What should you know about vertigo at high altitude?

Altitude can place extra strain on breathing and balance, especially after a quick ascent. Headache, nausea, unusual tiredness, breathlessness, or poor coordination can accompany altitude illness and need prompt attention. Dehydration, heat, alcohol, and missed meals can make light-headedness worse. True vertigo feels as though you or the surroundings are moving; it can also come from the balance organs of the inner ear. Benign Paroxysmal Positional Vertigo may be triggered by turning the head, while migraine or Meniere's Disease can cause vertigo with other symptoms. The setting alone cannot identify the cause.

Sit or lie somewhere safe, avoid driving and steep routes, and tell a companion what is happening. Stop ascending. Rest, breathe steadily, and take small sips of water if you are awake and able to drink. Move your head slowly and avoid alcohol or sedating medicines unless prescribed. If symptoms began after a head movement, do not attempt an Epley Manoeuvre without guidance in an unfamiliar or unsafe setting. Descending to a lower altitude is often advised when altitude illness is suspected; obtain local medical help rather than continuing upward.

Seek emergency help immediately for confusion, fainting, severe breathlessness at rest, inability to walk normally, a severe or unusual headache, repeated vomiting, chest pain, weakness, numbness, trouble speaking, or new double vision. Do not leave someone with these symptoms alone. Arrange same-day medical assessment if vertigo persists after stopping the ascent, returns repeatedly, or occurs with hearing change, ear pain, fever, or a severe headache. Altitude symptoms can worsen, so do not rely on sleep or waiting it out.

Ask whether the pattern fits altitude illness, dehydration, migraine, or an inner-ear condition; whether you should descend; which medicines are safe at altitude; and whether balance or hearing tests are needed. Mention your ascent speed, highest point, fluid intake, other symptoms, and any recent infection or head injury.