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Health effects and risks of sauna bathing

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Abstract

Objectives. To study physiological, therapeutic and adverse effects of sauna bathing with special reference to chronic diseases, medication and special situations (pregnancy, children). Study design. A literature review. Methods. Experiments of sauna bathing were accepted if they were conducted in a heated room with sufficient heat (80 to 90 degrees C), comfortable air humidity and adequate ventilation. The sauna exposure for five to 20 minutes was usually repeated one to three times. The experiments were either acute (one day), or conducted over a longer period (several months). Results. The research data retrieved were most often based on uncontrolled research designs with subjects accustomed to bathing since childhood. Sauna was well tolerated and posed no health risks to healthy people from childhood to old age. Baths did not appear to be particularly risky to patients with hypertension, coronary heart disease and congestive heart failure, when they were medicated and in a stable condition. Excepting toxemia cases, no adverse effects of bathing during pregnancy were found, and baths were not teratogenic. In musculoskeletal disorders, baths may relieve pain. Medication in general was of no concern during a bath, apart from antihypertensive medication, which may predispose to orthostatic hypotension after bathing. Conclusions. Further research is needed with sound experimental design, and with subjects not accustomed to sauna, before sauna bathing can routinely be used as a non-pharmacological treatment regimen in certain medical disorders to relieve symptoms and improve wellness.
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International Journal of Circumpolar Health 65:3 2006
HEALTH EFFECTS AND RISKS OF
SAUNA BATHING
Katriina Kukkonen-Harjula, Kyllikki Kauppinen
UKK Institute for Health Promotion Research, Tampere, Finland
Received 1 February 2006; Accepted 2 May 2006
ABSTRACT
Objectives. To study physiological, therapeutic and adverse effects of sauna bathing with special
reference to chronic diseases, medication and special situations (pregnancy, children).
Study design. A literature review.
Methods. Experiments of sauna bathing were accepted if they were conducted in a heated room
with sufcient heat (80 to 90ºC), comfortable air humidity and adequate ventilation. The sauna
exposure for ve to 20 minutes was usually repeated one to three times. The experiments were
either acute (one day), or conducted over a longer period (several months).
Results. The research data retrieved were most often based on uncontrolled research designs with
subjects accustomed to bathing since childhood. Sauna was well tolerated and posed no health
risks to healthy people from childhood to old age. Baths did not appear to be particularly risky
to patients with hypertension, coronary heart disease and congestive heart failure, when they
were medicated and in a stable condition. Excepting toxemia cases, no adverse effects of bathing
during pregnancy were found, and baths were not teratogenic. In musculoskeletal disorders, baths
may relieve pain. Medication in general was of no concern during a bath, apart from antihyper-
tensive medication, which may predispose to orthostatic hypotension after bathing.
Conclusions. Further research is needed with sound experimental design, and with subjects not
accustomed to sauna, before sauna bathing can routinely be used as a non-pharmacological treat-
ment regimen in certain medical disorders to relieve symptoms and improve wellness.
(Int J Circumpolar Health 20 06:65(3):195-205.)
Keywords: sauna bathing, cardiovascular diseases, medication, pregnancy, heat
REVIEW
196 International Journal of Circumpolar Health 65:3 2006
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INTRODUCTION
Sauna bathing is a special form of heat expo-
sure characterized by a short-term exposure
to exceptionally high environmental tempera-
tures. It is an ancient habit in both cold and
warm climates. Sauna bathing is still popular
in many northern circumpolar countries and,
during the past decades, it has also become a
widely practiced wellness form in many central
European countries. Virtually all Finns are
used to weekly bathing since early childhood.
The sauna is a log, or wood-paneled room,
where the bathers relax on benches well above
the oor level in the heat from the heater
constructed of, or lled with, rocks. The hot
room air temperature falls within the range
of 70 to 100°C, optimally between 80 and
90°C at the face level of the bathers. The air
humidity, modied by bathers tossing water
on the heated rocks, ranges from 15 to 30%
relative humidity (r.h.) at the recommended
temperatures.
The sauna bath consists of repeated cycles
of exposure to heat and cold. The length of
stay in the hot room depends on each bath-
er’s own sensations of comfort; the duration
usually falls between ve and 20 minutes.
This is followed by a cool-off (shower, swim,
or a period at room temperature), the length of
which also depends on personal sensations (1).
A sufcient recovery period (usually about one
half of an hour) following a few hot/cold cycles
allows for normalizing the body temperature
and cessation of sweating.
During the past half a century, a consider-
able amount of research data on sauna bathing
has originated especially from Germany and
Finland. During the past 10 years, innovative
experiments investigating new therapeutic
uses of sauna bathing have been performed in
Japan (2).
The aim of this review is to present physi-
ological, therapeutic and adverse effects of
sauna bathing, particularly in cases of chronic
diseases, with special reference to cardiovas-
cular diseases and to medication. The habit of
ice-water immersion without sauna bathing
(see 3-5) will not be discussed. The literature
search was based on Medline and on own
personal les. Experiments (either acute, or
conducted over a longer period of up to several
months) were accepted, if bathing conditions
(temperature, humidity, length of exposure)
complied with the above-mentioned descrip-
tion of sauna bathing.
PHYSIOLOGICAL EFFECTS OF SAUNA
BATHING IN HEALTHY PERSONS
The overall physiological effects of sauna expo-
sure have been presented previously (e.g. 6).
The cardiovascular system combats the
thermal stress by cutaneous vasodilatation,
and increased skin blood ow, heart rate and
sweating. The heart rate accelerates up to
twice the resting rate and even more (7, 8).
The cardiac output is estimated to increase
by about 70 % over the resting state, the total
peripheral resistance of the vessels decreases
by about 40 % (9), the stroke volume is unaf-
fected, and the diastolic and mean arterial
pressures decrease, with practically no change
in the systolic pressure (7). The overall work of
the heart, as estimated from the heart rate and
systolic blood pressure, indicating myocardial
oxygen demand, does not increase greatly (6).
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International Journal of Circumpolar Health 65:3 2006
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The strain on the heart and the cardiovascular
system depends not only on the temperature in
the hot room, its air humidity and the duration
of stay in the heat (8), but also on the type of
cooling employed during the cool-off session.
The skin temperature uctuates from up to
40°C in the hot room, down to 33°C upon ice-
water immersion (1). The core temperature, as
measured from the esophagus, is more stable,
rising in the hot room at an average rate of
0.07°C × min-1 up to 38°C, then accelerating to
0.4°C × min-1 up to 39°C, and returning to initial
values rapidly after the exposure. The rate of
reduction depends on the type of cool-off (1).
Sweating results in a weight loss of about 0.5
to 1 kg. The water should be replenished by
drinking during, or after the sauna bath (10).
Athletes in sports performed in weight classes
often use prolonged sauna bathing to decrease
their weight rapidly. However, this can impair
sports performance (11).
The sympathetic nervous system and the
hypothalamus-pituitary-adrenal hormonal
axis are activated to maintain thermal balance
(6, 12). The overall effect of the hormonal
changes is water retention and a ght-or-
ight response of the organism, manifested as
reduced perception of pain, elated mood and
alertness. The thermal challenge of the bath
cycle is reected in increased plasma concen-
trations of noradrenaline (13, 14). The adren-
aline concentrations have been reported to
remain unchanged, or to increase. The discrep-
ancy is due to different bathing patterns, espe-
cially the type of cool-off, and to different
blood sampling techniques (12). When blood
samples were taken in the hot room and the
subjects were moved in wheelchairs for cool-
offs, plasma adrenaline concentrations were
elevated during bathing in young women (15).
