From the Guidelines
To mitigate dizziness associated with acute mountain sickness (AMS), adequate acclimatisation, slow ascent speed, and/or preventive medication such as acetazolamide are essential solutions. According to a recent study published in 2024 in the journal Sports Medicine 1, sex-dependent physiological reactions to hypoxia may contribute to an increased AMS vulnerability in some women, highlighting the importance of tailored approaches to prevention and management.
Key Management Strategies
- Gradual ascent to higher elevations, allowing the body time to acclimate
- Slow ascent speed to reduce the risk of AMS
- Preventive medication such as acetazolamide, which can be taken 24 hours before ascent and continued for 48 hours after reaching high altitude
- Targeted training of the respiratory musculature as a valuable preparation for altitude training, particularly in women
Additional Considerations
- Staying hydrated by drinking plenty of water
- Avoiding alcohol and sedatives, which can exacerbate AMS symptoms
- Considering the potential influence of sex hormones on hypoxia responses and acclimatisation to altitude, particularly in women
- Recognizing that severe altitude sickness can be dangerous and requires immediate descent to a lower altitude if symptoms worsen or persist, as noted in the context of managing AMS 1.
From the Research
Management Strategies for Mitigating Dizziness Associated with Acute Mountain Sickness (AMS)
- Descent to a lower altitude is considered the most effective treatment for AMS, including dizziness 2, 3, 4
- Acetazolamide is the drug of choice for prevention of AMS, and can be taken 12 to 24 hours before ascent to high altitude 2, 5, 6, 4
- The recommended dosage of acetazolamide varies, but lower dosages (e.g. 250 mg twice daily) may offer adequate protection with fewer side effects 2, 5, 6, 4
- Dexamethasone may be effective for treatment of AMS, including dizziness, but its use is limited by side effects and it should not be used for more than 2 to 3 days 2, 5, 3, 4
- Oxygen therapy can be effective in treating mild AMS, including dizziness, but is not as useful for cerebral edema 2, 3
- Slow ascent to high altitude is the best method for preventing AMS, including dizziness, as it allows for acclimatization to the lower oxygen levels 5, 3, 4
- Pre-treatment with acetazolamide at least two days before arrival at high altitude may be more effective in reducing the incidence of AMS, including dizziness, than starting treatment on the day of ascent 6