High altitude Illnesses

Sleep Disturbances

These are commonly observed in healthy subjects at altitudes greater than 2,500 m. They are
typically associated with periodic breathing owing to alternating respiratory stimulation by
hypoxia .This periodic interruption to breathing results in frequent arousals from sleep, which is
distressing and may prevent revitalizing rest and impair daytime performance. A recent study
demonstrated that sleep quality is predominantly impaired during the first days at high altitude
but improves when oxygen saturation increases with acclimatization.

High‐Altitude Headache

HAH is the most frequent symptom afflicting up to 80% of high‐altitude sojourners. Besides
hypoxia, risk factors such as hypohydration( uncompensated loss of water), overexertion, and
insufficient energy intake can trigger the development of HAH in susceptible subjects. The
hypoxia‐induced cerebral vasodilation and consequent brain swelling are among the most likely
mechanisms responsible for the development of HAH.

Acute Mountain Sickness

AMS is thought to be a progression of HAH, which usually manifests with symptoms of

headache, dizziness, vomiting, anorexia, fatigue, and insomnia within 6 to 36 hours of high‐
altitude exposure.  AMS is usually benign and self‐limiting. Symptoms are often manifested first
or in greater severity the morning after the first night at higher altitude.

High‐Altitude Cerebral Edema

HACE is thought to be a progression of AMS representing the final encephalopathic, life‐

threatening stage of cerebral altitude effects. It is characterized by ataxia, hallucinations,
confusion, vomiting, and decreased activity and is mostly but not necessarily accompanied by
severe, unbearable headache. Ataxia is the key sign.

High‐Altitude Pulmonary Edema

HAPE symptoms are dyspnea(shortness of breath) at rest and especially when attempting to
exercise, bother some cough, weakness, and chest tightness. The signs include central cyanosis,
frothy sputum, tachypnea(abnormally rapid breathing) and tachycardia. HAPE is most often
misdiagnosed or mistreated as pneumonia. If the conditions worsen, the extreme oxygen
desaturation may also lead to HACE.
Thermoregulation has three mechanisms: afferent sensing, central control, and efferent
responses. There are receptors for both heat and cold throughout the human body. Afferent
sensing works through these receptors to determine if the body is experiencing either too hot or
too cold of a stimulus. Next, the hypothalamus is the central controller of thermoregulation.
Lastly, efferent responses are carried out primarily by the body’s behavioral reactions to
fluctuations in body temperature. For example, if a person is feeling too warm, the normal
response is to remove an outer article of clothing. If a person is feeling too cold, they choose to
wear more layers of clothing. Efferent responses also consist of automatic responses by the body
to protect itself from extreme changes in temperature, such as sweating, vasodilation,
vasoconstriction, and shivering.