Altitude Sickness

Learn more about Altitude Sickness (Acute Mountain Sickness):
Signs, Symptoms, Causes, Prevention and Treatment

What is Altitude Sickness (Acute Mountain Sickness)?

Air pressure at higher elevations is lower than at sea level, and at high altitudes oxygen molecules exist in lower concentrations. The higher in elevation you go, the lower the oxygen ratio is, and the “thinner” the air is. Elevations of 4,900 feet (about 1,500 meters) and above contain a lower percentage of oxygen in the atmosphere.

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If you’re not accustomed to increased altitude and travel to a higher elevation, your body needs time to adjust to the reduced oxygen levels. You may experience symptoms of altitude sickness (also known as “acute mountain sickness” or “altitude illness”) if you’ve ascended to high elevation faster than your body can acclimate. Symptoms can occur anywhere above 4,900 feet – and are felt by the majority of people visiting high altitude.

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What are the Signs and Symptoms of
Altitude Sickness?

Mild- to moderate- instances of altitude sickness are very common among travelers to higher elevations: at 4,900 feet (1,500 meters) and above, 75% of people will experience at least mild altitude sickness. Altitude sickness has a wide range of potential symptoms and has often been described as feeling like a hangover or the onset of the flu. Symptoms can appear as early as two hours after arrival and can include:

75%

of people will experience at least mild altitude sickness

headache
shortness of breath
fatigue / weakness
loss of appetite
nausea / vomiting

dizziness / lightheadedness
insomnia
swelling of extremities
diarrhea

A small percentage of people may experience more severe forms of altitude sickness called high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE). Symptoms of these severe forms of altitude sickness can include:

extreme difficulty in breathing, even while at rest
hearing a sound like a crumpling paper bag when you breathe
persistent cough
difficulty walking/exercising

loss of coordination
mental confusion or slowness
severe fatigue
having blue or gray lips or fingernails

If you or anyone in your party experience these symptoms, seek medical attention immediately.

How do you Prevent Altitude Sickness?

Though extremely common, it’s impossible to predict how altitude sickness will affect you. Your fitness level, age and sex have nothing to do with whether you’ll be more or less susceptible, and your best indicator might be whether you’ve experienced it on previous high elevation trips. However, there are some behaviors that may set the stage for the onset of symptoms, and avoiding them might ease your transition to high altitude.

Ascending too rapidly: your body doesn’t have time to acclimate to your high-altitude destination. Solution: ascend more slowly, if time allows, giving your body a chance to adjust to higher elevations.

Overexerting yourself within 24 hours of arrival at your high-altitude destination. Solution: instead of hitting the slopes immediately, begin your stay with a day of mild activity.

Dehydration: too much coffee and/or not enough water on your flight. Solution: make a point to cut back on caffeine and drink a lot of water, both en route and in the few days leading up to your visit.

Consuming alcohol or sedatives. Solution: though a glass of wine by the fire after a day of skiing may be enticing, opt for an non-alcoholic beverage until you’ve acclimated.

Take steps before and while traveling to help avoid symptoms of altitude sickness.

Hydrate beforehand.

Ascend slowly: spend a night at mid-altitude before arriving at your high-altitude destination.

Before traveling check with a medical professional about preventative medication.

What is the Treatment for Altitude Sickness?

If you find yourself experiencing symptoms of altitude sickness the best treatment is to descend to a lower altitude; don’t travel to a higher elevation until your symptoms subside. Some people find sleeping at a lower elevation than where the day was spent to be helpful. Other treatments include rest and drinking plenty of water. Avoid alcohol and sedatives, and keep exercise mild and to a minimum. Acetaminophen may help an altitude-related headache.

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Pharmaceutical and Prescription Treatments

There are also pharmaceutical options that a healthcare provider may be able to prescribe. Acetazolamide (also known as Diamox) is popularly used to prevent and treat altitude sickness. It helps speed acclimatization and may be taken before ascent as a preventative measure, or taken after symptoms develop to help your recovery. Acetazolamide is best for short exposures to elevation, as it can work less well over time.

Acetazolamide has several side effects, including more frequent urination, especially during the first few days while your body adjusts. Other common side effects include dizziness, lightheadedness, vibrating sensations in hands, feet, and lips, blurred vision, dry mouth, drowsiness, altered taste, and ringing in the ears. These should subside after the medication is stopped.

Another pharmaceutical option is dexamethasone, a steroid that treats the symptoms of altitude sickness. It doesn’t help you acclimate to altitude (as acetazolamide does) and is not generally used as a preventative measure.

Side effects of dexamethasone include trouble sleeping, increased appetite, and increased blood sugar (in diabetics). Some people experience euphoria. Before traveling to higher elevations, anyone taking dexamethasone should be sure the medication has worn off and they are acclimated to their current altitude.

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Oxygen Therapy Treatment

The use of supplemental oxygen therapy will also quickly relieve symptoms of altitude sickness, especially headaches. It’s important to consume oxygen for the appropriate length of time to completely resolve and avoid continued symptoms. Sources of supplemental oxygen may be hard to locate depending on your location and may be reserved for the most severe occurrences of altitude sickness. However, suppliers are beginning to rent oxygen concentrators to vacationers visiting high altitude destinations such as ski resorts.

Supplemental oxygen therapy typically comes from medical grade portable oxygen tanks or oxygen concentrators. Medical grade portable oxygen tanks have limitations that oxygen concentrators don’t. Because they contain a finite amount of oxygen, medical grade portable oxygen tanks can’t be used for long periods of time, and they’re expensive to constantly refill. They’re extremely flammable, and cumbersome to move around. They also don’t provide humidified air, which can result in bloody noses for users.

Oxygen concentrators intake room air and concentrate the oxygen within to near medical levels. Because of the unending air supply they can be left on 24 hours a day, 7 days a week (it’s recommended to always follow manufacturer guidelines). Typically oxygen concentrators come in 5 or 10 liters per minute (lpm) models. The 5 lpm machines can power a single nasal canula, while the 10 lpm machines can power a single non-rebreather mask or 2 nasal canulas via a Y-splitter, allowing two people to use it at the same time. Most oxygen concentrators come with bubble humidifiers which prevent dryness and bloody noses. There are no adverse side effects from the use of supplemental oxygen from an oxygen concentrator.

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