Sauna with cool-offs at room temperature
did not elicit increased circulating adrenaline
levels, whereas a sauna alternated with ice-
water immersion resulted in increased adrena-
line in persons used to winter swimming (14).
The bath cycles elicit secretions of ACTH
in some studies (8, 13, 14) and, especially with
ice-water immersion, of cortisol (14). Plasma
growth hormone, prolactin and β-endorphin
have also been reported to increase (8, 13). The
reduced plasma volume (16) and loss of sodium
in the sweat activate the renin-angiotensin-
aldosterone system (12). The plasma arginine
vasopressin levels and the plasma atrial natriu-
retic peptide concentrations rise during a bath
(17). In men, the plasma testosterone concen-
trations do not change. Evidence of regular
sauna bathing reducing male fertility was not
found. A two-week sauna exposure altered
sperm movement characteristics, but they
were reversed within one week after the end of
bathing sessions (18).
A comfortable relative humidity of 15 to 30
% keeps the mucous membranes of the upper
airways moist (19). Provided that the sauna
air is hot enough, about 80 to 90°C, there is
no concern about viable micro-organisms
being inhaled. The respiration becomes more
frequent and shallow, while the total respi-
ratory minute volume increases. The vital
capacity (VC), the peak expiratory ow rate
(PEF), and the forced expiratory volume in
the rst second (FEV1) all increase, implying
improved pulmonary ventilation. All changes
are minor, roughly 10 %, and initial levels
are reached quickly after the sauna (19). The
diffusing capacity did not change in healthy
subjects (20).
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THERAPEUTIC EFFECTS OF SAUNA
BATHING IN CHRONIC DISEASES
The effects of sauna bathing in the course of
various diseases have been previously reviewed
by Kauppinen (21), Keast and Adamo (22),
Hannuksela and Ellahham (23), and Nguyen
et al. (24).
Cardiovascular diseases
People with cardiovascular disorders are some-
times discouraged to enter a sauna. The bulk
of scientic evidence, however, supports the
view that persons with cardiovascular diseases
in stable state with medication (e.g., essen-
tial hypertension, coronary artery disease, or
compensated heart failure) may safely take
their sauna baths (23, 25). In addition, there is
no evidence that a bath would provoke throm-
botic episodes, or bleeding tendencies (6).
A study on 69 Finnish patients with
myocardial infarction and 32 healthy persons
showed that, four to six weeks after the inci-
dent, bathing was harmless (25). Only 8 %
of them had cardiac dysrhythmias during
bathing, compared to 18 % during a submax-
imal exercise test. A ten-year follow-up study
of 117 patients who had suffered myocardial
infarction (9) found only one patient who had
chest pain during or soon after a bath. On the
other hand, 60 % of the patients experienced
angina during normal daily life, in instances
other than bathing. Myocardial ischemia and
dysrhythmias were more pronounced during
an exercise test and walking, or jogging
outdoors than in connection with a sauna bath.
The load on, and the oxygen demand of, the
heart during bathing remained at a lower level
than under comparable physical or emotional
stress.
Myocardial ischemia during sauna bathing
and in a maximal exercise test was assessed in
16 U.S. patients with coronary heart disease,
using scintigraphic imaging (26). When
compared to rest, perfusion defects suggesting
myocardial ischemia were observed more
often during exercise than bathing, and ST
depression in electrocardiograms occurred
only in exercise.
During the past 10 years, interventions
have been conducted in Japan to use sauna
bathing as one component of the treatment of
congestive heart failure. Previously, hot sauna
was considered as a contra-indication for this
condition, but a milder form of sauna-like
exposure (60°C, dry air) was used in the Japa-
nese studies. Acute effects of sauna and hot
tub bath were compared in patients with heart
failure (27). Both heat exposures increased
the oxygen consumption by 0.3 MET (1 meta-
bolic equivalent equalling the resting energy
expenditure), increased the heart rate by 20
to 25 beats per minute, did not change the
systolic pressure during the heat exposure and
reduced it afterwards, increased the cardiac
output by 1.5 to 2.0-fold, reduced the total
peripheral resistance greatly and increased
the left ventricular ejection fraction. Hemo-
dynamics improved more after the hot air
bath than after the tub bath.
A further study compared the effects of two
weeks’ sauna bathing in patients with cardiac
failure (28). Endothelium-mediated vasodila-
tion was enhanced, in addition to a decreased
left ventricular end-diastolic dimension and
decreased circulating concentrations of brain
natriuretic peptide. Symptoms were improved
in most patients (2). An improvement in
impaired vascular endothelial function after
two weeks’ bathing was also seen in men
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International Journal of Circumpolar Health 65:3 2006
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with cardiovascular risk factors, but without
cardiac failure (29).
In a randomized controlled study, patients
with heart failure underwent sauna bathing on
ve days weekly for 2 weeks (30). Compared
with the non-treated group, premature
ventricular contractions decreased and heart
rate variability increased, which might have
prognostic signicance.
Musculoskeletal diseases
Sauna bathing has been used to relieve pain
in various musculoskeletal disorders, often
due to degeneration. The mechanism for the
heat-induced sedative effect might be medi-
ated through sensory nerves in the skin. When
heat stress is combined with intense cool-offs,
it may result in analgesia, which is reected by
increased levels of circulating β-endorphins
(12). This may enhance immunosuppressive
and anti-inammatory functions.
A peculiar nding in persons with rheu-
matoid arthritis, osteoarthritis and especially
bromyalgia, is that, while the sauna heat
presently alleviates the pain, there may be a
delayed effect of worsening pain the next day.
During bathing, pain increased in only about
10 % of persons with neuropathic, or rheu-
matoid pain (31). Within 12 hours following
the bathing, about 50 % of arthritis patients
reported exacerbation of pain. The increased
serum concentration of prolactin may be the
mediator. By experience, some patients have
learnt to prevent this ”hangover” by inten-
sive cooling after bathing (32). In a nonran-
domized six-week treatment study, women
with bromyalgia, but without previous
sauna use, increased their pain tolerance
more after sauna bathing than after aquatic
therapy (33).
Bathing has also been used to prevent
exercise-induced musculoskeletal pain. The
delayed onset muscular soreness that often
follows eccentric muscular work was studied
in untrained young women (34). After an exer-
cise session, they were randomly subjected
to a sauna bath, a hot water bath, a neutral
water bath, or no heat, and the exposure
was repeated after two days. The maximal
strength, subjective pain, pressure threshold
of pain and serum enzymes indicative of
muscular cellular damage, were assessed daily
for nine days after the exercise. The hot bath
induced the least decrease in the strength and
the least increase in the pain or the enzyme
concentrations, when compared to a neutral
bath. On the other hand, sauna bathing did not
prevent soreness, when compared to no heat
exposure.
Depression
There is some recent Japanese evidence
that sauna bathing might be benecial in
depressed, or fatigued persons. In a random-
ized controlled study, non-obese patients with
mild depression underwent sauna-like expo-
sure on ve days weekly for two weeks (35).
