Whether it’s mountain biking in the Sierras, trekking in the Himalayas, a ski trip to the Swiss Alps or a business trip to Denver, altitude changes can spell trouble for some of us.

You may discover that high altitude = headache upon arrival. High altitudes aren’t always heavenly for headache sufferers and migraine patients.

If you’re planning an alpine adventure, prevent a high altitude headache or migraine attack by planning ahead.

The International Headache Society (IHS) defines a high-altitude headache as:

A. Headache with at least two of the following characteristics and fulfilling criteria C and D

      1. Bilateral
      2. Frontal or frontotemporal (at the front of the head in the region of the temples)
      3. Dull or pressing quality
      4. Mild or moderate intensity
      5. Aggravated by exertion, movement, straining, coughing, or bending

B.  Ascent to altitude above 2500 metres, or 8200 feet
C.  Headache develops within 24 hours after ascent
D.  Headache resolves within eight hours of descent.
According to a report published by The Migraine Trust, high altitude headaches are experienced by many who live at lower altitudes and travel by air to mountainous regions.

Heavy perceived exertion, a history of migraine, the absolute altitude reached, little mountaineering experience and inadequate water intake (less than two litres or 67 ounces) have been found to be independent risk factors for acute mountain sickness.

Women and people who have headaches in daily life, were also more likely to report severe headaches at altitude.  In this study, 95 per cent of the women reported headaches compared to 82 per cent of the men, and the headaches of the women were reported more frequently and described as of greater severity than those of the men.  At normal altitudes, women have a higher rate of migraine and most other headaches than men, raising the possibility that they may be more susceptible to headache at altitude.

While there are no scientific studies that indicate specific measures that prevent HAHs or migraines at high altitudes, reduction or elimination of risk factors ought to help.

High Altitude Headaches and Migraines

Six Tips to Avoid A High Altitude Headache and Migraine

1. Ascend Slowly

Slow your ascent at a rate of 300 metres or 1000 feet a day, if possible, allowing two days of acclimatization.  Plan a stopover at a lower altitude.  Wait a day before that mountaintop hike or snowmobile ride.

2. Delay Exertion

3. Wait a day prior to engaging in strenuous exercise at high altitudes.

4. Avoid Alcohol:  Find another way to celebrate.  Those apres-ski libations at the ski lodge boost your risk.

5. Hydrate Heavily

Make sure you get at least 64 ounces or 2 litres of water a day.

6. Avoid Other Triggers

Limit bright sun reflected by the snow with high-quality goggles or sunglasses.

Pack Ibuprofen

If you feel a headache coming on, take ibuprofen quickly to manage inflammation.

Your medications may also work differently at high altitudes.  One study found ibuprofen 600 mg was effective for high altitude headache while sumatriptan 100 mg was ineffective.  You’ll want to treat it as usual, but have a back-up plan.

Don’t avoid the majestic mountains simply because you are getting frequent migraines or headaches. Instead, plan a trip long enough so you can adjust to the altitude before you get too adventurous in alpine areas.

Comments?  Have you visited the mountains and experienced a high-altitude headache?   If so, what would you do differently next time?

Attributing Article: MigraineTrust.org

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