Effects of warm water immersion on blood pressure, heart rate and heart rate variability in CFS

Messages
1,549
Likes
7,908
S Afr J Physiother. 2018; 74(1): 442.
Published online 2018 Aug 28. doi: 10.4102/sajp.v74i1.442
PMCID: PMC6131699
PMID: 30214947
The effects of warm water immersion on blood pressure, heart rate and heart rate variability in people with chronic fatigue syndrome
Romy Parker,
1,2 Zeenath Higgins,2 Zandiswa N.P. Mlombile,2 Michaela J. Mohr,2 and Tarryn L. Wagner2
Author information ► Article notes ► Copyright and License information ► Disclaimer
Go to:
Abstract
Go to:
Background
Chronic fatigue syndrome (CFS) is a central sensitisation syndrome with abnormalities in autonomic regulation of blood pressure (BP), heart rate (HR) and heart rate variability (HRV). Prior to exploring the effects of hydrotherapy as a treatment for this population, changes in BP, HR and HRV during warm water immersion need to be established.

Go to:
Objectives
The study aimed to determine the effects of warm water immersion on BP, HR and HRV in adults with CFS compared to matched-pair healthy adults.

Go to:
Method
A quasi-experimental, single-blinded study design was used with nine CFS participants and nine matched controls. Participants’ BP, HR and HRV were measured before, after 5 minutes and post warm water immersion at the depth of the fourth intercostal space, using the Ithlete® System and Dräger BP monitor.

Go to:
Results
There was a significant difference between groups in HRV prior to immersion (control group: 73 [55–74] vs. chronic fatigue syndrome group: 63 [50–70]; p = 0.04). There was no difference in HRV post-immersion. A significant difference in HR after immersion was recorded with the control group having a lower HR than those with CFS (78 [60–86] vs. 86 [65–112]; p = 0.03). The low HRV present in the CFS group prior to immersion suggests autonomic dysregulation. Individuals with CFS may have reduced vagal nerve activation post-immersion. During immersion, HRV of the CFS participants improved similar to that of the healthy controls.

Go to:
Conclusion
Prior to immersion, differences were present in the HRV of the participants with CFS compared to healthy controls. These differences were no longer present post-immersion.

Go to:
Clinical implications
Warm water immersion appears safe and may be beneficial in the management of individuals with CFS.
 

Moof

Senior Member
Messages
778
Likes
2,207
Location
UK
I'm hugely better after immersion in anything but very hot (which makes me exhausted) or very cold (which crashes my blood pressure and makes me pass out) water. It's not a long-lasting effect, but I feel like a normal human being for a few hours. It's the reason I try and keep up my visits to the swimming pool as much as possible – I've really missed it the last couple of months whilst I've been really tired from moving house. If I could trust myself to just go and lounge in the water, I'd have carried on going...but I know what'll happen! I'd just have to swim, thus risking a flare-up. :rolleyes:
 

Wonkmonk

Senior Member
Messages
915
Likes
1,293
Location
Germany
Interesting. The article says the water had body temperature (35-37°C). I am wondering if hyperthermia, e.g. sauna, or warm water above 40°C could be beneficial (or might be deleterious), because it is known to lead to reactivation of herpes virus.

In fact, in animal trials, if scientists want to reactivate herpes virus in mice, on way to do so is immersion in hot water (above 43°C) for a prolonged period. It reliably reactivates herpes virus, presumable because the virus "thinks" the body is feverish and sick/weakened and it can try to multiply and overwhelm the immune system and cause viremia and viral shedding in saliva so as to infect other people.

But of course, if you are in the sauna or immersed in hot water, you are not sick and your immune system is not weakened, so in theory you should be able to beat back the virus and destroy some of the host cells.

This is not what has been done in the article above, of course, but I just wanted to mention it, because I want to try what effects a short sauna might have.

I also feel clearly that I get worse in summer when temperatures in my bedroom are above 25°C over a long period of time (esp. at night). Temperature definitely matters, one way or the other.
 

Wolfcub

Senior Member
Messages
7,089
Likes
18,009
Location
SW UK
Immersion in warm water makes me so much worse.