Compared with the control group, somatic
complaints, hunger and relaxation scores
improved, while concentrations of plasma
ghrelin, an orexigenic hormone, and daily
energy intake, increased.
Respiratory diseases
Some respiratory diseases, especially chronic
obstructive pulmonary diseases (COPD),
tolerate the sauna well. During bathing, 12
men with COPD experienced an improvement
in FVC and FEV1, and most of them described
decreased respiratory effort (36). On the other
200 International Journal of Circumpolar Health 65:3 2006
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hand, bathing did not enhance tracheobron-
chial clearance in ve men with chronic bron-
chitis (37). Based on this meager evidence on
COPD, bathing does not seem to cause any
harm, but neither does it improve the condi-
tion permanently.
Asthmatics usually feel that the heat in
sauna relieves their respiratory effort. The
mechanism is proposed to be mediated by
increased concentrations of circulating cate-
cholamines, which relax the bronchial smooth
muscle. Fourteen asthmatic children were
studied during weekly sauna bathing for seven
weeks (38). No signicant changes in PEF
were observed before and after sauna, and
after cooling.
The common cold is believed to be fended
off by regular bathing. In a nonrandomized
study, 25 adults unaccustomed to sauna were
submitted to bathing once or twice a week for
six months, while the control group abstained
from any hyperthermic exposures (39). For the
rst three months, the incidence of common
cold was about equal in the two groups. During
the latter three months, however, the incidence
among the sauna goers was less than one half
of that among the control group.
RISKS AND ADVERSE EFFECTS OF
SAUNA BATHING
Cardiovascular catastrophies,
and accidents
The most dreadful adverse effect during a
sauna bath, or within the rst 12 hours after-
wards, is sudden death, which most often is due
to underlying, though not always previously
diagnosed, cardiovascular disease. However,
both the absolute and relative risks are small.
In Finland in the 1970’s, sudden deaths among
men over 60 years occurred at a rate of 1 per
0.4 million sauna baths, while the rate for 50 to
59-year-olds was 1 per 2.3 million and for 40
to 49-year-olds 1 per 9 million (40).
Other severe adverse effects are due to
accidents, such as burns from the heater (41,
42) and drowning during a cool-off swim.
Alcohol is often a contributing factor (43, 44).
Alcohol consumption can also enhance the
risk for hypotension. However, bathing, even
in combination with heavy alcohol drinking,
does not appear to provoke cardiac dysrhyth-
mias in healthy young men (45).
Pregnancy
Sauna bathing as a source of hyperthermia
has been suggested to be teratogenic in early
pregnancy (46). When studying the relation-
ship between heat and birth defects, the use of
sauna, hot water baths and electric blankets, as
well as having a fever, or living in a hot climate,
have been used as examples of hyperthermia.
About two decades ago, central nervous system
defects, anencephaly and spina bida were
claimed to result from sauna baths during the
rst two months of pregnancy, which coincides
with the time for organogenesis. However, the
incidence of anencephaly in Finland, where 95
to 99 % of pregnant women take sauna baths
once weekly, or more, throughout their preg-
nancies, is lower than anywhere in the world
(47). Incidentally, in regions with high inci-
dences of anencephaly, such as Belfast and
Dublin, women do not seem to have fever, or
take hot baths, more often than those in other
regions (48).
Congenital cardiovascular malformations
are the most common birth defects. No asso-
ciation was found between maternal sauna
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bathing, the course of gestation, or the occur-
rence of congenital defects in a Finnish study
(a three-year national material with about
500 cases and 1000 healthy control babies)
(49). Similar results on the use of hot baths
and sauna have been reported from New York
(50). Nor was the risk increased in Finland
for defects of the central nervous system and
of orofacial clefts (51), or heart defects (49).
To our knowledge, experimental studies
on the effects of sauna bathing on pregnant
women and their fetuses have only been
carried out in Finland (15, 52). Two groups of
pregnant (early and late stage) women were
acutely exposed to sauna-like heat exposure,
as were 15 non-pregnant control women. In
both pregnant and control women, the rectal
temperature rose 0.3 to 0.5°C during the expo-
sure, i.e., not enough to reach the supposed
teratogenic level of 38.9°C, while the skin
temperature rose by about 5°C. In pregnant
women, no changes were found in umbilical
artery blood ow. All deliveries took place at
the estimated time, and the newborn infants
were all in good condition at delivery.
Thus, during uncomplicated pregnancies,
sauna baths neither seem to harm the fetus,
nor are they dangerous to the mother. On the
other hand, the resistance to the blood ow in
the uterine artery was increased in toxemic
patients subjected acutely to sauna-like
thermal challenge, while no such event was
recorded in normal controls (53). In severe
toxemia, the fetal compensation mechanisms
may already be utilized maximally at room
temperature, and the heat exposure might
compromise the availability of oxygen to the
fetus. Therefore, pregnant mothers suffering
from toxemia are advised to avoid the sauna
bathing.
Children
It is often believed that children should take
sauna baths because of its dangers. Yet, most
children in Finland are introduced to the
sauna at the mean age of ve months, and
they continue to take a sauna bath at least
once a week throughout life (54). However,
there has only been one physiological study
on sauna bathing in healthy infants (mean age
seven months) (55). A three-minute exposure
induced no harmful cardiovascular responses.
The sauna places greater demands on a
child’s circulatory regulation than on that of
adults. The maintenance of homeothermia,
as studied in 20 children aged 5 to 10 years
(56), resulted in moderate hormonal changes.
Under adequate adult supervision, healthy
children over two years of age may well be
allowed in a sauna (57). The most common
problems related to sauna bathing of children
are accidental burns and scalds by hot water
(58). There is a risk of vasovagal collapse at
the very beginning of the cool-off phase. The
heat stress may be risky for those children
who have disorders of the sinoatrial node of
the heart (56).
Sauna-like heat exposure bathing was used
as vasodilative therapy in 12 infants aged
1 to 4 months, who had severe heart failure
due to ventricular defects (59). A four-week
daily therapy improved hemodynamics and
decreased symptoms, and surgical repairs
were avoided in 9 patients.
Contra-indications to sauna bathing
Based on both physiological and adverse
effects of bathing, contra-indications include
prolonged, or unstable angina-type chest
pain, myocardial infarction, or other severe
cardiac events for four to eight weeks after the
202 International Journal of Circumpolar Health 65:3 2006
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incident, severe orthostatic hypotension and
severe aortic stenosis (9, 25), acute infectious
diseases with fever, rheumatoid arthritis in
the acute inammatory phase (32), fever for
any reason, and certain skin conditions, such
as cholinergic urticaria, abrasions and oozing
rashes (60).
MEDICATION AND SAUNA BATHING
Since bathing induces changes in body temper-
ature, circulation and uid balance, drug phar-
macokinetics, or responses to drug therapy,
may be affected. Absorption, metabolism and
elimination of drugs may be altered, as well as
the responses to drugs affecting the autonomic
nervous system and cardiovascular system. A
review by Vanakoski and Seppä (61) gives
an overall presentation of pharmacokinetics
under various hyperthermic conditions.
It has been proposed that, if sauna decreases
the hepatic circulation, it may inuence drugs
with hepatic rst-pass metabolism (e.g., mida-
zolam, propranolol). Indocyanine green was
used as an indicator of hepatic circulation (62).
