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Korean J Fam Med > Volume 42(3); 2021 > Article
Imamura: Clinical Implication of Korean Dry Sauna Therapy
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].



No potential conflict of interest relevant to this article was reported.


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.
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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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