We had a few heatwaves here from April onwards, and plenty of sunshine, and I seemed to be fine in it. I felt too hot at times -sure, but the sunshine didn't generally make me feel more ill. Or the UV light. or the actual heat.
But over two years ago when I first came down with symptoms, I went through a period when being in a warm bath even for a very short time (just to get clean), or showering in warm water would mysteriously make me feel more unwell.
Then that seemed to fade out, with just a few rarer occasions when it would happen.

But recently I have noticed it's happening again, worse. It seems every time warm water gets on my skin for more than a couple of minutes, I feel weak, sick, nauseous, get eye/right side of head twinges, heart palpitations, muscle tics, lose appetite, feel inner tremor, feel like crying. It even seems to affect my legs, and makes them feel so strange and weak.

Even worse than the bath (and I always have to make sure the temperature is not too warm) -is washing dishes at the kitchen sink, or doing anything at the kitchen sink involving warm water. Just having my hands in warm water -not even my whole body.

I do feel a little improvement if I have a bowl on the side to put my hands in really cold water. But the improvement doesn't last as soon as I have to go back to the warm water to finish the dishes.

This is so strange.

Tonight I put on two fan heaters in my room, to test if it's actual heat that disturbs me or what. I got "too hot" for sure, but no symptom increase.

So it's possibly not so much the ambient temperature which is causing this, but direct contact with warm water.

I am fine with hot drinks, hot (cooked temperature) food, soups, stews etc.

Does anyone else get anything similar? Heat intolerance related to warm water rather than sunshine?
 
Messages
6,504
Likes
15,196
Location
South east England
So it's possibly not so much the ambient temperature which is causing this, but direct contact with warm water.
It causes blood vessels to expand. Which is one of the changes that happens during migraine attack. But it's a bit hard to say for sure if the blood vessel expansion is the cause of a migraine or the effect of one.
 

Wolfcub

Senior Member
Messages
7,089
Likes
18,009
Location
SW UK
It causes blood vessels to expand. Which is one of the changes that happens during migraine attack. But it's a bit hard to say for sure if the blood vessel expansion is the cause of a migraine or the effect of one.
Yes I was also considering that same thing.
But why wouldn't a heatwave or bright sunshine bring that on? Or a warm room temperature? So odd :confused:
 
Messages
6,504
Likes
15,196
Location
South east England
One other thing worth a mention..... it's possible there is low level inflammation of the Hypothalamus in me/cfs. And that there are abnormalities of Hypothalamus in migraine. As this is the part of the brain that (among other things) regulates body temperature it seems possible to me that when there is a sudden temperature change in one part of the body the hypothalumus has to work extra hard to correct things.
 

Wolfcub

Senior Member
Messages
7,089
Likes
18,009
Location
SW UK
One other thing worth a mention..... it's possible there is low level inflammation of the Hypothalamus in me/cfs. And that there are abnormalities of Hypothalamus in migraine. As this is the part of the brain that (among other things) regulates body temperature it seems possible to me that when there is a sudden temperature change in one part of the body the hypothalumus has to work extra hard to correct things.
That makes a lot of sense, @andyguitar Thank you.
 
Messages
6,504
Likes
15,196
Location
South east England
Is it something specific about it being in water or just the temperature in general?
Being in water is the only thing that could lead to almost the entire surface of the body being exposed to a steady temperature. So maybe that lessens the activity of the Hypothalamus. I've got an idea about all this now. So will start a new thread.
 

Abrin

Senior Member
Messages
329
Likes
1,046
Being in water is the only thing that could lead to almost the entire surface of the body being exposed to a steady temperature. So maybe that lessens the activity of the Hypothalamus. I've got an idea about all this now. So will start a new thread.
So you don't think something similar to be achieved with a sauana?
 

hunter1899

Senior Member
Messages
152
Likes
123
This is an interesting question for sure! Is it something specific about it being in water or just the temperature in general?
I tried a sauna for 25 minutes and it knocked me on my ass for 5 days with PEM. But a like warm bath helps me big time.

so what’s the next step using what we know from this study?
 

Abrin

Senior Member
Messages
329
Likes
1,046
I tried a sauna for 25 minutes and it knocked me on my ass for 5 days with PEM. But a like warm bath helps me big time.
How warm was the sauna? I have a diy sauna that isn't well insulated so it doesn't get much hotter than the temperatures mentioned in the paper above.