{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:24:18Z","timestamp":1783009458689,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003547","name":"Bangor University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003547","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The independent effects of different cooling practices, such as cold\u2010water immersion (CWI), on thermal and cardiovascular responses to sauna remain unclear. This study tested the hypothesis that thermal and cardiovascular responses to sauna are attenuated when CWI was included in a cooling break compared to cooling in air only. In a counterbalanced, crossover design, 16 healthy adults (8 females; age 31 (7) years) participated, on separate visits, in two trials involving 2\u00a0\u00d7\u00a015\u00a0min, 85\u00b0C sauna bouts, each followed by a 10\u2010min cooling break in 23\u00b0C air (AIR), or AIR with a 90\u2010s, 20\u00b0C whole\u2010body CWI. At the end of the second sauna bout, core temperature and heart rate were lower in CWI than AIR (\n                    <jats:italic>P<\/jats:italic>\n                    \u2264 0.003, 37.55\u00b0C versus 38.03\u00b0C, \u22120.48\u00b0C [95% CI: \u22120.71, \u22120.25],\n                    <jats:italic>d<\/jats:italic>\n                    \u00a0=\u00a01.28, and 108\u00a0bpm versus 125\u00a0bpm, \u221217\u00a0bpm [95% CI: \u221226, \u22126.6],\n                    <jats:italic>d<\/jats:italic>\n                    \u00a0=\u00a01.05). Skin temperature was also lower in CWI than in AIR (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&lt;\u00a00.001). Systolic blood pressure and mean arterial pressure did not differ between conditions (\n                    <jats:italic>P \u2265<\/jats:italic>\n                    0.090), whilst diastolic blood pressure was lower in AIR than CWI at the end of cooling breaks and 20 min into recovery (\n                    <jats:italic>P<\/jats:italic>\n                    \u2264 0.038). Participants reported feeling less hot and more able to tolerate the second sauna in CWI than in AIR (\n                    <jats:italic>P<\/jats:italic>\n                    \u2264 0.002,\n                    <jats:italic>d<\/jats:italic>\n                    \u00a0=\u00a01.27 and 0.97). In conclusion, CWI substantially attenuated thermal and cardiovascular strain and improved the perceptual responses to sauna compared with air cooling alone, making sauna more tolerable and reducing heat illness risks.\n                  <\/jats:p>","DOI":"10.1113\/ep093626","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:01:50Z","timestamp":1783008110000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thermal and cardiovascular responses to sauna are attenuated by adding cold water immersion to cooling breaks"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9124-0967","authenticated-orcid":false,"given":"Tomos F.","family":"Owen","sequence":"first","affiliation":[{"name":"Institute for Applied Human Physiology School of Psychology and Sport Science College of Medicine and Health Bangor University  Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9030-4629","authenticated-orcid":false,"given":"Callum J.","family":"Giles","sequence":"additional","affiliation":[{"name":"Institute for Applied Human Physiology School of Psychology and Sport Science College of Medicine and Health Bangor University  Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0231-7616","authenticated-orcid":false,"given":"Samuel F.","family":"Leaney","sequence":"additional","affiliation":[{"name":"Institute for Applied Human Physiology School of Psychology and Sport Science College of Medicine and Health Bangor University  Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2667-0013","authenticated-orcid":false,"given":"Geoff B.","family":"Coombs","sequence":"additional","affiliation":[{"name":"Institute for Applied Human Physiology School of Psychology and Sport Science College of Medicine and Health Bangor University  Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9971-9546","authenticated-orcid":false,"given":"Samuel J.","family":"Oliver","sequence":"additional","affiliation":[{"name":"Institute for Applied Human Physiology School of Psychology and Sport Science College of Medicine and Health Bangor University  Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"issue":"6","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.1152\/japplphysiol.00141.2020","article-title":"Heat therapy: Mechanistic underpinnings and applications to cardiovascular health","volume":"130","author":"Brunt V. E.","year":"2021","journal-title":"Journal of Applied Physiology"},{"issue":"1","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S0306-4565(99)00039-X","article-title":"Relative contribution of core and skin temperatures to thermal comfort in humans","volume":"25","author":"Bulcao C. F.","year":"2000","journal-title":"Journal of Thermal Biology"},{"issue":"3","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/jn\/9.3.261","article-title":"Human Calorimetry: II. The average temperature of the tissues of the body: Three figures","volume":"9","author":"Burton A. C.","year":"1935","journal-title":"The Journal of Nutrition"},{"key":"e_1_2_9_5_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J.","year":"1988"},{"issue":"11","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0048190","article-title":"Muscle, skin and core temperature after \u2212110\u00b0C cold air and 8\u00b0C water treatment","volume":"7","author":"Costello J. T.","year":"2012","journal-title":"PLoS ONE"},{"key":"e_1_2_9_7_1","unstructured":"Department of Health. (2009).The General Practice Physical Activity Questionnaire (GPPAQ): A screening tool to assess adult physical activity levels in primary care.Department of Health London [Accessed February 20 2025].https:\/\/www.gov.uk\/government\/publications\/general\u2010practice\u2010physical\u2010activity\u2010questionnaire\u2010gppaq?utm"},{"issue":"5","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/MBP.0000000000000266","article-title":"Validation of the A&D UM\u2010211 device for office blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010","volume":"22","author":"Fania C.","year":"2017","journal-title":"Blood Pressure Monitoring"},{"issue":"5","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"R629","DOI":"10.1152\/ajpregu.00115.2017","article-title":"Effects of heat and cold on health, with special reference to Finnish sauna bathing","volume":"314","author":"Heinonen I.","year":"2018","journal-title":"American Journal of