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If you enjoy hiking or skiing in the mountains, you may be aware of one of the most common side effects of spending time in high-altitude settings: altitude headaches. These occur when a person ascends to high altitudes. It is the most prominent symptom of acute mountain sickness (AMS), which can also include other symptoms such as dizziness, muscle aches, and nausea.
This article reviews why altitude headaches occur and how to prevent them.
Elevation Range for Altitude Headache
People who travel to destinations with an altitude higher than 8,000 feet above sea level may experience altitude headaches and other acute mountain illness symptoms.
At higher altitudes, a decrease in barometric pressure lowers the oxygen capacity in your cells, called cellular hypoxia. This results in a headache. Symptoms worsen as you travel to even higher altitudes.
Headache Sensation and Location
An altitude headache may feel different and more intense than other types of headaches. You may be able to identify an altitude headache by characteristics such as:
- Intense and throbbing head pain that develops six hours to four days after being in high altitudes
- Generalized head pain or pain only in the forehead
- Head pain that becomes worse with exertion, straining, lying flat, or coughing
- Head pain that lasts up to five days
Other Signs of Altitude Sickness
Altitude headaches are the most common symptom of AMS, but symptoms can include:
- Loss of appetite
- Sleep disturbances
Prevalence of AMS
The American Migraine Association reports that 1 in 4 people who ascend to higher than 8,500 feet above sea level will develop at least some symptoms of AMS.
As you travel to high altitudes, there is decreased oxygen for your lungs to breathe. As a result, you can develop hypoxia, or low oxygen, in the bloodstream. Hypoxia can then lower oxygen in body tissues, such as the brain.
Research shows that hypoxia triggers altitude headaches, even in healthy people without a past history of headaches.
Many factors influence whether a person will develop an altitude headache or other AMS symptoms. These can include:
- Physical condition
- Rate of ascent
- Intensity of exercise
- Preexisting conditions
- Home altitude
Sports and other types of physical activity take place in areas at a high altitude for many reasons.
Many sports and recreational activities occur only in high-altitude settings, such as mountainous areas. However, performing activities in high-altitude areas can put you at a higher risk for altitude headaches and other AMS symptoms.
Some professional and recreational athletes, such as football players, boxers, or gymnasts, train at high altitudes to maximize their endurance and athletic potential. Many athletes and coaches believe that training at high altitudes improves overall athletic performance better than training at sea level.
Some of the recreational activities associated with the highest levels of altitude headache and other AMS symptoms include:
- Downhill skiing
- Endurance races
- Mountain biking
In general, these activities can be safe as long as people acclimate slowly to new altitudes, take notice when AMS symptoms occur, get treatment when needed, and return to a lower altitude if symptoms are persistent or become dangerous.
Areas in the United States with the tallest mountains (that ascend higher than 8,000 feet above sea level) are the most vulnerable to altitude headaches. These include:
- Denali, Mount Saint Elias, and several others in Alaska
- Mount Whitney, Mount Williamson, and others in California (particularly in the Sierra Nevada region)
- The Rocky Mountains in Colorado and Wyoming
- Mount Rainer in Washington
- The Uinta Mountains in Utah
Treatment for an altitude headache is similar to that for other types of headaches. This can include over-the-counter (OTC) products like ibuprofen and antinausea medication, if needed.
Many acute mountain sickness symptoms can also be relieved upon returning to a lower altitude. People must descend slowly to decrease the risk of:
- High-altitude pulmonary edema (HAPE): Excess fluid in the lungs (causes breathlessness)
- High-altitude cerebral edema (HACE): Excess fluid on the brain and brain swelling (causes confusion or lack of coordination)
HAPE and HACE are life-threatening forms of altitude illness. Both require immediate descent to a lower altitude and emergency medical treatment.
Prevention and Travel Advice
There are helpful ways to prevent or minimize the development of an altitude headache or other symptoms of AMS, such as:
- Staying hydrated
- Ascending gradually with days of rest (acclimate)
- Sleeping at lower altitudes whenever possible
Talk to your healthcare provider about medications you can take in advance of your trip that may help minimize or prevent altitude-related health issues, such as aspirin, furosemide, or acetazolamide.
Altitude headaches can occur in people who ascend to higher than 8,000 feet above sea level due to changes in barometric pressure. They commonly feel like intense, throbbing head pain that can develop and persist after being in high altitudes.
Treatment includes ibuprofen and antinausea medication or returning to a lower altitude. You can prevent or minimize the development of an altitude headache by staying hydrated, ascending gradually, sleeping at lower altitudes when possible, and taking certain medications.
A Word From Verywell
High altitude sports and other recreational events provide enjoyment for many people. However, altitude headaches or other AMS symptoms can be painful, debilitating, or dangerous. It's essential to understand the risks and symptoms to watch for before ascending to high altitudes. Before your next high-altitude trip, talk to your healthcare provider and discuss potential risks and treatments.
Frequently Asked Questions
- What medicine for altitude headache provides fast relief?
Treatment for an altitude headache is similar to that for other types of headaches and includes ibuprofen and antinausea medication if needed.
- How long do altitude headaches last?
Altitude headaches can last up to five days. They may be relieved as soon as you return to a lower altitude.
- What states are more vulnerable to altitude headaches?
The states most vulnerable to altitude headaches are those that have the tallest mountains (which ascend higher than 8,000 feet above sea level), such as:
- California (mainly in the Sierra Nevada region)
- Colorado and Wyoming (Rocky Mountains)
- Does supplemental oxygen help prevent altitude headaches?
Research shows that supplemental oxygen by nasal cannula (a two-pronged tube in the nose) at high altitudes can prevent chronic mountain sickness symptoms, such as headaches, by protecting respiratory function and improving hypoxia.