The advice Jacqueline Garguilo offers new students in her hot yoga classes might sound, well, a bit chilling.

“We tell people that for your first hot class, the No. 1 goal is just to stay in the room,” says Garguilo, who along with her husband, Frank, owns Long Beach Yoga, a hot yoga studio in the seaside New York suburb.

That begs the question: Just how hot is this class?

At Long Beach Yoga, the temperature in the practice room rests at 105 F, the standard, recommended setting for a form of yoga that an estimated 13.8 million people practice—about 36 percent of the total population of yoga practitioners in the United States, according to a study by yoga accessories marketer Asivana.

Evidenced by the sold-out classes at Garguilo's studio, hot yoga, introduced to many as Bikram yoga in the 1990s, clearly is popular—but is it right for you? If you're managing a neurologic condition, the answer is maybe not.

Benefits and Cautions

Kara A. Stavros, MD, FAAN, associate professor of neurology at the Warren Alpert Medical School of Brown University, can speak to what attracts people to hot yoga. She's a longtime practitioner as well as a certified hot yoga instructor.

“I really enjoy the ability to get into the poses in a deeper way,” she says. “And I find I'm able to really focus my mind in that setting.”

That's consistent with the feedback Garguilo gets from students at her classes—and what she and her husband, both of whom formerly worked in law enforcement, personally experienced when they first tried hot yoga as a way to destress.

Yoga in general can benefit your balance, flexibility, posture, and strength and can help improve sleep, says neurologist Roople Unia, MD, of MaineHealth-Neurology Brunswick. A 2019 report in the journal Brain Plasticity found that yoga can positively impact physical and brain health in many ways. An analysis of randomized controlled trials found positive associations between yoga practice and diabetes, cardiovascular function, and musculoskeletal conditions. Researchers found considerable evidence for beneficial effects on mental health, too, including reduced anxiety, stress, and depression.

Investigations into the benefits of non-hot yoga for people with neurologic conditions also have turned up encouraging results. A 2023 study in Neurology looked at the benefits for people with epilepsy and found that in addition to reducing seizure frequency and anxiety, regular yoga may help reduce feelings of stigma about the disease. That is not an insignificant finding, says lead researcher Manjari Tripathi, MD.

“People with epilepsy often face stigma that can cause them to feel different than others due to their own health condition, and that can have a significant impact on their quality of life,” says Dr. Tripathi, a board-certified neurologist at the All India Institute of Medical Sciences in New Delhi. “This stigma can affect a person's life in many ways, including treatment, emergency department visits, and poor mental health. Our study showed that doing yoga can alleviate the burden of epilepsy and improve the overall quality of life by reducing this perceived stigma.”

As for the benefits of hot yoga specifically, studies from Colorado State University in 2014 found that practitioners of hot yoga showed significant gains in spine, hamstring, and shoulder flexibility and improved whole body strength. But the benefits of hot yoga depend on the individual and their specific health conditions, Dr. Stavros notes.

“There are a lot of things to consider,” she says. “For example, for certain neurological conditions that affect your balance, you want to take extra caution.”

Experts recommend that patients with neurologic conditions check with their physician before trying any type of yoga. Hot yoga in particular is inadvisable for many neurologic conditions, says Darshan Mehta, MD, MPH, medical director for the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital. The heated classes might not be safe for people who take medication that can impair their thermal regulation, for example. Since heat also can worsen symptoms of multiple sclerosis, Dr. Mehta says, people with that condition might want to avoid hot yoga. Those with autonomic dysfunction or myasthenia gravis may want to do the same, Dr. Stavros adds.

Turn Up the Heat

Hot yoga classes generally follow a prescribed structure: over 90 minutes, participants move through a series of 26 asanas (poses), each held for about 60 seconds.

“For 90 minutes, there's nothing else you can focus on,” Garguilo says. “When you do this, you're not worried about your homework, your finances, your career, your divorce. It's about nothing except standing and staring in front of the mirror and holding true to the poses for the entire 60 seconds.”

While that may not be possible for some, Dr. Stavros points out that many types of yoga exist. “Some put a greater emphasis on the movement, some on mindfulness and breath work,” she says. “Patients might find that there are particular types of practice that fit their needs.”

For example, older people and those with physical limitations widely practice chair yoga, which mimics the standing poses from a seated position. Most yoga studios also offer less-intense, gentle, yin or restorative-type classes, like Garguilo recently introduced (in slightly lower temperatures).

While hot yoga might not be a fit for you, there's no doubt that people seem to enjoy it—and Garguilo says there's a reason it has become so popular.

“I can tell you multiple stories of people who've done these classes and they are seeing a reduction in their anxiety, lower blood pressure, people losing their beer gut, [and] people whose balance has improved exponentially,” she says.

And if beginners feel overwhelmed by the heat of the room? Garguilo has a go-to tip: “I tell them, ‘Just pretend you're in a sauna.’”

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Follow these tips to safely get started with your hot yoga journey.