Kevin Lutz, MD, FACP
Nov 1 2019

Do you ever remember going skiing up at one of the resorts in the Rocky Mountains and you had a headache all day and didn't sleep well that night? You may have had altitude sickness.

ExerciseMen’s HealthWomen’s Health

Do you ever remember going skiing up at one of the resorts in the Rocky Mountains and you had a headache all day and didn't sleep well that night? How about when your relatives from Florida came to visit and got sick up in Aspen; it probably wasn't a bug. You, and they, may have had altitude sickness. Many people in Colorado experience various stages of altitude sickness every day. You can get it even going from Denver to 10,000 or 11,000 feet above sea level.

At higher altitudes, the pressure of the air around you (barometric pressure) decreases so there is less oxygen in the surrounding air. People can live comfortably at moderately high altitudes, but the body must make some adjustments, and this takes time. If you ascend to altitudes above 8,000 feet, you will be in danger of developing uncomfortable or dangerous symptoms from the change in altitude. The more rapid a climb to high altitude, the more likely that altitude sickness will develop. Altitude sickness is also more likely to develop when ascents are more difficult and take more energy, compared with a slow and easy climb.

What are the symptoms of Altitude Sickness?

Symptoms of mild, short-term altitude sickness include dizziness, fatigue, shortness of breath, loss of appetite, sleep problems and a general loss of energy. Symptoms usually begin within 12 to 24 hours of arriving at a high altitude. Symptoms lessen within a day or two as the person gets used to the altitude.
Symptoms of moderate altitude sickness are more intense and are not relieved by over-the-counter medicines. Fatigue, weakness and shortness of breath worsen instead of improving over time. The affected person may start to show loss of coordination and have difficulty walking, severe headache that is not relieved by medications, nausea and vomiting, and tightness or congestion in the chest. Normal activity is difficult, although the person may still be able to walk on his or her own.
Symptoms of severe altitude sickness include shortness of breath at rest, inability to walk, confusion and fluid buildup in the lungs and/or brain. Other symptoms may include productive cough and a gray, pale or bluish skin tone. Severe altitude sickness is an emergency situation, and the affected person must be taken to a lower altitude immediately.

How can Altitude Sickness be prevented?

As with any illness, prevention is always the best approach. These are things you can do to improve your chances of preventing altitude sickness.

  • Slow ascent to altitude is the key to prevention. Almost anyone can get altitude illness if they go too high, too quickly. Because of the individual differences, a preventive rate of ascent for one person may be too slow or fast for another.
  • An overnight stay at an intermediate altitude such as Denver or preferably a bit higher prior to further ascent into the mountains is helpful.
  • Staying hydrated is important as it supports your body in acclimatizing.
  • Avoid use of alcohol or sleeping agents, since they both suppress breathing and result in lower blood oxygen.
  • Avoid over-exertion for 1-2 days after arrival to altitude.
  • Acetazolamide taken 24 hours prior to arrival to altitude and the first 2 days at altitude is 75% effective in preventing altitude sickness. It speeds up the acclimatization process in the body, stimulates breathing, raises blood oxygen and increases urination.
  • While at a high altitude, eat a diet that includes more than 70% carbohydrates.
  • Know the early signs and symptoms of altitude sickness and take action to prevent it from worsening.

What is the treatment for Altitude Sickness?

The first rule of treatment for mild symptoms of acute mountain sickness is to stop ascending until your symptoms are completely gone. If you have more severe symptoms or any symptoms of high-altitude cerebral edema (fluid in the brain), high-altitude pulmonary edema (fluid in the lungs), or blurred vision, you need to move to a lower altitude as soon as possible, even if it's the middle of the night. If you remain at your current altitude or continue going higher, the symptoms will get worse and the sickness can be fatal. Some highly skilled climbers and hikers may carry a portable oxygen chamber, also called a hyperbaric oxygen chamber, with them as part of their standard high-altitude gear. The "chamber" is a body bag that is pumped full of air. Inflating the bag increases the oxygen concentration allowing the person in the bag with altitude sickness to breathe in more oxygen.

What is the prognosis for a person who gets Altitude Sickness?

The prognosis for mild altitude sickness is excellent as long as common sense is used. Descending, delaying further ascent, rest, and paying attention to the body's symptoms are usually all that is necessary to ensure a complete recovery. High-altitude pulmonary edema has a good outcome if symptoms are recognized and treated early. If descent is impossible or if hyperbaric therapy, supplemental oxygen, and access to medical care are not available, high-altitude pulmonary edema can progress to respiratory failure and death. High-altitude pulmonary edema is the number one cause of death from high altitude sickness. More than half of people with high-altitude cerebral edema who develop coma die. Of those who survive, mental impairment and coordination defects may continue to affect them. High-altitude cerebral edema can be fatal if not recognized and treated quickly.

For more information, please click here.