/ High Alititude Acclimitisation

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CurlyStevo - on 26 Oct 2012
Can anyone recommened a good sourse of information regarding speedy but effective acclimitisation? For example the type of things I want to know are:

In terms of getting Acclimitised faster is it better to come back down to valley level (after day trips) or to sleep progressively higher up?

Do you acclimitise better doing exercise at altitude or rest?

Do you acclimitise better trying to get up high every day or would every other day / less frequent visits have the same effect?

If you have acclimitised at 3000 meters will this help you going to 4000?
Joe G - on 26 Oct 2012
In reply to CurlyStevo:
The Medex book would be a good place to start, probably tells you things you already know and might not answer all your questions, but as I say, a good starter.
http://medex.org.uk//medex_book/about_book.php
CurlyStevo - on 26 Oct 2012
In reply to Joe G:
Yeah it does have usefull information and I'll bookmark it for future use, however it doesn't answer the questions I'm really interested in. Seems more gauged for a trip where you are gradually getting higher up in a greater mountain range.
David Hillebrandt - on 26 Oct 2012
In reply to CurlyStevo:
> Can anyone recommened a good sourse of information regarding speedy but effective acclimitisation? For example the type of things I want to know are:
>
> In terms of getting Acclimitised faster is it better to come back down to valley level (after day trips) or to sleep progressively higher up? In theory better to sleep progressively higher but going high during the day and then dropping down to sleep can help.

> Do you acclimitise better doing exercise at altitude or rest? Rest. Hard exercise prior to good natural acclimatisation can make you more prone to HAPE.
>
> Do you acclimitise better trying to get up high every day or would every other day / less frequent visits have the same effect? High as you can without feeling ill each day woudl seem to be more logical but a days rest lower in a cafe in bad weather would do no harm.
>
> If you have acclimatised at 3000 meters will this help you going to 4000?
Yes very much.

David Hillebrandt
Neil Mackenzie - on 26 Oct 2012
In reply to CurlyStevo:

hey man, take a look at this website:

http://www.altitude.org/altitude_training.php

it give basic medical information about altitude sickness, the effect of low atmosperic oxygen preesure and altitude training..... i am supposed to be writing a page for it about acclimatisation strategies but havent got round to it yet
hokkyokusei - on 26 Oct 2012
In reply to CurlyStevo:

> Do you acclimitise better doing exercise at altitude or rest?

I took part in a study last year that was looking into that. There were two groups, one exercised at sea level and rested at simulated altitude. The other did the same exercise regime at simulated altitude. A third, control group, just did the same exercise at sea level. We all then went and attempted to climb Mera Peak, with a bit some testing every day including completing diaries of how we were coping taking blood sats and heart rate etc. Sadly, I haven't seen the results as yet.
Rollo - on 26 Oct 2012
In reply to CurlyStevo: It depends....!

The reccommendations I have all seen are exercise up high then go lower to sleep.

Increase you sleeping altitude by no more than 500m per day.

If you are going to extreme altitudes your body starts to break down at the same time as acclimatising so going down for recovery can be beneficial.

Also short/medium term acclimatisation is very different from long-term acclimatisation or altitude training. For the first 2 weeks your red-blood cell volume does not change, the acclimatisation is mainly ventilatory (short/medium term). Only after three weeks or more do you start to see increase in red-blood cells (see P668 of the first reference of this Wiki link http://en.wikipedia.org/wiki/Effects_of_high_altitude_on_humans )
Rollo - on 26 Oct 2012
In reply to hokkyokusei: You're such a tease!
CurlyStevo - on 26 Oct 2012
In reply to Rollo: interesting. But does sleeping progressively higher help versis going back down to valley level to sleep if you go up higher climbing each day anyway.
Rollo - on 26 Oct 2012
In reply to CurlyStevo: I think so, but I can't find the references.

Sleep high, climb higher! (but don't increase sleeping height by more than 500m per day)

As with everything we are all different so best to get to know your personal response!
gneiss - on 27 Oct 2012
lost1977 - on 27 Oct 2012
In reply to CurlyStevo:

where are you planing on going as this will effect your acclimitisation plans. for the alps i would go with stress free time up high and focus on recovery when your back down
Blizzard - on 27 Oct 2012
In reply to CurlyStevo:

Some people simply acclimatise better than others. Sad fact.
Mark / Alps - on 28 Oct 2012
In reply to CurlyStevo:
Sorry I don't know a single source. Worth looking at the programs / schedules that guides / guide companies use as they have a wealth of experience. For example Jagged Globe.
Are you talking acclimatisation for European Alps ( 4,000 metres ) or higher?