Its clearance was not changed during bathing
in healthy individuals. The metabolism of
midazolam (a short-acting hypnotic) was not
altered either (63).
Ephedrine and tetracycline are both
excreted through the kidneys. Renal excretion
of ephedrine was unaffected (64) by bathing,
and the effects of sauna on tetracycline (65)
pharmacokinetics were modest in healthy
individuals.
Several cardiovascular drugs, including-
nitroglycerin, β-adrenergic blocking agents,
calcium channel antagonists, and ACE
inhibitors, have been studied in sauna (61).
β-blocking agents prevent the heat-induced
increase in heart rate. Generally, antihyper-
tensive medication taken immediately before
bathing is not advisable, because it parallels,
or amplies, the hypotensive effects (espe-
cially on diastolic pressure) of post-sauna
relaxation. However, diltiazem did not poten-
tiate sauna-induced vasodilation in hyperten-
sive patients (66).
Systemic sympathomimetics (e.g., ephe-
drine) and parasympatholytics (e.g., scopo-
lamine) may enhance the sauna-induced
effects of increased sympathetic activity, and
of elevated heart rate and blood pressure,
so that their administration shortly before
bathing should be done with caution. The use
of drugs affecting the autonomous nervous
system, such as scopolamine, atenolol, or their
combination, did not have harmful effects on
healthy young men during bathing (67).
As bathing increases cutaneous blood ow,
it may increase the absorption of transder-
mally administered drugs. Indeed, the use
of transdermal glyceryl trinitrate (nitroglyc-
erin) (68) and nicotine (69) patches increased
plasma concentrations of nitroglycerin and
nicotine in healthy subjects after bathing;
headaches, a clinical sign of enhanced absorp-
tion of glyceryl nitrate, were experienced (68).
From experience, many coronary patients
know the nitroglycerin-like effect of sauna
(i.e., vasodilation) and, therefore, avoid
taking such drugs shortly before bathing. By
a physiological mechanism similar to that of
transdermal administration, insulin absorp-
tion from a subcutaneous injection site in
diabetics was enhanced during bathing (70).
Another issue when using transdermal drug
administration in the form of patches, is their
adhesion stability to skin in various tempera-
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International Journal of Circumpolar Health 65:3 2006
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tures. The adhesive reliability of a contra-
ceptive patch was shown to be good in sauna
bathing (71).
Conclusions
Human studies on the benecial and adverse
effects of sauna bathing are relatively scarce,
and the study designs are often uncontrolled,
with small subject numbers. Sauna heat has
been administered as either acute, or repeated
exposures. The physiological effects of
eventual habituation to sauna bathing since
childhood have not been studied in depth, in
healthy persons, nor in persons with chronic
diseases.
Based on the present scientic knowledge,
sauna bathing poses no risks to healthy people
from childhood to old age. Even persons with
a cardiac condition may take their sauna baths
safely, if the disease state and medication are
under control. There are new promising Japa-
nese research results on benecial therapeutic
effects of bathing as a part of the treatment
for cardiac failure (2). However, this regimen
has not been repeated in persons accustomed
to bathing. Therefore, further research, with
sound experimental design, is needed before
sauna bathing can be used routinely as a non-
pharmacological treatment regimen in certain
medical disorders.
Acknowledgement
We owe our sincere thanks to Prof. Martin
Halle (Department of Preventive and Rehabil-
itative Sports Medicine, School of Medicine,
Technical University, Munich, Germany) for
his thoughtful comments on our manuscript.
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pl 2):S32-35.
Katriina Kukkonen-Harjula, D. Med. Sci., Adjunct Prof., Senior Researcher
UKK Institute for Health Promotion Reseach
P.O. Box 30
FI-33501 Tampere, Finland
Email: katriina.kukkonen-harjula@uta.fi
... These strategies have been traditionally used by endurance sportsmen to increase their thermal tolerance to heat and to increase their physiological economy in hot conditions (Guy et al., 2016). The second ones, specially sauna baths, have been traditionally linked to health-promoting contexts with a reduced rate of use among sportsmen, and they are generally characterized by the absence of exercise and by noticeably higher temperatures (70-80°C) (Kukkonen-Harjula and Kauppinen 2006). ...
... Passive sauna baths are a kind of exposure to environmental heat which induces several hemodynamic and endocrine responses, some of them similar to the ones produced by physical exercise (Hannuksela and Ellahham, 2001;Kukkonen-Harjula and Kauppinen 2006). Sportsmen can benefit from these heat-induced adaptions by two general ways. ...
... Regarding cardiocirculatory responses to exercise, maximal hearth rate (HR max ) was also unaltered but post-exercise blood pressures decreased significantly, fact which may reflect (considering the Bartolomé et al. Journal of Thermal Biology xxx (xxxx) 103048 absence of changes in body water nor in hematological parameters) endothelial adaptations (Imamura et al., 2001;Kukkonen-Harjula and Kauppinen 2006). Heat acclimation increases the expression of endothelial nitric oxide synthase as well as the production of nitric oxide in endothelial tissue, being these factor two power inductors of vasodilation (Brunt et al., 2016;Ikeda et al., 2005;McCarty et al. 2009). ...
Article
This manuscript aims to evaluate the influence of a novel passive heat acclimation program among human participants in the physical performance, as well as in several physiological parameters. 36 male football players were acclimated using a dry sauna bath to extreme hot (100 ± 3 °C), performing a total of nine sauna sessions with a weekly frequency of three sessions. The players were randomly into the sauna group (SG; n = 18; age: 20.69 ± 2.09 years) and the control group (CG; n = 18; age: 20.23 ± 1.98 years). All participants performed maximal effort test until exhaustion as well as hamstring flexibility test before and after the acclimation program. Anthropometric, respiratory, circulatory, hematological and physiological variables were evaluated at the beginning and at the end of the survey. Statistical analysis consisted of a Mann-Whitney U test to determine differences between groups at the beginning and at the end of the survey and a Wilcoxon test for paired samples to compare the differences for each group separately. Additionally, size effects of the pre-post acclimation changes were calculated. After the acclimation program SG participants experienced a diminution in body weight (p < 0.01), body mass index (p < 0.01), body fat (p < 0.05) and fat percentage (p < 0.05) decreased. Hamstring flexibility (p < 0.05) and work capacity (p < 0.05) increased. External basal temperature decreased (p < 0.05) as well as post-exercise systolic and diastolic blood pressures (p < 0.05). Finally, maximal oxygen uptake (ml Kg⁻¹ min⁻¹) (p < 0.05), maximal minute ventilation (p < 0.05) and maximal breath frequency (p < 0.05) increased at the end of the intervention. There were no significant changes in the CG in any variable. Favorable adaptations have been observed in this survey, suggesting a beneficial effect of extreme heat acclimation on physical performance. Several of the observed responses seem interesting for sport performance and health promotion as well. However, this is a novel, extreme protocol which requires further research.
... There is evidence to indicate that PA significantly influences hormone levels in the human body (Hagobian & Braun, 2010;Poehlman & Copeland, 1990). According to Kukkonen-Harjula and Kauppinen (2006), sauna is an ancient habit in both cold and warm climates, which is why cooling factors such as cooling time, temperature and the cooling environment (water or air) should be taken into account when analyzing changes in the hormonal milieu. The aim of this study was to analyze the basic responses of the endocrine system in young healthy men with moderate and high levels of PA, who were exposed to heat during four 12-min sessions in a Finnish sauna. ...
