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How to deal with altitude sickness in Nepal?

With the high influx of tourists for trekking and mountain climbing, altitude sickness is one of the major subjects of interest for the visitors of Nepal.

To put in a simpler term, altitude sickness is the negative health hazard due to lack of oxygen at a higher elevation. Although the general problem is termed as altitude sickness, it is only the mildest form being acute mountain sickness (AMS).

Altitude sickness affects everyone despite age, gender, and physical fitness level. Thus, there is no bar to the impacts of altitude sickness depending on one’s physical aspects.

It is typically at an elevation of above 2,500 meters when minor symptoms of altitude sickness start to show. Altitude sickness is not preventable, but there are measures one can take to avoid the effect to some extent. Yearly many people lost their life or go through serious illness because of altitude sickness.

Well, so here we are with detailed information on altitude sickness. From minor symptoms to the extreme ones, the complications of altitude sickness and preventive measures, let’s look into them


Altitude sickness starts showing its signs around 2,000 meters; however, people have different susceptibilities depending on their health. Then, as you scale-up higher, the effects get more severe at a higher altitude above 5,500 meters.

With the increase in elevation above the sea level, the amount of oxygen and air pressure decreases. As the available amount of oxygen to sustain and physical alertness decreases, our body starts to reciprocate to the change, which is altitude sickness.

It is due to the sudden change that our body faces negative hazards. For the inhabitants of Mountain region, who have acclimatized enough with less oxygen, altitude sickness is rare.

Just within the six to ten hours after ascent, you will experience the initial symptoms, which will subside in one to two days. However, the symptoms develop only to be more serious.

Following are the general altitude symptoms of altitude sickness.



-Sleep disturbance or Insomnia

-Fatigue or weakness

-Loss of appetite



-Shortness of breath

The reason for altitude sickness is because of rapid ascent, and it does get prevented by ascending slowly. In most of the cases, the symptoms are temporary and lessens with acclimatization. But, altitude sickness must not be taken lightly as in extreme cases, it can be fatal.


Drink more than enough water

Keeping yourself hydrated is one of the easiest preventive measures for altitude sickness. Let the threshold be 4 liters per day, no less. It will be easier in lower elevation as the temperature is high and hot, however, as you scale-up, the temperature cools off, and your perspire less.

You may feel enough and hydrated with just a couple of liters but your body is doing extra work with less oxygen and requires more water.

Ascend at a slow pace

It is even established by Wilderness Medical Society (WMS) that above 3,000 meters not to gain more than 500 meters a day. You can ascend for 300 meters a day to avoid symptoms of altitude sickness.

Also, there is a misconception while trekking, that your physical condition is the determinant of the vulnerability towards altitude sickness. That’s why people with good physical fitness, ascend fast without heeding the acclimatization rules, which ultimately causes a problem.

Get down for sleep

Acclimatization is very important for preventing altitude sickness, and the best way to do is to expose yourself to higher altitude but return to a lower altitude for sleep.

When you reach the destination for the day and set up a camp, hike up to some distance, check out the view and come back to the camp for night’s sleep. You can also use your rest day for hiking to a higher elevation. It is a very effective rule as it lets your body exposed to a higher altitude in considerably less oxygen.

No alcoholic drink

People often choose alcohol if they are tired or exhausted. However, do not make that mistake as you make your way upward at a high altitude. Alcoholic drinks, cigarettes and medication like sleeping pills will only support the cause and make things worse.

Eat with a full heart

Your body is doing extra work while scaling-up to the higher region, so you must stay nourished and full of carbohydrates. Nepali Dal-Bhat-Tarkari is the best meal while trekking in Nepal. It comes with a portion of rice, lentil soup, and vegetables. Apart from this, there are several trekkers meal you can choose as you camp on tea houses.

Use of medications

Along with all the preventive measures, the use of medications is one of the help for altitude sickness symptoms.

Ibuprofen helps with the symptoms of mild altitude sickness like headache and nausea. Diamox (Acetazolamide) helps the body metabolize more oxygen, mainly at night and accelerates the process of acclimatization. Dexamethasone is for severe AMS and HACE during descents and Nifedipine may prevent HAPE.


At first, the symptoms are general and be avoided with acclimatization, medication, and other preventive measures. Acute Mountain Sickness is the initial phase of altitude sickness, and its symptoms are the above mentioned. However, we are here to discuss the most severe ones, high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE).

High Altitude Cerebral Edema (HACE)

HACE is a critical condition in which the brain swells with fluid due to the physiological effects of traveling to high altitude. Symptoms of HACE are:


-Loss of consciousness

-Rapid heartbeat






-Diabetic symptoms



The early symptoms of HACE are similar to those of moderate to severe AMS. Patients should be immediately taken for treatment within 48 hours. If not descend immediately to a lower altitude, death can occur. And, for those who receive treatment, it makes take several weeks to fully recover.

Treatment & Prevention of HACE

-Ascend slowly allowing your body more time to acclimatize. Do not ascend more than 1,000 meters in a day and do not sleep at a greater height than 300 meters more than the previous night.

-Immediately make a descend to a lower altitude and get supplemental oxygen.

-Medications like Sildenafil and Tadalafil may help too.

-Get to the hospital as soon as possible.

High Altitude Pulmonary Edema (HAPE)

HAPE is a critical condition when fluids accumulate in the tissue and air space of the lungs. It is a life-threatening condition when people living at lowe altitude travel to a higher region above 2,500 meters. It is deemed that there are factors that make a person more vulnerable to developing HAPE, including genetic factors. Symptoms of HAPE are:


-Shortness of breath while resting

-Chest tightness


-Rapid breathing and heart rate

-Blue skin color

It is in the first 2 to 4 days of trekking at an altitude above 2,500 meters, when symptoms of HAPE starts occurring. It usually gets worse on the second night. Starting with fatigue, shortness of breath, weakness, and so on, it gets worse with dry and persistent cough and cyanosis of lips.

Treatment & Prevention of HAPE

-Gradual climb while trekking.

-Warming techniques, adequate rest, and supplemental oxygen can be provided once the symptoms start to show.

-Use Nifedipine.

-After 3-4 days of ascent, take a rest for a day.

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