To the editor
I would like to congratulate Choi et al. [
1] for their successful study on Korean dry sauna therapy where the health-related quality of life of obese people had improved without any adverse events. The therapy included 15 minutes of dry sauna at 90°C, twice daily for 4 consecutive days. Given our experience of Japanese dry sauna therapy in patients with advanced heart failure [
2], I have several concerns regarding their protocol and future perspectives.
In our Japanese prospective randomized control trial [
2], we performed Waon therapy with 15 minutes of dry sauna at 60°C, once daily for 10 days. While the frequency of twice daily might be more effective than once daily, it might reduce the participants’ adherence. An explanation of the implications of a twice-daily protocol would be helpful. The sauna temperatures were also different between the two studies (90°C versus 60°C) [
1,
2]. It would be interesting to compare the outcomes stratified by temperature settings.
The therapeutic effects on the hemodynamics and autonomic nervous systems would be evident immediately [
3], but it might be weeks or months until the metabolic benefits can be enjoyed. Long durations of dry sauna therapy may be required to assess its implications for obesity-related metabolic diseases.
Finally, as the authors stated in the limitations section [
1], objective parameters might be useful for quantifying the impact of dry sauna therapy on the quality of life, including blood catecholamine levels and heart rate variability [
3].
Notes
REFERENCES
- 1. Choi HS, Kwon H, Cho KH, Thuc LC, Park SY, Kim NH, et al. Repeated dry sauna therapy improves quality of life in obese Korean people. Korean J Fam Med 2020;41:312-7.
- 2. Tei C, Imamura T, Kinugawa K, Inoue T, Masuyama T, Inoue H, et al. Waon therapy for managing chronic heart failure: results from a multicenter prospective randomized WAONCHF study. Circ J 2016;80:827-34.
- 3. Imamura T, Kinugawa K, Nitta D, Komuro I. Real-time assessment of autonomic nerve activity during adaptive servo-ventilation support or Waon therapy. Int Heart J 2016;57:511-4.
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