Physiology\u2010Regulatory, Integrative and Comparative Physiology"},{"key":"e_1_2_9_10_1","unstructured":"International Organization for Standardization. (2019).Ergonomics of the physical environment \u2014 Subjective judgement scales for assessing physical environments (ISO Standard No. 10551).https:\/\/www.iso.org\/standard\/67186.html"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP289874"},{"issue":"2","key":"e_1_2_9_12_1","first-page":"55","article-title":"Sauna, shower, and ice water immersion. Physiological responses to brief exposures to heat, cool, and cold. Part I. Body fluid balance","volume":"48","author":"Kauppinen K.","year":"1989","journal-title":"Arctic Medical Research"},{"issue":"2","key":"e_1_2_9_13_1","first-page":"64","article-title":"Sauna, shower, and ice water immersion. Physiological responses to brief exposures to heat, cool, and cold. Part II. Circulation","volume":"48","author":"Kauppinen K.","year":"1989","journal-title":"Arctic Medical Research"},{"issue":"2","key":"e_1_2_9_14_1","first-page":"75","article-title":"Sauna, shower, and ice water immersion. Physiological responses to brief exposures to heat, cool, and cold. Part III. Body temperatures","volume":"48","author":"Kauppinen K.","year":"1989","journal-title":"Arctic Medical Research"},{"issue":"3","key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.3402\/ijch.v65i3.18102","article-title":"Health effects and risks of sauna bathing","volume":"65","author":"Kukkonen\u2010Harjula K.","year":"2006","journal-title":"International Journal of Circumpolar Health"},{"issue":"4","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/HCR.0000000000000876","article-title":"Enhancing cardiorespiratory fitness through sauna bathing: Insights from the Kuopio Ischemic Heart Disease prospective study","volume":"44","author":"Kunutsor S. K.","year":"2024","journal-title":"Journal of Cardiopulmonary Rehabilitation and Prevention"},{"issue":"1","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/23328940.2023.2300623","article-title":"The multifaceted benefits of passive heat therapies for extending the healthspan: A comprehensive review with a focus on Finnish sauna","volume":"11","author":"Laukkanen J. A.","year":"2024","journal-title":"Temperature"},{"issue":"8","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.mayocp.2018.04.008","article-title":"Cardiovascular and other health benefits of sauna bathing: A review of the evidence","volume":"93","author":"Laukkanen J. A.","year":"2018","journal-title":"Mayo Clinic Proceedings"},{"issue":"4","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1001\/jamainternmed.2014.8187","article-title":"Association between sauna bathing and fatal cardiovascular and all\u2010cause mortality events","volume":"175","author":"Laukkanen T.","year":"2015","journal-title":"JAMA Internal Medicine"},{"issue":"6","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1159\/000493392","article-title":"Sauna bathing and risk of psychotic disorders: A prospective cohort study","volume":"27","author":"Laukkanen T.","year":"2018","journal-title":"Medical Principles and Practice"},{"issue":"6","key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1097\/00000542-200612000-00011","article-title":"Estimation of mean dody temperature from mean skin and core temperature","volume":"105","author":"Lenhardt R.","year":"2006","journal-title":"Anesthesiology"},{"issue":"5","key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"R601","DOI":"10.1152\/ajpregu.00315.2021","article-title":"A comparison of medium\u2010term heat acclimation by post\u2010exercise hot water immersion or exercise in the heat: Adaptations, overreaching, and thyroid hormones","volume":"323","author":"McIntyre R. D.","year":"2022","journal-title":"American Journal of Physiology\u2010Regulatory, Integrative and Comparative Physiology"},{"issue":"6","key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1177\/2047487315594506","article-title":"Acute effects of Finnish sauna and cold\u2010water immersion on haemodynamic variables and autonomic nervous system activity in patients with heart failure","volume":"23","author":"Radtke T.","year":"2016","journal-title":"European Journal of Preventive Cardiology"},{"key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1152\/jappl.1964.19.3.531","article-title":"A new weighting system for mean surface temperature of the human body","volume":"19","author":"Ramanathan N. L.","year":"1964","journal-title":"Journal of Applied Physiology"},{"issue":"1","key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1152\/jappl.1975.39.1.93","article-title":"Skinfolds and resting heat loss in cold air and water: Temperature equivalence","volume":"39","author":"Smith R. M.","year":"1975","journal-title":"Journal of Applied Physiology"},{"issue":"7","key":"e_1_2_9_26_1","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1097\/HJH.0000000000002843","article-title":"2021 European Society of Hypertension practice guidelines for office and out\u2010of\u2010office blood pressure measurement","volume":"39","author":"Stergiou G. S.","year":"2021","journal-title":"Journal of Hypertension"},{"issue":"9","key":"e_1_2_9_27_1","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1007\/s40520-017-0855-z","article-title":"Sauna bathing, health, and quality of life among octogenarian men: The Helsinki Businessmen Study","volume":"30","author":"Strandberg T. E.","year":"2018","journal-title":"Aging Clinical and Experimental Research"},{"issue":"11","key":"e_1_2_9_28_1","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1113\/EP086283","article-title":"Cold water immersion: Kill or cure?","volume":"102","author":"Tipton M. J.","year":"2017","journal-title":"Experimental Physiology"}],"container-title":["Experimental Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/EP093626","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/full-xml\/10.1113\/EP093626","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/EP093626","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:02:01Z","timestamp":1783008121000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.1113\/EP093626"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":27,"alternative-id":["10.1113\/EP093626"],"URL":"https:\/\/doi.org\/10.1113\/ep093626","archive":["Portico"],"relation":{},"ISSN":["0958-0670","1469-445X"],"issn-type":[{"value":"0958-0670","type":"print"},{"value":"1469-445X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"assertion":[{"value":"2025-12-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"EP093626"}}