1) Speedy and effective acclimatisation varies hugely from individual to individual and sometimes trip to trip - and a very small number never seem to achieve it in the time available to them.
2) A huge array of factors will come into play such as diet, equipment, how well you sleep. For example drinking more liquids really helps, ensuring you eat plenty of food even though your appetite may not be up to much, ensuring you sleep comfortably and feel warm helps, having the mental drive to stay fit, healthy and keep going. Some people have the skills and experience to acclimatise very well in a variety of circumstances - others really struggle

Here is what has worked for me and my climbing buddies for Alpine 4,000m and up to about 6,000metres elsewhere:

1) Exercising ( by walking / climbing but perhaps on routes you find easy to start with ) rather than resting seems to help. For example, do a route at 3,500 metres then drop down to sleep seems to work better than going to 3,500 metres and sitting around for a day or so.
2) Getting back to valley ( I'm assuming European Alps here ) works better for many after the first trip to altitude as they sleep and recover better but thereafter staying high, in a hut or bivvy, works well for most. Sometimes accessibility of beer really hampers the process! It is often the weather that dictates this!
3) Getting high every day does not work for many but can do if you feel fit, comfortable etc. Listen to what your body is telling you and how well you recover after each route.
4) Some people don't seem to think 3,000m acclimatisation helps with 4,000m - it definitely helps me.

Possible profile of an Alpine two weeks assuming no weather interruptions but there is no fixed plan - flexibility is the key:

1) Check weather and conditions from knowledgable local sources ( guides office )
2) Route ( not too challenging ) around 2,500 - 3,000 metres and sleep around 2,000 metres
3) Route 3,000 metres return to valley for a rest
4) Route more challenging around 3,000 metres or less challenging 3,500 metres. Stay in hut / bivvy
5) More challenging route around 3,500 metres stay in hut / bivvy if feeling good
6) Easier 4,000 metre route then a valley rest
7)Ready for more challenging 4,000 metre routes

Going to 6,000+ metres requires more planning and forethought. Here is a profile of one trip with four peaks ascended, some of the stops are based around villages / accommodation rather than a chosen height:
1) Fly in to 2,800 metres, descend to 2,600 village.
2) Ascend to 3,400 metres village
3) Rest day in village (Namche Bazaar) with a gentle walk to 3,840 metres and back to 3,400m
4) Walk to Tyangboche @ 3,760 m
5) Walk to 4,350 metres village
6) Rest day @ 4,350 but most of the group walked gently uphill to 4,750 metres and returned back to 4,350m
7) Ascent to a camp at 5,145 metres
8) Ascent to high camp at 5,450 metres ( first signs of slight nausea )
9) Ascent to a summit at 5,800 metres ( not everyone made it )
10) Descent to village at 4,750 metres
11) Rest at 4,750 metres with gentle walking
12) Now most people were ready to go to high camps at 5,500 metres over two days followed by a 6,000 metre peak and descent to valley at 4,750 metres to rest between each peak.

Even at these modest altitudes we came across several people who had HACE or HAPE varying from early stages to one needing a helicopter evacuation. Not to be taken lightly!!

Hope this helps

Andes - on 29 Oct 2012
In reply to CurlyStevo:

Working in the Andes for twenty years I've seen nearly a thousand different clients acclimatise (or not) to altitudes generally in the 4000m-6000m range. I've also seen several regular clients make ten or more trips to these sorts of altitudes. Here is an observational summary of what I have learned about acclimatisation so far.

1. If you acclimatise well one time you are a good acclimatiser, and barring illnesses etc, are likely to always acclimatise well. If you acclimatise badly you'll probably always acclimatise badly, and often have problems at remarkably similar heights.

2. Wherever you rate on the "good v. bad acclimatiser" scale, being fit (particularly heart and lungs)improves things simply because your body will be under less stress, exercising and at rest.

3. I would say that you acclimatise to your "average" height (hour by hour) over the last days and weeks. So a week spent sleeping at 3000m and climbing to 4000m will put you at about a 3300m level of acclimatisation, but it is not an exact science.
Since sleeping and all the associated faffing about (like pitching tents and eating meals) will take up 14-16 hours of a day, you will largely acclimatise to the height that you sleep at. So staying higher is better for acclimatisation ....BUT.... if you sleep too high too soon you risk getting serious or fatal altitude illness. So you have to be very careful about going too high too soon. As someone else has already said, dropping low overnight allows you to eat and sleep better, so although it will reduce your acclimatisation it will (perhaps) boost your overall well-being and performance. You have to balance these two factors for your particular body and acclimatisation profile.!

4. I would say that you acclimatise better by exercising ...BUT.... if you exercise too hard too soon you risk getting serious or fatal altitude illness. So again you have to strike a reasonable balance. All the cases of pulmonary oedema I have seen have resulted from people exercising too hard - sometimes unfit people who may be reasonably good acclimatisers, but others have been very fit people who are poor acclimatisers.

