Saunas: the facts, the myths, and the how-to

Sauna use appears to be genuinely beneficial, but not all claims stand up to scrutiny

Peter Attia

Read Time 31 minutes

As far as healthy lifestyle practices go, few are quite so mystifying as that of sauna bathing. There is a long history of heat therapy in cultures all around the world, including Finnish dry saunas, sweat lodges pervasive among native american cultures in North America, and “banya” steam saunas in Russia. Sauna use and its equivalents have been around for thousands of years and are deeply rooted in relaxation and socialization for many cultures. 

Popular media has recently fixated on sauna use and has touted the practice as a “longevity hack,” claiming that saunas provide benefits across the health spectrum, ranging from better cardiovascular health to improved complexion. We’ve examined a few of the purported benefits over the years on the podcast (most recently on AMA #42 and a brief note on the five year anniversary post for The Drive), but given the sheer variety of claims, the topic deserves a deeper, more comprehensive look. Does current evidence support sauna as a panacea for human longevity?

Here, we will take a closer look at the strengths and weaknesses of existing evidence for a wide range of alleged benefits before exploring possible mechanisms behind the effects, and ultimately, the practical considerations and recommended protocols for sauna use.

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  1. I’m curious about the relative efficacy of the IR: I had understood that the temperature was inadequate so had held off on getting an IR. This article seems to imply an IR sauna might be beneficial and now wonder if an IR sauna has benefit? Can someone make recommendation?

  2. I’m researching dry saunas for the home and am a retired Army officer who wants a good deal and a reliable product——I am doing CGM and Levels at your recommendation and find it very Interesting and helpful. Can you provide any suggestions on brands? I know there are some home units that won’t go to the 190-200 degree temp ranges.

    • I bought the Finlandia FPF44

      They are a quality brand. It is self assembly but many of the pieces are pre-assembled, so it’s mostly a question of making sure the alignment is very good. Best to have 2 people to assemble.

      I paid about $4.5k incl. shipping but need to consider electrical installation on top of that. It can get to 190 after 45-50 mins, 200 at a push but steam is more of a factor of how hot it is, so I typically use at 170 – 180 which is plenty.

      I ordered my during peak pandemic and they were back ordered for months but hopefully that’s improved… Enjoy!

  3. Appreciate excellent, balanced review!
    (1) Interesting to note that there is evidence from pre-clinical studies that (non-VO2-max) effects of aerobic exercise may be partially mediated by heat shock proteins (eg, HSP70)
    (2) There appear to be HSP knock-out mouse models, which may be useful for disentangling the mechanism of the specific cardiovascular and other health effects that are (or are not) mediated by HSP.
    (3) I recall seeing some published literature in the past year or two suggesting that sauna bathing may stimulate mitochondrial biogenesis

  4. Peter, one thing I was missing in your excellent review beyond frequency per week was the number of courses per session, i.e. 2 times 15 mins or 3 times 15 minutes with adequate cool-down breaks in between. I usually do three courses and I have realized that they are all feeling slightly different. But I definitely can say that 3 courses feel even better overall than 1 or 2. Have you seen data on this?

  5. I have an infrared sauna and use it 4 to 5 times per week for about 40 minutes per session. It gets anywhere from 120 to 140°.
    I’ve been using it in the mornings, but I’m going to switch now based on this article to the evenings to help improve my sleep. Thank you for the article.

  6. Great article! I enjoyed the details, and the illustrations were a great way to summarize the high level. I’ll be sure to share with my family and friends.

  7. What are your latest view on taking metformin drugs as first defense line on diabetes? Would you take along drugs such as Jardiance too?

    Diet adjusted, sleep adjusted, movement adjusted – what else?

  8. Aloha, I enjoy the little bit of content I get from the doctor, I have ordered some of his books but find that pain for a podcast is a little ludicrous. I am sure he makes plenty of money on his books as well as his products that he recommends.
    Unfortunately for some we cannot afford to pay for Podcasts or for the information that he may provide. Unfortunately that’s the way this doctor has chosen to do it.
    If I was a doctor, and I had the wealth of information that he could share with making people healthier, I would provide it With no cost because that’s what doctors who take an oath do, help people, not just for money, have a great day and thank you for any thing that you put out there with no cost

    • Could not agree more. Tons of docs trying to help for free while selling books as well as charging a fee for ad free podcasts (podcast with ads is free) – eg Mark Hyman. Peter is a smart guy but so are many others out there trying to help everyone – not just those with money.

    • The exceptional amount of time effort and cost that goes into providing such excellent content needs to be compensated for.

      • Agree! Very grateful for the impact that Peter has had on my life. So much more beneficial than most of the medical visits/testing I have paid for. I’m happy to see Peter value his gifts enough to ask for a very fair fee.

    • Vic, I suggest that you should become a doctor, that is, do the study. It is only about 6 years to start with. Also, while working during the day, you could make podcasts at night, using your family for the technical assistance – time for reading scientific papers, researching, comparing and understanding the results. Then there is the purchasing video equipment, organising other experts, plus filming, and the huge amount of time to edit the podcasts. You would only need 4 or 5 family members to help you to provide the information free.

    • Hello sir by that logic doctor should not be taking any salaries either. That’s the real cost of bloated healthcare costs in the US and we spend 30% of GDP on healthcare despite how much people want to villainize big pharma. Let’s be real here.

  9. This was very informative as I have been contemplating purchasing a home steam sauna until I can get a home dry sauna. I now understand much better why I need to do sauna and how. Often we get info on why to do something but not the how recommendation. The time and temperature recommendations toward the end are especially helpful. Thank you.

  10. Given that the purported benefits of sauna mainly come from decrease in CV mortality, I wonder how much excess benefit you get for folks already aggressively maintaining their ApoB <30mg/dL.

  11. Peter can you address the common practice of cold plunge after sauna course and if there is any evidence about the effect of this combination?

  12. I’d like to believe that sauna use has a positive impact on dementia risk, but Finland leads the world in dementia rates. I’m having a hard time reconciling the data points here.

  13. Thank you for a comprehensive overview!

    I would be interested to hear more about where exercising in a heated room falls on the spectrum of benefits, Bikram yoga in particular. Aside from the risk of dehydration, where does it fall on the benefit-risk spectrum for a reasonably well-trained, healthy individual? It was recommended to me to help with recurring niggles resulting from triathlon training.

  14. I am curious what HUMIDITY LEVEL is maintained in a 120 degree wet sauna? I am trying to find good information on that…

    I keep my sauna at 23% humidity, 170 degrees…and we stay in for 15 min, then cold plunge for 5 min, then back in for 20 min.

    This ritual has helped me obtain great DEEP SLEEP at night.

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