Sauna for asthma
Evidence review
Overview
A German study of children with asthma monitored peak flow during Finnish dry sauna bathing and observed no complications except one asthma attack in a child using a cold shower afterwards, attributed to cold air. A Russian health-resort series of 107 patients with asthma or chronic bronchitis reported faster symptom regression and a bronchodilator effect when sauna was added to multimodal treatment, without a control group. Laboratory studies in asthmatic adults show that cooling the body with a cold shower and wind triggers bronchoconstriction, which is relevant to the cooling phase after a sauna.
Key findings
- Children with asthma: no complications during sauna except one attack while using a cold shower afterwards; peak-flow figures not reported in abstract (Preisler 1990)
- Multimodal health-resort treatment including sauna: bronchodilator effect and faster symptom regression reported, no figures (Kholopov 1985, n=107, asthma or chronic bronchitis)
- Cold shower at 59 F plus wind lowered FEV1 to 79% of baseline in asthmatic adults; a 98.6 F shower did not (Chen 1978, PMID 653323, cold-modality entry)
Every study we reviewed
1 mixed results · 1 found benefit
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 5 studies on asthma, across all heat and cold therapies, including case reports and older work not graded here.
[The effect of the Finnish dry sauna on bronchial asthma in childhood].
Preisler B et al. Pneumologie. 1990. PubMed 2281065
- Who
- children with bronchial asthma
- What
- Finnish dry sauna bathing with peak-flow monitoring
- Measured
- peak expiratory flow, complications
- Result
- No complications apart from one 12-year-old girl who had an asthma attack while using a cold shower after the sauna, attributed to breathing cold air; peak-flow results not quantified in abstract. Authors considered sauna suitable for children with asthma.
- Limitations
- uncontrolled; sample size and peak-flow data not given in abstract; claimed benefits (infection resistance, psychosocial) not measured
[Use of the sauna in the complex health resort treatment of patients with nonspecific bronchopulmonary diseases].
Kholopov AP et al. Ter Arkh. 1985. PubMed 2934844
- Who
- health-resort patients with asthma or chronic bronchitis
- What
- therapeutic sauna hyperthermia as one part of multimodal health-resort treatment
- Measured
- clinical symptoms, adaptation period, bronchial patency, cardiodynamics
- Result
- Authors report faster regression of clinical symptoms, a shorter adaptation period at the resort, a bronchodilator effect and normalization of cardiodynamics; no figures given in abstract.
- Limitations
- no control group described in abstract; sauna was one component of multimodal treatment; asthma and chronic bronchitis not reported separately; no numbers in abstract
Protocols used in the studies
Neither abstract reports sauna temperature, session length or frequency. The pediatric study used a Finnish dry sauna; the Russian series used sauna within multimodal health-resort treatment.
What is still unknown
Controlled trials with exacerbation, symptom-control and lung-function outcomes; safe cooling practice after sauna; effect in exercise-induced or cold-induced asthma phenotypes.
Safety
Cautions for sauna in this condition
- Cooling after the sauna is the documented trigger: a child had an asthma attack while using a cold shower after sauna (PMID 2281065), and a 1-minute 59 F shower plus wind caused bronchoconstriction in asthmatic adults (PMID 653323), reduced by breathing warm humid air (PMID 421517).
- Avoid sauna during an acute exacerbation or respiratory infection; sympathomimetic (beta-agonist) drugs may provoke tachycardia and arrhythmias in the sauna (review, PMID 3218895).
- See general-safety.
For clinicians
Suggested rationale
Evidence for sauna in asthma is limited to small uncontrolled studies (Preisler 1990; Kholopov 1985) reporting good tolerance and a bronchodilator effect; no controlled trial shows clinical benefit, and cold showers or cold air after the sauna can trigger bronchoconstriction.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: J45.909, J45.20. Examples only; the clinician assigns the code.
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