5. There are about 5 or 6 processes going on which have different time scales (see the interesting diagram in British Medical Journal BMJ2011;343:d4943). Broadly speaking at any particular new altitude I'd say there was a 2-3 day acclimatisation phase (this is largely heart rate and ventilation adjusting), then a 7-10 day phase (this is red blood cell concentration going up), then a 4-5 week phase (this is apparently a capillary blood vessel thing). I've never been continually at high altitude longer than 2 months.

Climbing higher every day will definitely help, but if you're not pushing too hard (which you should not be) this may only give you a few hours of exposure to higher altitudes.

Finally once you have slept at (say) 3000m for 4 or 5 days most people are then OK to move to a sleeping altitude of 4000m... then after 4 or 5 nights at that sort of height most people will be fine going up to sleep at 5000m.

Finally finally, drink lots of fluid, over-hydrate!
Damo on 29 Oct 2012
In reply to Andes:
> (In reply to CurlyStevo)
>
>
>
> 1. If you acclimatise well one time you are a good acclimatiser, and barring illnesses etc, are likely to always acclimatise well. If you acclimatise badly you'll probably always acclimatise badly, and often have problems at remarkably similar heights.

Hi John,

Hard to argue with your experience but I disagree with this first point. There are just too many variables. Two people can acclimatise at different rates, but ultimately both reach a suitable and equal level. If this is individuals taking their time based on experience it's not a problem. If it's individuals trying to fit into a group trip schedule with half a dozen others it can be a problem (I've seen this a lot).

Personally I found that I need to take more time low down than many others - say, around 3000-4000m - but once I do I'm as strong as anyone else at 6000m. If you saw me at 3500m you might say was a 'bad acclimatiser' but I usually feel better than most at 6000m if I've had that extra time down lower. I deliberately tested this on Aconcagua twice, then used it on Ausangate last year and on Peak Lenin last August - working out what works best for me.

There are also other variables such as hydration, diet, fitness, other medical conditions (as you mention) that can vary from time to time within the same person, sometimes without them realising, resulting in different experiences acclimatising on different trips.

Having the same problems at similar heights is fine, all other things being equal - but they so often aren't. Going to 4000m in a week of walking should be fine for most. Going to 4000m via a flight into LaPaz floors a lot of people. Those are two extremes of course, but again there are variables in between. I've seen people get into trouble this way, thinking 'oh I've been fine at 4000m before' - but not having driven there in 24hrs they're not!
Pero - on 29 Oct 2012
In reply to Rollo:
> (In reply to CurlyStevo) I think so, but I can't find the references.
>
> Sleep high, climb higher! (but don't increase sleeping height by more than 500m per day)

If you should only sleep 500m higher each day, does that mean it should take 3 days to bivi on top of the Ben?

CurlyStevo - on 29 Oct 2012
In reply to Andes:
Great stuff thanks for the info :)
Andes - on 29 Oct 2012
In reply to Damo:
Damo,
I think we maybe agree, I've just phrased it differently... in my experience people have pretty similar acclimatisation profiles provided the "variable" factors like hydration and fitness are generally the same. So I have seen some like yourself who are slow to start with in the 3000m range but when they do get going, they get going well. Others can, for instance, fly into 3500m without much problem, but then struggle to get acclimatised above 5000m. I think the point is that the old "myth" that it was all somehow random and a matter of luck on each different trip is wrong.
I totatlly agree about the 4000m thing in your last paragraph. It's no use saying you are good at 4000m without taking into account how quickly you got there last time and how quickly you're going to arrive at that altitude this time.
John
CurlyStevo - on 29 Oct 2012
In reply to Andes:
Last(and first!) trip I was on to the Alps I found I acclimitised the quickest of the three of us. I'm just looking at ways of speeding that up safely bareing in mind I'd like to go next year for around 2 weeks.

I think the main things I'll change are sleeping progressively higher up and better hydration.
ads.ukclimbing.com
Avinash Aujayeb - on 30 Oct 2012
In reply to Damo:
Hi Damo, sorry to highjack the thread. But saw that you did peak Lenin last year??
I was wondering if I could have some details of logistics and if you used a company etc as would be keen to give it a go.
Cheers
Avi

aujayeb@doctors.net.uk
Damo on 30 Oct 2012
In reply to aujayeb:

Avi,

I put some detailed info in this thread over on SP: http://www.summitpost.org/phpBB3/7000m-peak-w-most-realistic-chance-of-success-t63448.html

Used these guys for BC services: http://www.ak-sai.com/en/mountaineering/Lenin-peak

D
Avinash Aujayeb - on 30 Oct 2012
In reply to Damo:

Thanks

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