... In turn, Kukkonen-Harjula and Kauppinen (1988) demonstrated sauna-induced changes in TES secretion. Testosterone plays a key role in triggering and maintaining sexual functions in males, and there is no scientific evidence to indicate that regular sauna bathing reduces male fertility (Kukkonen-Harjula & Kauppinen, 2006). ...
Article
The aim of the study was to determine the effect of repeated hot thermal stress and cold water immersion on the endocrine system of young adult men with moderate and high levels of physical activity (PA). The research was conducted on 30 men aged 19–26 years (mean: 22.67 ± 2.02) who attended four sauna sessions of 12 min each (temperature: 90−91°C; relative humidity: 14–16 %). Each sauna session was followed by a 6-min cool-down break during which the participants were immersed in cold water (10−11°C) for 1 min. Testosterone (TES), cortisol (COR), dehydroepiandrosterone sulfate (DHEA-S), and prolactin (PRL) levels were measured before and after the sauna bath. The participants’ PA levels were evaluated using the International Physical Activity Questionnaire. Serum COR levels decreased significantly (p < .001) from 13.61 to 9.67 µg/ml during 72 min of sauna treatment. No significant changes (p >.05) were noted in the concentrations of the remaining hormones: TES increased from 4.04 to 4.24 ng/ml, DHEA-S decreased from 357.5 to 356.82 µg/ml, and PRL decreased from 14.50 to 13.71 ng/ml. After sauna, a greater decrease in COR concentrations was observed in males with higher baseline COR levels, whereas only a minor decrease was noted in participants with very low baseline COR values (r =−0.673, p <.001). Repeated use of Finnish sauna induces a significant decrease in COR concentrations, but does not cause significant changes in TES, DHEA-S, or PRL levels. Testosterone concentrations were higher in men characterized by higher levels of PA, both before and after the sauna bath.
... There is evidence to indicate that PA significantly influences hormone levels in the human body (Hagobian & Braun, 2010;Poehlman & Copeland, 1990). According to Kukkonen-Harjula and Kauppinen (2006), sauna is an ancient habit in both cold and warm climates, which is why cooling factors such as cooling time, temperature and the cooling environment (water or air) should be taken into account when analyzing changes in the hormonal milieu. The aim of this study was to analyze the basic responses of the endocrine system in young healthy men with moderate and high levels of PA, who were exposed to heat during four 12-min sessions in a Finnish sauna. ...
... In turn, Kukkonen-Harjula and Kauppinen (1988) demonstrated sauna-induced changes in TES secretion. Testosterone plays a key role in triggering and maintaining sexual functions in males, and there is no scientific evidence to indicate that regular sauna bathing reduces male fertility (Kukkonen-Harjula & Kauppinen, 2006). ...
Article
Full-text available
The aim of the study was to determine the effect of repeated hot thermal stress and cold water immersion on the endocrine system of young adult men with moderate and high levels of physical activity (PA). The research was conducted on 30 men aged 19–26 years (mean: 22.67 ± 2.02) who attended four sauna sessions of 12 min each (temperature: 90−91°C; relative humidity: 14–16 %). Each sauna session was followed by a 6-min cool-down break during which the participants were immersed in cold water (10−11°C) for 1 min. Testosterone (TES), cortisol (COR), dehydroepiandrosterone sulfate (DHEA-S), and prolactin (PRL) levels were measured before and after the sauna bath. The participants’ PA levels were evaluated using the International Physical Activity Questionnaire. Serum COR levels decreased significantly ( p < .001) from 13.61 to 9.67 µg/ml during 72 min of sauna treatment. No significant changes ( p >.05) were noted in the concentrations of the remaining hormones: TES increased from 4.04 to 4.24 ng/ml, DHEA-S decreased from 357.5 to 356.82 µg/ml, and PRL decreased from 14.50 to 13.71 ng/ml. After sauna, a greater decrease in COR concentrations was observed in males with higher baseline COR levels, whereas only a minor decrease was noted in participants with very low baseline COR values ( r =−0.673, p <.001). Repeated use of Finnish sauna induces a significant decrease in COR concentrations, but does not cause significant changes in TES, DHEA-S, or PRL levels. Testosterone concentrations were higher in men characterized by higher levels of PA, both before and after the sauna bath.
... [34,35]. The mechanistic pathways postulated to underlie the association between frequent passive heat exposure (eg, regular sauna bathing) and decreased risk of death include reduction in blood pressure [36]; improvement in endothelial function [37,38]; reduction in oxidative stress [39,40]; beneficial modulation of the autonomic nervous system [41] and in levels of circulating cardiovascular risk factors such as natriuretic peptides [42]; improved arterial stiffness; decreased intima media thickness [39,[42][43][44]; and substantial improvement in cardiovascular function [45][46][47]. These findings add to the emerging evidence on the ability of frequent sauna baths to promote longevity and attenuate or offset the adverse effects of cardiovascular risk factors [18,19]. ...
Article
Full-text available
Inflammation and sauna bathing are each related to the risk of all-cause mortality. The interplay between inflammation, sauna bathing and all-cause mortality is not well understood. We aimed to evaluate the separate and joint associations of inflammation (high sensitivity C-reactive protein, hsCRP) and frequency of sauna bathing (FSB) with all-cause mortality in a cohort of Caucasian men. We used the Kuopio Ischaemic Heart Disease Study cohort comprising 2575 men aged 42–61 years at baseline. Serum hsCRP was measured using an immunometric assay and sauna bathing habits were assessed by a self-administered questionnaire. High sensitivity CRP was categorized as normal and high (≤ 3 and > 3 mg/L, respectively) and FSB as low and high (defined as ≤ 2 and 3–7 sessions/week respectively). A total of 1618 deaths occurred during a median follow-up of 27.8 years. Comparing high vs normal hsCRP levels, the multivariable-adjusted HR (95% CI) for all-cause mortality was 1.27 (1.13–1.44). Comparing high vs low FSB, the multivariable-adjusted HR (95% CI) for all-cause mortality was 0.86 (0.76–0.97). Compared with normal hsCRP-low FSB, high hsCRP-low FSB was associated with an increased risk of all-cause mortality 1.28 (1.12–1.47), with no evidence of an association for high hsCRP-high FSB and all-cause mortality risk 1.06 (0.81–1.40). Positive additive and multiplicative interactions were found between hsCRP and FSB in relation to mortality. In a general Finnish male population, both hsCRP and FSB are each independently associated with all-cause mortality. However, frequent sauna baths appear to offset the increased all-cause mortality risk related to high hsCRP levels.
... дневных городских условиях [2,3]. В эксперименте на крысах были получены данные, что ингибиторы ангиотензинпревращающего фермента (ИАПФ) и блокаторы рецепторов ангиотензина II (БРА) подавляют центр жажды, что, в свою очередь, может вести к дегидратации организма в жару [1], однако эти сведения тоже нельзя экстраполировать на человеческую популяцию, тем более на больных сердечно-сосудистыми заболеваниями (ССЗ). ...
