Adjusting to Altitude: Handling the Ups and Downs
By Becki Rupp
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Becki rocking her Explorer X gear!
The first time I stayed in the Colorado mountains, my friend and I got a motel room outside of Leadville as our “base” for skiing at several nearby mountains. We flew in from Washington, DC, rented a little pickup truck (not a good choice for snowy roads, we later learned), and headed up I-70 for our adventure.
I didn’t sleep well that first night – I figured it could be the time change, the excitement about skiing, or the unfamiliar bed. Yet every night it was a struggle to sleep, even after skiing our legs out and being exhausted.
It wasn’t until I moved to Colorado nearly 4 years later that I learned that having trouble sleeping is common at high altitude. Considering that we’d gone from sea level to about 10,000 feet of elevation in just a few hours, it’s not surprising that we felt the effects of high altitude.
Since moving to Colorado nearly 20 years ago, I’ve learned how to prepare myself and my visitors for being active at higher altitudes. The physical impact can range from mild to miserable, though with some preparation and proactive prevention, you can minimize the effects and enjoy your time in the mountains.
How high is “high altitude”?
Although the definition of high altitude varies, generally an elevation of 5,000 feet to 8,000 feet above sea level is considered moderately high altitude, and an elevation of 8,000 to 14,000 feet is designated as high altitude. Once you go above 14,000 feet, you’re into very high altitude territory – many of those places are difficult to reach, though.
And just to clarify, elevation is the height of a point relative to sea level. Elevation is what’s noted on maps. Altitude is the vertical distance between an object and the earth’s surface, though it’s often used interchangeably with elevation.
To give you a sense of how different areas stack up in terms of elevation, here are some examples.
Denver touts its status as the “Mile High City,” and the state capitol building has a marker where the elevation is 5,280 feet above sea level. Leadville, Colorado, is the highest incorporated city in North America at 10,151 (no wonder I had trouble sleeping there!).
Many people don’t realize there are several other cities outside of Colorado that are more than a mile high, though, including Santa Fe, NM, at nearly 7,200 feet elevation, and Flagstaff, AZ, at 6,909 feet.
And although Mexico may bring to mind miles of beaches, Mexico City is at 7,382 feet above sea level.
In South America, high altitude cities are more common. Leadville has nothing on La Paz, Bolivia, which sits at 11,942 feet. Cuzco, the Peruvian city where many stay before heading to Machu Picchu, is at 11,152 feet above sea level – and Machu Picchu itself is actually lower at 7,972 feet. When you land in Quito, Ecuador, you’re at 9,350 feet above sea level, and Bogota, Colombia, sits at 8,675 feet.
If you look over to Europe, the cities are much lower – even Geneva and Zurich in Switzerland are below 1,400 feet, while the highest peaks in the Alps top out over 15,000 feet high!
How altitude affects your body
You may have experienced or heard about some of the symptoms of altitude sickness, such as headaches and trouble breathing, especially when exercising.
You may have heard that’s because there’s “less oxygen” at higher altitude. Actually, though, it has to do with the concentration of oxygen. It’s lower as you get farther from sea level, because lower air pressure “spreads out” the gas molecules, so less oxygen is inhaled with each breath.
Climate and humidity also impact air pressure, and so does distance from the earth’s poles. So being at 10,000 feet of elevation in Alaska feels different than being at 10,000 feet of elevation in Ecuador.
Since our bodies need oxygen for metabolism, when we’re not getting enough, our bodies react. Many people feel some physical effects when they get to about 5,000 feet of elevation.
Symptoms include:
headache
shortness of breath
dizziness
nausea
difficulty sleeping
low energy/tired
deterioration of motor skills – getting “clumsy”
How you can get ready to “go higher”
Being physically fit helps your body use oxygen more efficiently, though those who are fit can (and do) still feel the effects, especially as they go to places in much higher elevations.
Even though my house sits at about 8,000 feet of elevation, so I’m well acclimated to thinner air, I still feel short of breath when I’m hiking, biking, or skiing above 11,000 feet!
Doing some pre-trip physical conditioning will prepare your muscles (including your heart muscle!) for what you’ll be doing, which eases the transition.
