditional dry heat Finnish saunas that harness the power of high temperatures between 176 and 210 °F. These original saunas were heated by wood stoves that heated rocks, which were then splashed with water to create steam to help heat the air. An alternative type of sauna, called infrared (or far infrared), is becoming increasingly popular as many people don’t have access to traditional saunas or can’t tolerate higher temperatures. Infrared saunas are heated using infrared heaters, which emit infrared light that directly warms your body by penetrating the skin using lower temperatures between 110°F and 140°F.

Far infrared saunas are a type of infrared sauna that emits infrared light with longer wavelengths. There are different health benefits associated with different wavelengths. Some saunas offer the full spectrum with a combination of different wavelengths. In general, shorter wavelengths, like those found in near-infrared saunas, penetrate less deeply than longer wavelengths found in far-infrared saunas.

We don’t have long-term prospective studies doing a head-to-head comparison between the two types of saunas, but preliminary research on infrared saunas finds favorable outcomes for cardiovascular disease that reinforce the earlier findings of traditional Finnish saunas. This suggests that heat stress, whether induced by a traditional or infrared sauna, that causes significant sweating is likely to lead to healthful adaptation and beneficial cardiovascular effects. (7)

Infrared saunas come in a variety of options. Some look very much like the original Finnish saunas but are heated differently. Others involve a chair with a pop-up tent that allows your head to stick out. There are even saunas that allow you to lie down, either in a tunnel or in a sleeping bag-style sauna. If you decide to try an infrared sauna, be sure that it emits low levels of electromagnetic frequency (EMF). The US Environmental Protection Agency (EPA) has set those emitting no higher than 3mG as the safe standard. You can easily find saunas that emit even lower levels.

Optimal Length for a Sauna Session

Please check with your physician before engaging in a sauna protocol. Once you’re cleared, it’s best to start with a shorter session to evaluate how your body responds. You may want to slowly work up to longer sessions as the evidence suggests they may offer more health advantages, especially when used four to seven times per week.

For dementia benefits, the original study only used sessions that lasted between five to fourteen minutes but those were in very high temperatures, between 176 to 210 °F. If you’re using an infrared sauna, you may need to engage in longer sessions for the same benefit. The best time to end your session is when you begin to feel tired and/ or the heat becomes unbearable. Don’t push yourself.   

The most important thing is to ensure that you’re sweating. In an effort to get the most out of your session, you may want to pre-heat your sauna and jump in directly after an exercise session where you’ve already worked up a sweat. This will most efficiently allow you to use your sauna time.     

Ready to Get Started?

Once you’ve received your physician’s approval, follow these steps for a safe and healthful sauna experience.

1. Choose your Timing Wisely. As you experiment with initial shorter sessions, pay attention to how you feel after sauna. If you feel energized afterwards, feel free to enjoy sauna earlier in the day. If you feel relaxed or even slightly depleted afterward, you may want to time your sauna prior to bedtime.

2. Avoid a Heavy Meal. It’s best to go into a sauna session during a fasting period or after a very light meal. Remember, a sauna mimics exercise. You’d never engage in a strenuous exercise session after a heavy meal. Allow your body to rest and detoxify during your session without dually having to digest a meal.

3. No alcohol. Combining alcohol with a sauna can be dangerous for multiple reasons. Alcohol is a diuretic and will cause you to more easily become dehydrated, which can cause dizziness and lead to falls. It also places extra stress on your heart and liver, which are already working hard during sauna.  

4. Hydrate. Before entering the sauna slowly drink at a pint of clean, filtered water as this is the amount of sweat you can lose in just a 20-minute session. It’s great to also drink during the sauna session, especially if you’re feeling thirsty.

5. Low Blood Pressure? If your blood pressure tends to be on the low side, consider bringing a small amount of high-quality sea salt in a small ramekin into the sauna with you. As you hydrate, occasionally take in small amounts of salt throughout your session. Alternatively, you could use an electrolyte mix, like LMNT, mixed into your water.

6. Start clean. Some people shower right before using a sauna, which is a great way to remove any lotions, sunscreens, or cosmetics. You want your skin to be able to breathe and detoxify. If you decide to exercise beforehand to work up a sweat to make your session more effective, just be sure that you start your exercise session with clean, product-free skin.