Article
Full-text available
Actuality. The effect of drugs on adaptation to abnormal temperatures is one of the most important questions put to practical medicine by the heat waves of recent years. One of the controversial issues - safety of use during the heat wave of calcium channel blockers (ACC) and blockers of receptors for angiotensin II (ARBS). The goal is to evaluate the efficacy and security of treatment of patients with arterial hypertension (AH) during the heat wave of a fixed combination of ARBS+ACC (Lortenza, KRKA). Materials and methods. Included 26 patients with hypertension 1 and 2 degrees from 42 to 81 years. All patients underwent measurement of office blood pressure, electrocardiography, body sphygmography with the determination of the pulse wave velocity and selectively CAVI, biochemical analysis of blood, estimation of osmolarity of blood, questionnaire: visual analogue scale, a questionnaire for patients exposed to heat, the test of adherence to treatment Moriscos-Green. Estimated diaries of self-control of blood pressure. The inclusion visit took place in spring 2016, 1st visit was in May - June 2016, 2nd - during heat waves, 3rd - September - October 2016. Results. The observed decrease in systolic blood pressure and diastolic blood pressure (p=0.000) to the target values, preserved for the whole period of observation. According to the diaries of self-control of blood pressure controlled blood pressure 81% of patients. During a heat wave, this value decreased to 58%, in autumn - to 63%. The 3rd visit achieved a reduction in heart rate at -6.0 (-11.1; and 2.8) beats/min; p=0.007. A noticeable decrease of the pulse wave velocity from 15.2±3.4 to 14.4 V±3.0 m/s; p=0.01 and CAVI in of-2.1 (to -2.9; -0.65); p=0.01; the decline in uric acid level c of 415.3 to 346.2 mmol/l (p=0.04) and creatinine on the 2nd visit compared to baseline (p=0.02). Electrolyte shifts and increasing the osmolarity of the blood during heat waves have not been identified. There is a growing commitment therapy (p=0.04) and quality of life to 20.0 (7.4; 23.3); p=0.000 by visual analogue scale. Conclusion. Fixed combination of losartan and amlodipine (Lorenza) is an effective, safe and may be recommended for patients receiving AG in the hottest period.
... Небольшое количество экспериментальных работ было посвящено изучению адсорбции, метаболизма и элиминации препаратов под воздействием высоких температур [10]. Эти исследования выполнялись в период короткого и интенсивного воздействия, что трудно соотнести с длительным влиянием жары в повседневных городских условиях [11,12]. ...
Article
Full-text available
Relevance. The impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions, concerning heat waves, recent years. One of the points at issue is safety administration of calcium channel antagonists and ACE inhibitors during abnormal heat.Aim of the study is to assess the efficacy and safety of the fixed combination of perindopril arginine (drug Prestance, Servier Industries, Ltd.)/amlodipine in patients with arterial hypertension (AH) during the summer heat and the summer heat influence on the mechanisms of heat adaptation to abnormally high temperature.Material and methods: The study enrolled 165 patients with stages 1-2 AH: 69 patients with average risk and 91 patients with high/very high risk of cardiovascular complications. There were 69 men and 96 women in the study, living in Moscow city, in the Moscow and in the Ivanovo Regions. All patients were measuring office BP, undergoing biochemical analysis of blood, running questionnaire survey: visual analogue scale (VAS), questionnaire for the patients who were exposed to heat, the level of products reacting with the 2-thiobarbituric acid (malonyldialdehyde, MDA) and activity of superoxide dismutase (SOD) using standard test-kits and the pulse ware velocity (PWV) was measured in 30 patients. The first visit was in the first half of June 2013, the second visit - during the heat (July 2013) and the third one in September 2013.Results: In the course of the study SBP (systolic BP) and DBP (diastolic BP) were reduced (р
... Небольшое количество экспериментальных работ было посвящено изучению адсорбции, метаболизма и элиминации препаратов под воздействием высоких темпера-тур [13]. Эти исследования выполнялись в период короткого и интенсивного воздействия, часто в условиях сауны, что трудно соотнести с длительным влиянием жары в повседневных городских условиях [13,14]. ...
Article
Full-text available
Relevance. Impact of the drugs on adaptation to the heat wave of abnormal temperature has been one of the most important practical medicine questions in recent years. One of the points at issue is safety calcium channel antagonists and ACE inhibitors treatment during abnormal heat. The aim of the study is to investigate the efficacy and safety of perindopril arginine (drug Prestance - Servier Industries, Ltd.) and amlodipine fixed combination in arterial hypertension (AH) patients during the summer heat and the summer heat influence on the adaptation mechanisms to abnormally high temperatures.Materials and methods. The study enrolled 165 patients with stages 1 and 2 AH: 69 patients with average risk and 91 patients with high andvery-highrisk of cardiovascular complications. There were 69 men and 96 women in the study, living in Moscow city, in the Moscow and in the Ivanovo Regions. All patients were measuring office BP, biochemical blood assay and hematocrit and were running questionnaire survey: visual analogue scale (VAS), Morisky-Green test and questionnaire for the patients who were exposed to heat. Pulse ware velocity was measured in 30 patients. The first visit was done in the first half of June 2013, the second visit - during the heat (July 2013), the third one in September 2013. Results. In the course of the study systolic (SBP) and diastolic BP (DBP) were reduced (р
Article
Full-text available
Objective : Sauna bathing (SB) is an important strategy in cardiovascular protection, but there is no mathematical explanation for the reallocation of blood circulation during heat-induced superficial vasodilation. We sought to reveal such reallocation via a simulated hemodynamic model. Methods : A closed-loop cardiovascular model with a series of electrical parameters was constructed. The body surface was divided into seven blocks and each block was modeled by a lumped resistance. These resistances were adjusted to increase skin blood flow (SBF), with the aim of reflecting heat-induced vasodilation during SB. Finally, the blood pressure was compared before and after SB, and the blood flow inside the aorta and visceral arteries were also analyzed. Results : With increasing SBF in this model, the systolic, diastolic, and mean blood pressure in the arterial trunk decreased by 13–29, 18–36, and 19–37 mmHg, respectively. Despite the increase in the peak and mean blood flow in the arterial trunk, the diastolic blood flow reversal in the thoracic and abdominal aortas increased significantly. Nevertheless, the blood supply to the heart, liver, stomach, spleen, kidney, and intestine decreased by at least 25%. Moreover, the pulmonary blood flow increased significantly. Conclusion : Simulated heat-induced cutaneous vasodilation in this model lowers blood pressure, induces visceral ischemia, and promotes pulmonary circulation, suggesting that the present closed-loop model may be able to describe the effect of sauna bathing on blood circulation. However, the increase of retrograde flow in the aortas found in this model deserves further examination.
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Das Regenerationsmanagement im Leistungssport umfasst die Abschätzung von Ermüdungszustand und Regenerationsbedarf (Teil 1 dieser Beitragsreihe) sowie den Einsatz regenerationsfördernder Maßnahmen (Teil 2 dieser Beitragsreihe). Die Erfassung des Regenerationsbedarfs erfolgt durch die Dokumentation der externen Trainings- und Wettkampfbelastung, der damit einhergehenden internen Beanspruchung und der resultierenden Leistungsveränderung. Hierzu sind zahlreiche Surrogat-Parameter verfügbar (z. B. Laborparameter, sportmotorische Tests und psychometrische Verfahren). Diese sollten sensitiv für unterschiedliche Belastungsformen und Dimensionen der Ermüdung, ausreichend reliabel und objektiv, kostengünstig und praktikabel sowie engmaschig durchführbar und demnach nicht zu belastend sein. Für die Beurteilung des Regenerationsbedarfs einzelner Athleten sind neben einer individualisierten Interpretation der Surrogat-Parameter stets auch der vertrauensvolle Diskurs zwischen Athleten und deren Betreuerstab erforderlich.
