Dr Ula: Sauna, the cardiovascular session that doesn’t require exercise
- Apr 17
- 4 min read
Sauna feels indulgent. I know. When I tell a member I’m adding regular sauna sessions to their plan, there’s sometimes a pause — like I’ve just recommended a spa day.
But here’s what most people don’t realise: a sauna session isn’t a reward at the end of a hard week. It’s a meaningful cardiovascular and thermal stressor that mimics a moderate exercise session. Your heart rate rises. Your blood vessels dilate. Your cardiac output increases. At a cellular level, heat exposure triggers stress-response pathways, including heat shock proteins, which help protect your cells during periods of physiological stress.
That’s not pampering. That’s a physiological intervention.
And it’s particularly useful if you’re limited with exercise right now, whether that’s an injury, joint inflammation, or simply a body that isn’t recovering the way it used to.
The Finnish research that shifted the conversation
One of the most cited studies in this space followed more than 2,000 men in Finland over roughly 20 years.
It found a clear pattern: the more frequently men used a sauna, the lower their risk of cardiovascular and overall mortality.
Using a sauna 2–3 times per week was associated with about a 20–25% lower risk of death
Using it 4–7 times per week was associated with around a 40% lower risk
This was observational data, so it shows association rather than causation, but it’s one of the studies that moved sauna from a lifestyle extra into something worth taking seriously.
What's driving this
Repeated heat exposure appears to influence your vascular function, that’s how well your blood vessels respond and adapt. Studies suggest sauna use may support endothelial function, blood pressure regulation, and arterial flexibility in some populations. Nitric oxide is one of the proposed mechanisms, although the full picture is still being worked out.
Beyond your cardiovascular system, there’s developing evidence around metabolic effects. Passive heat exposure is being studied for its influence on glucose regulation and metabolic function. Some studies show benefit; others are more neutral. I don’t use sauna as a stand-alone metabolic tool, I use it as part of a broader plan, alongside your sleep, training, nutrition, and body composition.
Regular sauna use has also been associated with lower rates of depression, improved mood, and better sleep, particularly when used earlier in the evening. There’s some evidence suggesting reductions in joint pain and stiffness, especially in inflammatory conditions. These aren’t the primary reason I prescribe it, but they’re often part of your overall response.
Why your context changes everything
This is where it gets interesting, and where most generic sauna advice falls short. Sauna is a useful tool, but how you respond depends on what your body is already carrying.
We call this your allostatic load, the total physiological strain on your system. If that load is low, sauna tends to be adaptive. It builds resilience. If that load is already high - if you’re living too fast, stressed, not eating or sleeping well and running on fumes — the same session can become another demand on a system that’s already stretched too thin.
That’s why two people can do the same 20-minute session and have completely different experiences. It’s not about whether sauna is “good.” It’s about what role it plays for you, right now.
There’s also emerging evidence that the recovery phase after sauna — the cool-down — may influence your autonomic balance, including heart rate variability. If you feel like your system has been running “on” for too long, that recovery window matters. I wouldn’t call sauna a treatment for stress, but it can support the conditions your body needs to shift out of that mode. Our patients frequently report feeling very relaxed and refreshed after sauna sessions, sleeping better that night and noticing improved mood. Having scheduled recovery sessions like this each week can cumulatively make a big difference to over-all health.
What we do differently
That’s why I prescribe sauna in context, not as a trend or a default, but as part of a personalised plan.
If you’re using sauna as a health tool, how you apply it matters. For most of our members, that looks:
Sauna
80–90°C
15–20 minutes
2–4×/week (up to 4–7 if well tolerated)
Cold (optional)
10–15°C
1–3 minutes
2–3×/week
More extreme cold like ice baths isn’t always better. Many people, particularly women, respond well to moderate exposure.
The benefit isn’t in pushing extremes, it’s in applying the right level of stress for the system you’re working with.
We do not recommend sauna in the following situations:
Pregnancy
Men trying to conceive
Uncontrolled hypertension or cardiovascular disease
History of syncope or heat intolerance
Acute illness or dehydration
The conversation that changes the approach
If you’ve been doing the right things but not getting the response you’d expect, or if you want to understand whether what you’re doing is actually working at a biological level, that’s exactly the conversation we have in a Discovery Consultation.
Dr. Ula
Co-Founder and Lead Physician, Autonomy
Book a Discovery Consultation today!
Our Discovery Consultation is a one hour session with our clinical team. It is an opportunity to understand where you are, what your body may be signalling, and whether further investigation is appropriate.