7. Try dry brushing.  To really open up your pores to aid in both sweating and detoxification, consider a dry brushing session beforehand. You can learn more in Dry Brushing — An Ancient Ritual for Today.     

8. Socialize. If you’re lucky enough to have or use a large, multi-person sauna, use this as a period of socialization. In Finland, families and friends often sauna together and use the experience as a means of bonding.

9. Meditate. If you’re enjoying a solo sauna,consider shutting your eyes and meditating. If you’re new to meditation, consider a guided session from an app like Calm or Headspace. This is a perfect way to reap extra benefits while you sauna. 

10. Shower after. Once you’ve completed your sauna, it’s very important to shower afterward. Toxins, such as heavy metals, organic environmental chemicals (like pesticides), and even mycotoxins, may have been excreted in your sweat. Use a non-toxic soap like Castille.

11. Consider a cold blast. If you end your shower with a cold blast, you could take your sauna experience to the next level, reaping even more health benefits. Cold therapy offers a host of health benefits. Most importantly, it upregulates mitochondrial biogenesis, the growth and division of pre-existing mitochondria — the batteries of our cells. (Apollo Health members can learn much more by reading Cold Therapy.) Finns have traditionally concluded their sauna sessions by rolling in the snow or jumping into cold water. Like a sauna, cold therapy isn’t for everyone. Combining it with sauna will put extra strain on your heart, so be sure to check with your physician before engaging. Many people very slowly work up to several minutes of 100% cold water (without shivering) at the end of every shower.

Contraindications

Unfortunately, sauna bathing isn’t for everyone because of the extra strain that it puts on your body. Please see all of the contraindications below, but always check with your doctor to see if it could be a helpful therapy for you. Many healthy older people can safely enjoy it as can some with various forms of stable heart disease despite the cautions below.  

• Chest pain.  If you’ve been having chest pain, stay out of the sauna until your doctor has examined you.
• Heart attacks.  Avoid saunas if you’ve recently had a heart attack or a stroke. It’s best not to risk overexerting your heart. ‌
• Severe aortic stenosis.  This occurs when your heart’s aortic valve doesn’t allow blood to flow freely. Saunas can increase your heart rate, which could cause your aortic valve to become blocked.
• Older People.  Those aged 65 and older should be wary of heatstroke in the sauna. They may experience a more extreme reaction to heat as their body’s internal temperature regulation is weakened. 
• Children.  In case you’re tempted to bring your grandchildren into the sauna with you, be aware that those under the age of seven have a less developed internal temperature system and can be more susceptible to heatstroke than adults. (Children born in Finland are the exception, as many have been acclimated to sauna since infancy.)  
• Seizure disorders. Many seizure disorders interfere with your internal temperature or can be triggered by a sudden change in temperature. If you often get seizures or are diagnosed with a seizure disorder, you should avoid going into the sauna altogether. 
• Certain medications. Those taking stimulants, tranquilizers, or other mind-altering drugs should avoid sauna.
• Pregnant women. Pregnant women should be careful of overheating, dehydration, dizziness, and fainting in the sauna.

Make Sauna a Regular Part of
your Lifestyle

If taking a sauna is appropriate for you, find a way to work it into your routine regularly. The evidence clearly shows that the more often you use it, the more benefits you will reap. Schedule regular sauna sessions on your calendar and gradually increase your sauna time as you get accustomed to the heat. Consider using it post-workout for muscle recovery and to take advantage of the sweat you’ve already worked up. When you’re ready, consider combining it with cold therapy for added health benefits. Prioritize sauna time for relaxation, socialization, or meditation. Essentially, treat it like a dedicated wellness practice with a consistent routine for optimal cognition and overall health.

References

1. https://pubmed.ncbi.nlm.nih.gov/27932366/
2. https://pubmed.ncbi.nlm.nih.gov/25705824/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262976/
4. https://onlinelibrary.wiley.com/doi/10.1155/2016/1624643
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998800/
6. https://pubmed.ncbi.nlm.nih.gov/29861191/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5941775/