MANAGING YOUR ALTITUDE SICKNESS

What is Altitude Sickness?

Altitude sickness is an illness that results from travel to high altitudes. Acute mountain sickness (AMS) is the most common such illness; as many as 50% of people may be affected at 15,000 feet, men and women equally. Younger adults may be more affected. AMS is more common in people with lung problems and people who usually live at very low altitudes.

What Causes Altitude Sickness?

High altitudes have less oxygen in the air. Breathing and heart rates increase to adjust to the thin air. High altitude may lead to swelling (edema) of hands, face, and feet. The body may not adapt to rapid exposure to 7000 to 8000 feet or more. Illnesses such as AMS and high-altitude lung (pulmonary) and brain (cerebral) edema can result.

What Are the Symptoms of Altitude Sickness?

Symptoms are headache, nausea, vomiting, shortness of breath, difficulty sleeping, dizziness, and malaise. They usually occur 6 to 48 hours after ascent. Symptoms may mimic alcohol hangover, exhaustion, or infection.

High-altitude pulmonary edema is a life-threatening condition often seen in young, fit climbers who made earlier high-altitude trips without problems. The first symptom is reduced ability to exercise. Later symptoms include cough, chest congestion, shortness of breath at rest, reduced alertness, and poor coordination.

Symptoms of high-altitude cerebral edema (brain swelling) are severe headache, impaired walking, and other neurologic problems (e.g., hallucinations and even coma).

How Is Altitude Sickness Diagnosed?

Diagnosis is based on symptoms and a history of travel to higher altitudes.

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How Is Altitude Sickness Treated?

Treatment depends on how severe the illness is and the altitude. The goal is to go down to a lower altitude quickly and safely and to begin oxygen therapy as soon as possible. Symptoms usually disappear in 1 to 3 days. Acetaminophen or aspirin can help with minor symptoms. Drugs such as acetazolamide and nifedipine can help with more severe symptoms.

For high-altitude cerebral edema, immediate descent and oxygen therapy, and often dexamethasone (a steroid), help prevent serious nerve damage or death.

DOs and DON’Ts in Managing Altitude Sickness:

DO prevent altitude sickness by gradually ascending, taking 2 to 4 days to adjust to 6000 to 8000 feet.
DO talk with your health care provider about the need for medications to help prevent altitude sickness. Acetazolamide is usually started before ascent and continued at high altitude. Nausea and numbness or tingling of the lips, fingers, and toes may be side effects.
DO get enough rest.
DO increase fluid and carbohydrate intake to help minimize effects of altitude illness.
DO start moving, as safely and quickly as possible, to a lower altitude if serious nerve or breathing problems develop.

DON’T use alcohol and sleeping pills.
DON’T overexert yourself when first arriving at high altitude. Exercise before traveling to high altitude does not help prevent altitude sickness.
DON’T take acetazolamide if you’re allergic to sulfa drugs.
DON’T go to high altitudes if you had previous high-altitude sickness.

FOR MORE INFORMATION

Contact the following sources:

American Lung Association
Tel: (212) 315-8700
Website: http://www.lungusa.org

Ferri’s Netter Patient Advisor