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Objective: To study the hemodynamic response to lower leg heating intervention (LLHI) inside the abdominal and iliac arterial segments (AIAS) of young sedentary individuals. Methods: A Doppler measurement of blood flow was conducted for 5 young sedentary adults with LLHI. Heating durations of 0, 20, and 40 min were considered. A lumped parameter model (LPM) was used to ascertain the hemodynamic mechanism. The hemodynamics were determined via numerical approaches. Results: Ultrasonography revealed that the blood flow waveform shifted upwards under LLHI; in particular, the mean flow increased significantly (p < 0.05) with increasing heating duration. The LPM showed that its mechanism depends on the reduction in afterload resistance, not on the inertia of blood flow and arterial compliance. The time-averaged wall shear stress, time-averaged production rate of nitric oxide, and helicity in the external iliac arteries increased more significantly than in other segments as the heating duration increased, while the oscillation shear index (OSI) and relative residence time (RRT) in the AIAS declined with increasing heating duration. There was a more obvious helicity response in the bilateral external iliac arteries than the OSI and RRT responses. Conclusion: LLHI can effectively induce a positive hemodynamic environment in the AIAS of young sedentary individuals.
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Objective. —To determine if exposure to hot tub, sauna, fever, or electric blanket during early pregnancy was associated with an increased risk for neural tube defects (NTDs).Design. —Prospective follow-up study.Setting. —Mostly private obstetric practices, primarily in New England. Participants.—A cohort of 23491 women having serum alpha-fetoprotein screening or an amniocentesis were identified. Complete exposure and outcome information was available for 97% of these women.Outcome Measures. —Relative risks (RRs) were used to compare incidence of NTD in those exposed to heat with those who were not exposed to any heat. Crude RRs were calculated directly from the data. Unconfounded RRs were calculated using logistic regression.Results. —Women reporting any heat exposure (sauna, hot tub, fever, or electric blanket) in early pregnancy had a crude risk of their fetuses developing NTD of 1.6 (95% CI [confidence interval], 0.9 to 2.9). Women reporting exposure to sauna, hot tub, or fever in early pregnancy had a crude risk of their fetuses developing NTD 2.2 times that of women without heat exposure (95% CI, 1.2 to 4.1). For hot tub use, the crude RR was 2.9 (95% CI, 1.4 to 6.3); for sauna, 2.6 (95% CI, 0.7 to 10.1); for fever, 1.9 (95% CI, 0.8 to 4.1); and for electric blanket, 1.2 (95% CI, 0.5 to 2.6). Multivariate adjusted RRs for individual heat sources, after controlling for maternal age, folic acid supplements, family history of NTD, and exposure to other heat sources, were for hot tub use, 2.8 (95% CI, 1.2 to 6.5); sauna, 1.8 (95% CI, 0.4 to 7.9); fever, 1.8 (95% CI, 0.8 to 4.1); and electric blanket, 1.2 (95% CI, 0.5 to 2.6). When only hot tub, sauna, and fever were considered and the women's exposure to each tallied, compared with no heat exposure, the RR for NTDs increased from 1.9 (95% CI, 0.9 to 3.7) after one type of heat exposure to 6.2 (95% CI, 2.2 to 17.2) after two types of heat exposure.Conclusions. —Exposure to heat in the form of hot tub, sauna, or fever in the first trimester of pregnancy was associated with an increased risk for NTDs. Hot tub exposure appeared to have the strongest effect of any single heat exposure. Exposure to electric blanket was not materially associated with increased risk for NTDs.(JAMA. 1992;268:882-885)
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Exposure to sauna heat during sauna bathing raises the skin temperature of the bather near the hot pain perception threshold and enhances sympathetic activity. Self-reports provided by regular bathers of changes in intensity of their ongoing pain might, therefore, add novel information on the effect of intense heat on various pain conditions. We interviewed consecutive patients attending our pain clinic over a period of 1 year about their pain-related responses to sauna bathing and controlled the results by quantitated somatosensory tests. There were 61 patients with chronic neuropathic pain of peripheral origin, 13 patients with central pain and 59 patients with rheumatoid pain. Allodynia and hyperalgesia to heat were relatively infrequent in all groups (10%, 15% and 8%, respectively), Three out of 17 patients with postinjury nerve pain reported similar exacerbation. By contrast, mechanical allodynia was present in 48% of patients with peripheral neuropathic pain and in 54% of patients with central pain. The results speak against an important role for C-afferent or sympathetic postganglionic fibres in most subclasses of neuropathic pain. Animal models of neuropathic pain should be critically viewed against this finding.
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Zur therapeutischen Wirkung der Sauna bei der primären Fibromyalgie, einer Erkrankung mit bekannter Therapieresistenz und erheblichem Leidensdruck, liegen bisher keine gesicherten Daten vor. Patientenkollektiv und Methodik: Neun Patientinnen mit einer primären Fibromyalgie (ACR-Kriterien) wurden in zwölf Anwendungen zweimal wöchentlich mittels Saunabad behandelt, als Kontrolle dienten neun Patientinnen, die zwölf Bewegungsbäder (BWB) ebenfalls zweimal wöchentlich erhielten. Mit einem Dolorimeter wurde die Druckschmerzschwelle vergleichend an den ACR „tender points” bestimmt. Zusätzlich wurden 18 Patientinnen, bei denen neben milden Saunabädern zahlreiche weitere physikalische Therapieformen (u. a. Stangerbäder, Bewegungsbäder, medizinische Trainingstherapie, Packungen, Massagen) zur Anwendung gekommen waren, mit einem standardisierten Fragebogen nach einer vergleichenden Beurteilung des Therapieerfolges der verschiedenen Verfahren befragt. Ergebnisse: Die Einzelanwendungen in der milden Sauna führten zu einem unmittelbaren leichten analgetischen Effekt, wobei die stärksten Anstiege der Schmerzschwelle erst in der zweiten Hälfte der Behandlungsserie eintraten (p < 0,05 beim 6. und 12. Bad). Nach Abschluss der gesamten Saunaserie konnte eine signifikante Erhöhung der Druckschmerzschwelle um im Mittel 22 % im Vergleich zum Ausgangswert beobachtet werden; demgegenüber führten die Bewegungsbäder nur zu einem statistisch nicht signifikanten Anstieg von 8 %. Die Auswertung der Fragebogen zeigte, dass die meisten Patientinnen (10 von 18) durch die Saunabehandlung eine Schmerzlinderung erfahren hatten, weniger häufig auch unter Packungen (7 von 16), Krankengymnastik (6 von 16), im BWB (7 von 18) sowie unter Massagen (6 von 15). 8 von 12 Patientinnen, die Stangerbäder erhalten hatten, gaben eine Zunahme ihrer Beschwerden unter der Therapie an, dementsprechend fand diese Therapie von allen Verfahren die geringste Akzeptanz. Schlussfolgerung: Diese vorläufigen Ergebnisse belegen analgetische Effekte einer mild dosierten Saunabehandlung, die mit einer objektivierbaren Erhöhung der Druckschmerzschwelle einhergeht. Analgesic effects of sauna in fibromyalgia Mild sauna baths have not been considered up to now for therapeutical trials in fibromyalgia. Material and methods: 9 female patients with primary fibromyalgia (ACR-criteria) received twice a week 12 mild doses of sauna-therapy, a control group included 9 female patients receiving 12 aquatic therapies twice a week. Measurements of the pain pressure thresholds were performed at the ACR tender points with a standardised algometer. In addition, 18 female patients, who had received besides mild sauna baths several further physical therapies for fibromyalgia (i.e. aquatic therapy, hydrogalvanic baths, medical condition training, local heat therapy, massage etc.), answered a standardised questionnaire about beneficial and adverse effects of these therapies. Results: A moderate, but significant increase (p < 0.05) of the pain threshold was detected directly after single sauna baths in the second half of the series (i.e. after the 6th and the 12th application). When compared to the initial values, there was a significant increase of the pain threshold of 22 % after the entire sauna series, whereas serial aquatic therapy led to no significant increase of 8 %. In the standardised questionnaire, analgesic effects were most frequently reported after mild sauna baths (10 of 18 cases), but also after warm packs (7 of 16 cases), exercises conducted by a physiotherapist (6 of 16 cases), aquatic therapy (7 of 18 cases) and massages (6 of 15 cases). 8 of 12 patients who had received hydrogalvanic baths, reported increased pain after this therapy. Conclusion: These preliminary results suggest that mild sauna therapy exerts analgesic effects in fibromyalgia with an increase of the pain-pressure-threshold.
