Resilience You Can Measure
When we speak of resilience in this article, we mean something specific and demonstrable: less chronic stress, better sleep, more movement and habits you take home with you. That is what a spa stay can do, and the studies below show how well.
What "Resilience" Means and What Actually Influences It
The immune system has two branches: innate (skin, mucous membranes, NK cells, phagocytes) and adaptive (T and B lymphocytes, antibodies). Both work best when a person sleeps enough, moves regularly, is not under long-term stress and has no significant nutritional deficiencies. None of these conditions is "spa-specific"; a spa stay, however, is an environment where all of them can be met at once and under supervision.
Chronic stress and lack of sleep are well documented to impair the immune response. This is an established fact of general medicine, not a specific discovery of balneology. It also yields the realistic goal of a stay: to reduce stress and improve sleep.
What the Studies Say about a Spa Stay
Stress and Sleep
A meta-analysis of 17 studies with 765 participants found that cortisol levels fall in the short term after balneotherapy in healthy people with a high degree of stress; the pooled difference between treated and control groups, however, did not reach statistical significance (Antonelli et al., 2024, Int J Biometeorol). Questionnaire-based studies are more practical: in 362 "sub-healthy" adults in China, five months of regular bathing led to fewer sleep disturbances and less psychological stress than in the control group (Yang et al., 2018, Int J Biometeorol). In a Lithuanian randomised trial with 373 people with high stress, spa programmes of just 6–11 days improved fatigue, sleep and quality of life, and the effect persisted for 6 months; balneotherapy worked better than time in nature alone (Rapolienė et al., 2025, Int J Biometeorol).
One thing needs saying clearly: a spa stay does not replace psychotherapy or psychiatric care. If you suffer from long-term anxiety, depression or burnout, a spa stay is a complement to the treatment led by a psychologist or psychiatrist, not an alternative to it.
The Forest
In Mariánské Lázně (Marienbad), the forest is within reach of every hotel. A meta-analysis of eight studies found lower salivary cortisol after time in the forest than in the city; the authors add that this is a short-term effect and that expectation may play a role (Antonelli et al., 2019, Int J Biometeorol). A meta-analysis of 20 studies described a short-term reduction in anxiety (Kotera et al., 2020, Int J Ment Health Addict). The forest is therefore a reliable and measurable tool against stress, reachable on foot from every spa hotel.
Sauna and Cold Exposure
A Finnish cohort of 1,935 men followed for 25 years found a 27% lower risk of respiratory disease in those who used the sauna 2–3 times a week, and 41% lower with four or more sessions a week (Kunutsor et al., 2017, Eur J Epidemiol). This is a long-term observation, not an experiment. A Dutch randomised trial with 3,018 participants then showed that 30 days of cold showers reduced the number of days of sick leave by 29% (Buijze et al., 2016, PLoS ONE). Sauna and cold exposure therefore belong to the spa regimen as a documented means against stress and for everyday resilience.
Habits That Last
The strongest preventive effect of a spa may be the least spectacular one: learning to move. In a French randomised trial with 228 spa patients, 81% of those who received coaching and an app at the spa were meeting physical activity recommendations after one year, compared with 67% in the control group (Fillol et al., 2021, J Med Internet Res). A cross-sectional study of 3,341 Japanese civil servants found better quality of life and sleep among more frequent spa visitors; causality, however, cannot be read from it (Sekine et al., 2006, Complement Ther Med).
What a Preventive Stay Might Look Like
The following programme is an example; the specific plan is drawn up by the spa physician at the initial examination according to your condition.
- Drinking cure — if the physician recommends it, 2–3 times a day at the spring
- Terrain cure — 45–90 minutes of walking daily through the spa park and forest
- Carbonic bath — every other day, 20 minutes
- Sauna — 1–2 times a week, as tolerated
- Sleep — a regular routine, 7–8 hours in a quiet environment
When to come? There is no better or worse season for a preventive stay; September and October tend to be the quietest, January and February the cheapest. A preventive stay is not covered by health insurance; you come as a self-paying guest.
When a Stay Is Not Suitable
Acute infection, fever and the period of convalescence after an infectious illness are among the general contraindications to spa care; baths and sauna during an ongoing infection do harm. If you are being treated for a chronic condition, consult your doctor before booking.
Summary
A spa stay in Mariánské Lázně can reduce stress, improve sleep, get the body moving and help with habits that last at home. These are documented things, and for long-term health they mean the most.
More about the springs and planning your stay.
