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Altitude Sickness
The following article is reprinted from Kaiser Permanente Web Site

Altitude sickness

Altitude sickness occurs when people go to a higher altitude too quickly and do not get enough oxygen in the air they breathe. Common symptoms include having a headache and not feeling like eating.

Altitude sickness most often occurs at altitudes above 8000ft(2438m). In mild cases, the symptoms can be treated with over-the-counter medicine, but the best way to treat altitude sickness is to go to a lower altitude quickly.

Altitude sickness can be deadly. People with symptoms should not go to a higher altitude until the symptoms are gone. Symptoms of confusion, feeling faint, or not being able to walk in a straight line mean the condition is life-threatening.

Topic Overview

What is altitude sickness?

Altitude sickness occurs when you cannot get enough oxygen from the air at high altitudes. This causes symptoms such as a headache and not feeling like eating. It happens most often when people who are not used to high altitudes go quickly from lower altitudes to 8000ft(2438m) or higher. For example, you may get a headache when you drive over a high mountain pass, hike to a high altitude, or arrive at a mountain resort.

Mild altitude sickness is common. In the United States, more than 20% of people visiting the western mountains have it.1 Experts do not know who will get it and who will not. Your age, sex, and how physically fit you are play no role in whether you get altitude sickness.

Altitude sickness can be dangerous. It is smart to take special care if you go high-altitude hiking or camping (like in the Rockies) or have plans for a vacation or trek in high-altitude countries like Peru, Ecuador, or Nepal.

Altitude sickness is also called acute mountain sickness.

What causes altitude sickness?

Air is "thinner" at high altitudes. When you go too high too fast, your body cannot get as much oxygen as it needs. This causes the headache and other symptoms of altitude sickness. As your body gets used to the altitude, the symptoms go away.

What are the symptoms?

The symptoms of altitude sickness include:

  • Having a headache. The headache is usually throbbing. It gets worse during the night and when you wake up.
  • Not feeling like eating.
  • Feeling sick to your stomach. You may vomit.
  • Feeling weak and lazy. In severe cases, you do not have the energy to eat, dress yourself, or do anything.
  • Waking up during the night and not sleeping well.
  • Feeling dizzy.

Your symptoms may be mild to severe. They may not start until a day after you have been at a high altitude. Many people say altitude sickness feels like having a hangover.

Altitude sickness can affect your lungs and brain. When this happens, symptoms include being confused, not being able to walk straight (ataxia), feeling faint, and having blue or gray lips or fingernails. When you breathe, you may hear a sound like a paper bag being crumpled. These symptoms mean the condition is severe. It may be deadly.

If you are going on a high-altitude trek, tell your group about altitude sickness, its symptoms, and how to treat it. Look out for each other. You can learn more about altitude sickness at the International Society for Mountain Medicine Web site at http://www.ismmed.org/.

How is altitude sickness diagnosed?

If you are at a high altitude, your doctor may think you have this condition. Your doctor will ask you questions about your symptoms and examine you. To rule out other conditions, your doctor may ask if you have been drinking fluids or alcohol or using any medicines, or if you have a cold or the flu.

If you are hiking or camping, you and those with you need to know the symptoms of altitude sickness. People often mistake altitude sickness for the flu, a hangover, not getting enough fluids, or feeling tired. As a rule, consider your symptoms to be altitude sickness unless you can prove they are not.

How is it treated?

The best treatment for altitude sickness is to go to a lower altitude. But if you have mild symptoms, you may be able to stay at that altitude and let your body get used to it. Symptoms often occur if you have just arrived at a mountain resort from a lower altitude.

If you stay at a high altitude, rest. You can explore the area, but take it easy. Limit any walking or activity. Drink plenty of water, but do not drink alcohol. Do not go to a higher altitude until your symptoms go away. This may take from 12 hours to 3 or 4 days.

For the headache, you can take an over-the-counter medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Do not give aspirin to anyone younger than 20. Aspirin has been linked to Reye’s syndrome, a serious illness. You may also use medicine to help with being sick to your stomach or other symptoms.

A doctor can give you acetazolamide (Diamox). This speeds up how fast your body gets used to the a higher altitude. Dexamethasone (Decadron) and nifedipine (such as Adalat or Procardia) are also used for altitude sickness.

Go to a lower altitude if your symptoms are moderate to severe, they get worse, or medicine does not help them. Go down at least 1500ft(457m). Go to a lower altitude as fast as you can or get emergency help if someone with you has severe symptoms such as being confused or not being able to walk straight. Go with the person. Never let someone with severe altitude sickness go down alone.

Can I prevent altitude sickness?

You may be able to prevent altitude sickness by taking your time when you go to high altitudes, using medicine in advance, and eating certain foods.

  • If you go to altitudes higher than 8000ft(2438m), try to spend a night at a medium altitude before going higher. For example, in the United States, spend a night in Denver before going to the Rocky Mountains.
  • Do not fly into high-altitude cities. If this is not possible, avoid large meals, alcohol, and being very active after you arrive. Rest, and drink plenty of liquids. Talk to your doctor about taking acetazolamide before you arrive. If you have symptoms, do not go higher until they have gone away. Examples of high-altitude cities include Cuzco, Peru; La Paz, Bolivia; and Lhasa, Tibet.
  • Sleep at an altitude that is lower than the altitude you were at during the day. For example, if you ski at 9500ft(2896m) during the day, sleep the night before and the night after at 8000ft(2438m). "Climb high, sleep low" is standard practice for those who spend time at high altitudes.
  • You may consider taking acetazolamide (Diamox) before going to a high altitude. Talk to your doctor about this.
  • Eat a lot of carbohydrate. This include breads, cereals, grains, and pasta.

What if I have a lung problem or other disease?

Experts do not know much about how altitude affects other diseases. Many people with allergic asthma do better at high altitudes. Still, if you have asthma and are going to high altitudes, continue to use your usual medicine and take your reliever medicine with you. Talk with your doctor about altitude sickness if you have long-term diseases, especially heart problems, sickle cell anemia, chronic obstructive pulmonary disease, or sleep apnea.



Medical review Author Last updated
Renée M. Crichlow, MD - Family Medicine; Martin Gabica, MD - Family Medicine

Paul Lehnert
April 5, 2006

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