Acclimatization is the process of the body adjusting to the decreased availability of oxygen at high altitudes. It is a slow process, taking place over a period of days to weeks. Practically speaking, we generally don’t worry much about elevations below about 8000 ft (2500 m) since altitude illness rarely occurs lower than this.

Normal Symptoms for Everyone

1) Hyperventilation:
Persistent increased breathing results in reduction of carbon dioxide in the blood, a metabolic waste product that is removed by the lungs. The build-up of carbon dioxide in the blood is the key signal to the brain that it is time to breathe, so if it is low, the drive to breathe is blunted (the lack of oxygen is a much weaker signal, and acts as an ultimate safety valve). As long as you are awake it isn’t much trouble to consciously breathe, but at night an odd breathing pattern develops due to a back-and-forth balancing act between these two respiratory triggers.

2) Shortness of Breath:
As one ascends through the atmosphere, barometric pressure decreases (though the air still contains 21% oxygen) and thus every breath contains fewer and fewer molecules of oxygen. One must work harder to obtain oxygen, by breathing faster and deeper. This is particularly noticeable with exertion, such as walking uphill, or skiing.

Being out of breath with exertion is normal, as long as the sensation of shortness of breath resolves rapidly with rest. The increase in breathing is critical. It is therefore important to avoid anything that will decrease breathing, e.g. alcohol and certain drugs. Despite the increased breathing, attaining normal blood levels of oxygen is not possible at high altitude.

3) Changed Breathing Pattern at Night:
Periodic breathing consists of cycles of normal breathing which gradually slows, breath-holding, and a brief recovery period of accelerated breathing. The breath-holding may last up to 10-15 seconds. This is not altitude sickness. It may improve slightly with acclimatization, but does not usually resolve until descent.

Periodic breathing can cause a lot of anxiety in the person who wakes up during the breath-holding phase and knows he has stopped breathing, or during the recovery phase and thinks he’s short of breath and has High Altitude. It can also startle the person who wakes up and realizes his neighbor has stopped breathing.

If you wake up experiencing this, it’s best to wait a few moments until you establish a normal breathing pattern. If you notice your neighbor experiencing this, he will eventually take a breath, though periodic breathing cycles will likely continue until he or she is awake. If periodic breathing symptoms are troublesome, a medication called acetazolamide may be helpful.

4) Increased Urination:
Dramatic changes take place in the body’s chemistry and fluid balance during acclimatization. The osmotic center, which detects the “concentration” of the blood, gets reset so that the blood is more concentrated. This results in an altitude diuresis as the kidneys excrete more fluid. The reason for this reset is not understood, though it has the effect of increasing the concentration of red blood cells and perhaps improving the blood’s oxygen-carrying ability somewhat. It is normal at altitude to be urinating more than usual. If you are not, you may be dehydrated, or you may not be acclimatizing well.

*Please note that the above tips are tips only. For more details on high altitude tips, please contact you local family physician.References:
1. http://www.ismmed.org/np_altitude_tutorial.htm.
2. http://www.beavercondos.com/sitepages/pid55.php.

 

MORE INFORMATION ON HIGH ALTITUDE:
Basic High Altitude Advice Page
Acute Mountain Sickness & Treatment