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Objective:Verification of therapeutic effects of hyperthermal applications (hotwater-bath, sauna-bath) at painful muscle overload ("delayed-onset muscle soreness"; DOMS). Subject:Controlled study concerning the course of loss of muscular strength, muscle pain and serum level of muscle enzymes in muscle overstrain (DOMS) with and without hyperthermal applications with respect to untrained women. Design:Production of muscle overload of the arms with defined, negative-dynamic work (30 % of maximal power for 30 mins). Partition (randomised) of 60 females into 4 groups (n = 15) with the following therapeutic applications (twice): 1. Group with complete hot water-bath (41 °C) for 20 mins; 2. Control group: complete water-bath with thermoindifferent temperature (36 °C) for 20 mins; 3. Group with hot, dry Finnish Sauna-bath (twice 15 mins). 4. Control group with no application. Measurement of all parameters were done 2 days before muscle overload, lasting for nine subsequent days. Results:A significantly smaller decrease in maximal isometric arm force, a lesser degree of muscle pain (scale estimation), a lower level of muscle enzymes (creatine kinase; aspertate amino transferase) in the serum as well as a faster fading away of the symptoms were found in the group with hyerthermal water baths in comparison to their control group. In the group with sauna-baths similar results were found (in parts), but the differences to the control group were not of statistical significance. Conclusions:Intensive hyperthermal applications have a probable effect on “delayed-onset muscle soreness” (DOMS) and confirm the experiences of athletes. Ziel:Uberprufung der Wirkungen von Uberwarmungsmasnahmen (heises Wannenbad, Saunabad) bei schmerzhafter Muskeluberlastung („Muskelkater”, DOMS: “delayed onset muscle soreness”). Gegenstand:Kontrollierte Verlaufsbeobachtung von Muskelkraftverlust, Muskelschmerz und Serumspiegel der Muskelenzyme bei Muskeluberlastung (DOMS) mit und ohne Uberwarmungsmasnahmen an untrainierten Frauen. Gestaltung:Erzeugung einer Muskeluberlastung der Arme mit definierter, negativ-dynamischer Arbeit (30% der Maximalkraft uber 30 min). 60 Frauen (randomisiert in 4 Gruppen mit je n = 15) erhielten folgende therapeutische Anwendungen (2mal): 1. Gruppe mit 20minutigem Uberwarmungswannenbad (41 °C); 2. Kontrollgruppe mit thermoindifferentem Vollbad (36 °C; 20min); 3. Gruppe mit Saunabad (2mal a 15 min); 4. dazugehorige Kontrollgruppe ohne Anwendung. Die Messungen aller Parameter erfolgten zwei Tage vor bis neun Tage nach der Muskeluberlastung. Ergebnisse:Ein signifikant geringerer Abfall der isometrischen Maximalkraft, ein geringerer Grad des Muskelschmerzes (skalierte Einschatzung), ein tieferer Serumspiegel der Muskelenzyme (Kreatinkinase; Aspertat-Amino-Transferase) sowie ein schnelleres Abklingen der Symptomatik fanden sich in der Gruppe mit Uberwarmungsbadern im Vergleich zu ihrer Kontrollgruppe. In der Saunabadgruppe fanden sich z. T. ahnliche Ergebnisse, doch waren die Unterschiede zur Kontrollgruppe nicht signifikant. Schlusfolgerungen:Intensive hypertherme Anwendungen haben eine nachweisbare Wirkung bei Muskeluberlastung („Muskelkater”, DOMS) und bestatigen die Erfahrungen von Athleten.
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The effect of heat stress on plasma prostacyclin and thromboxane A2 and serum estradiol, estriol and progesterone responses was studied in pregnant and non-pregnant women. Group I consisted of 15 healthy non-pregnant women, group II of 23 women 13-14 weeks pregnant, and group III of 23 women 36-37 weeks pregnant. Blood samples were taken before the heat stress, at the end of the stress (70 degrees C for 20 min) and 20 min and/or 45 min after the end of stress. The rectal temperature increased 0.3-0.4 degrees C. The concentration of progesterone did not change during the experiment but that of estradiol increased by 11% (P less than 0.005) in group II and by 10% (P less than 0.01) in group III after the end of the stress. Estriol increased only in group III (by 12%, P less than 0.005) after the end of the stress and the increase was higher as compared to group II (P less than 0.005). The metabolite of prostacyclin increased only in group III by 15% (P less than 0.05) during the heat stress. The metabolite of thromboxane A2 decreased in group II by 20% (P less than 0.005) at the end of the stress while there was no change in group III. The fetal heart rate reactivity remained unchanged and only few uterine contractions were recorded. The small changes found in the levels of prostanoids and placental steroids in response to heat stress do not seem to have any deleterious effects on fetal well-being. The slightly increased concentration of placental steroids may rather reflect changes in metabolism than an increase in uteroplacental blood flow.
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The effect of heavy drinking and sauna bathing on cardiac rhythm, blood pressure, and serum electrolyte and cortisol concentrations was studied in 10 healthy male volunteers. Sauna bathing induced a comparable, significant increase in heart rate with and without alcohol consumption. During sauna bathing without alcohol, systolic blood pressure remained at the baseline level, whereas sauna and alcohol together decreased systolic blood pressure markedly from 136 +/- 4 to 113 +/- 3 mmHg (P less than 0.01). Neither sauna alone, nor sauna combined with alcohol intake, increased the frequency of premature ventricular complexes. Serum potassium, calcium and cortisol concentrations changed slightly during sauna, but alcohol consumption did not contribute further to this. In conclusion, sauna bathing, even in combination with heavy drinking, does not appear to provoke cardiac arrhythmias in healthy young men. However, the risk of hypotension is increased when sauna bathing is combined with alcohol consumption.