If you’re planning to be active on your trip to a place “up high,” here are some ways to build your strength and stamina:
Walk and hike, especially up hills or on a treadmill with the incline set at a fairly steep angle
Climb stairs
Try high-intensity interval training (HIIT) – this type of workout combines short bursts (10—60 seconds usually) of challenging exercise, where you can barely say a few words, with rest periods where you catch your breath.
Of those, HIIT is probably the best at mimicking the effect that high altitude may have on you. It’ll help your body prepare for the “short of breath” feeling. The more often you do it, the more you’ll adapt – 1 or 2 sessions a week will help, though don’t do HIIT workouts on back-to-back days. There are LOTS of exercises you can use for HIIT, from jumping jacks to sprints to stair climbing and many more.
Here’s a sample 30-minute HIIT workout with different length of intervals.
If you’ve had any heart issues or even other health conditions like asthma or diabetes, check with your doctor before you ramp up your exercise, especially HIIT.
If you really want to know how it feels to exercise at a higher altitude, some places have special rooms for exercise/training where they adjust the air pressure to mimic or simulate different altitudes. You can also try a hypoxicator mask, though they’re expensive and bulky.
There are also “altitude tents” that you can set up over your bed at home to simulate sleeping at high altitude – though they’re also $3,000+ and reviews are mixed on if they make a significant difference. It may cost less to arrive at the higher altitude destination a few days before you’re going to be active so you can acclimate there!
If you can get to a higher elevation location for some hiking before your trip, all the better. Even if it’s not as high as where you’ll be traveling, just getting some experience with how your body reacts to exercising at a higher elevation helps you prepare.
Tips for managing the effects of high altitude
When you’re going to be active at higher elevations, planning ahead and taking specific steps can make it easier on your body.
Logistics:
Go up slowly and gradually – if possible, stay at the lowest elevation in the area for at least a day to allow your body to get used to the lower oxygen concentration and lower air pressure.
Try to avoid big changes in elevation – even 1,000 feet of elevation gain can be challenging, especially if you arrived from a much lower elevation, and the effect gets more pronounced as you go higher.
Sleep at the lowest elevation you can – you need all the oxygen you can get at rest. Some lodging locations are set up to pump extra oxygen into rooms – in Cusco, the hotel where my husband and I stayed had this perk.
You might consider getting an oxygen tank with a nasal cannula, though you may need a prescription from your doctor.
Actions:
Drink plenty of water.
Eat smaller amounts of food at frequent intervals, which can help minimize nausea.
Don’t drink as much alcohol – it can have a more pronounced effect at higher altitudes.
Start slow and pace yourself on your first activity especially, and take frequent breaks. Pay close attention to how your body is reacting, such as your breathing and heart rate.
Stop and sit down if you have a hard time catching your breath or feel dizzy.
If you’re feeling sick, really struggling to breathe, and have an especially bad headache, get to a lower altitude as soon as possible.
There are medications and herbal supplements that may help mitigate altitude sickness symptoms. If you’re considering this option, talk to your doctor about the pros and cons of taking them, as well as any potential interactions with medicine(s) or supplements you’re already taking.
Some places at higher elevations – including mountain towns in Colorado – have “oxygen bars” where you can sit and breathe concentrated oxygen through a nasal cannula. You can even pick a scent!
Or you can get “canned oxygen” – a container that holds a high concentration of oxygen that you breathe in through an attached mouthpiece – at stores in many towns and cities where visitors struggle to catch their breath.
Know before you go
Whether you’re planning your own trip to locations with high elevations, or working with a travel company, find out what elevations you’ll go up to, and how much change in altitude you’ll experience on each day. Spending time at high elevation doesn’t always mean big changes in altitude from one point to another.
Also, find out what resources are available where you’re going in case the altitude affects your health. And check with your doctor if you have any health conditions that could be exacerbated by higher altitude.
By being prepared and knowing what to do, you’ll be more comfortable enjoying the amazing views and making great memories!
CDC travel tips for high altitude
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Becki Rupp is the owner of Trailblazer Wellness, which exists to help people get more physically active, so they have the strength and stamina to enjoy the experiences they’ve dreamed of having. © 2020, Trailblazer Wellness, LLC.
Content created by Becki Rupp and Trailblazer Wellness, LLC, is for informational purposes only and may not be the best fit for you and your personal situation. Information included in these posts shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read in our blog posts.